Correlation Analysis Of Monocyte/High Density Lipoprotein And Coronary Vulnerable Plaque And Plaque Load

BACKGROUND:Coronary heart disease refers to the heart disease caused by atherosclerosis,which is result from stenosis and even occlusion of the intravascular lumen,leads to myocardial ischemia and hypoxia or necrosis.Acute coronary syndrome(ACS)is the most serious one among the types of coronary heart disease.The existence of vulnerable plaque and severe plaque load are the main pathological basis for its occurrence.Early identification of vulnerable plaques and recognized plaque load severity are important for assessing the course of coronary heart disease.Intravascular ultrasound(IVUS)and virtual histology intravascular ultrasound(VH-IVUS)can be used to determine vulnerable plaques and plaque load by the means of drawing,measuring and calculating datas.However,because it has the disadvantages of being invasive,complicated,and expensive to rely on catheter technology,researchers need to find simpler,more convenient,and cheaper indicators to predict plaque load and vulnerable plaque.In the basic pathology of coronary heart disease,monocytes can play an important role in the progress of atherosclerotic plaque formation,rupture,and thrombosis throughed by migration,adhesion,differentiation,and multiple cytokines production.High-density lipoproteins prevent atherosclerosis by promoting reverse cholesterol transport,inhibiting low-density lipoprotein oxidation,and preventing monocyte differentiation.Based on the different effects on atherosclerosis of the both,some studies have shown that monocytes to high-density lipoprotein ratio(MHR)is a new type of index in predicting atherosclerosis and it has predictive value in the degree of coronary artery stenosis,slow blood flow,in-stent restenosis,and major adverse cardiovascular events.OBJECTIVE:In this study,IVUS and VH-IVUS examination were used to determine the patients with coronary heart disease whether coronary plaques were vulnerable or not and calculate the plaque load.The differences in MHR levels among patients with coronary heart disease with different plaque characteristics were analyzed and to discuss whether MHR level can be a predictor of vulnerable plaque,to investigate the predictive value of MHR level on plaque load.METHODS:109 patients were selected into the study from Huaihe hospital of Henan University between October 2018 to October 2019 after inclusion and exclusion,all of these were diagnosed with coronary heart disease by coronary angiography and underwent IVUS examination.According to the results of IVUS and VH-IVUS,patients with Ct oronary heart disease were classified as vulnerable plaques group(n=65)and non-vulnerable plaque group(n=44),collect the general data(gender,age,weight,height and whether there is history of hypertension,diabetes,smoking and family history of coronary heart disease),some laboratory examination data(CBC,blood lipids test,etc.)and intravascular ultrasound data of the included patients,and use spss21.0 for statistical processing to calculate whether the variables between the two groups are different or not,the predictive value of plaque damage and the correlation between variables and plaque load.P <0.05 was considered statistically significant.RESULTS:1.The analysis of ?2 test and t test found that MHR,family history,diabetes history,BMI,LDL in the vulnerable plaque group and non-vulnerable plaque group were statistically significant(P(27)0.05);There was no statistically significant difference in gender,age,smoking history and hypertension history(P(29)0.05);2.Regression analysis found that MHR,family history of coronary heart disease,diabetes history,BMI,LDL are risk factors for vulnerable plaque(P(27)0.05),of which MHR,diabetes history,BMI,LDL are independent risks of vulnerable plaque Factors(P(29)0.05);3.Using ROC curve,it was found that MHR,BMI and LDL have high predictive value for coronary vulnerable plaques(P<0.05);the optimal critical point of MHR is 38.6%,AUC: 0.693(95% CI: 0.591-0.794,P = 0.001);the best critical point of BMI is 24.1kg / m2,AUC: 0.695(95% CI: 0.593-0.797,P = 0.001),the best critical point of LDL is 2.74 mmol / L,AUC: 0.645(95% CI: 0.540-0.749,P = 0.011);when MHR,BMI,LDL and the history of diabetes are combined to predict coronary vulnerable plaque,AUC: 0.815(95% CI: 0.732-0.898,P = 0.000);4.MHR,white blood cell count and neutrophil count were positively correlated with coronary plaque load(P(27)0.05),and HDL was negatively correlated with coronary plaque load(P(29)0.05)by used Person correlation analysis.CONCLUSION:1.MHR is one of the predictors of vulnerable coronary plaque in the coronary arteries,and its cut-off point is 38.6%,the sensitivity is 0.74 and the specificity is 0.61;2.There is a positive correlation between MHR and the degree of coronary plaque load.Higher MHR indicates that coronary plaque load may be heavier than others;3.MHR can be used as a convenient and low-cost indicator to assist in predicting coronary vulnerable plaques and assessing the degree of plaque load.