Correlation Between Monocyte/High-Density Lipoprotein Levels And Syntax Ⅱ Score In Patients With Unstable Angina

Objective In this study,we analyzed the relationship between MHR and coronary artery SYNTAX Ⅱ scores in patients with unstable angina pectoris(UA,aiming at exploring the predictive value of MHR in the severity and prognosis of coronary artery lesions in patients with UA.Methods 407 patients who underwent percutaneous coronary angiography(CAG and were clinically diagnosed as UA were chosen in the Affiliated Hospital of Southeast University from January 2014 to December 2017,which were divided into three groups,low risk group: MHR <0.29(n = 141,35%;intermediate risk group: 0.29 ≤ MHR ≤ 0.41(n = 126,31%;high risk group: MHR > 0.41(n = 140,34% according to the MHR value(obtained from blood routine,biochemical function and other clinical data,SYNTAXscores,SYNTAX Ⅱ scores(based on CAG results from specific computer software and follow-up results.The level of white blood cells count,monocyte count,lymphocyte count,monocyte ratio,triglyceride(TG,total cholesterol(TC,high density lipoprotein cholesterol(HDL-C,low density lipoprotein cholesterol(LDL-C,the direct bilirubin,EF value,SYNTAX scores,SYNTAX Ⅱ scores and other indicators in the three groups were compared to analyze the correlation between MHR and SYNTAX Ⅱ scores.Results(1 The white blood cell count,monocyte ratio,lymphocyte count,monocyte count,SYNTAXscores and SYNTAX Ⅱ scores in the high-risk group were higher than those in the intermediate-risk group and the low-risk group(P<0.01.The TC and the HDL-C in the low-risk group were higher than those of the middle-risk group and high-risk group(P<0.01.The direct bilirubin in the middle-risk group was higher than that in the low-risk group,while the TG was lower than that in the low-risk group(P<0.05.There were no significant differences in age,history of hypertension,history of diabetes,BMI,smoking history,hemoglobin,alanine aminotransferase,aspartate aminotransferase and platelet count among the three groups(P>0.05.(2 Results of echocardiographic parameters in the three groups: There was no significant difference in left ventricular(LV diameter(p = 0.537,interventricular septum(IVS thickness(p = 0.086,left ventricular ejection fraction(LVEF(p = 0.168 and segmental wall abnormalities(p=0.556 between the difference groups(P>0.05.(3 MHR levels were positively correlated with white blood cell counts(r=0.430,p<0.01,neutrophil counts(NE(r=0.316,p<0.01,SYNTAXscores(r=0.736,p<0.01 and SYNTAX Ⅱ scores(r=0.672,p <0.01.(4 Multiple linear regression analysis: After adjusting for gender,age,history of hypertension,history of diabetes,history of smoking,etc.,SYNTAXscores were positively correlated with MHR,lymphocyte count and monocyte count,and were negatively correlated with HDL-C.Meanwhile,SYNTAX Ⅱ scores were positively correlated with MHR,lymphocyte count,and monocyte ratio.(5 407 patients were enrolled in the study(12 months following-up,21 of them were excluded,the total number of final included cases was 386(94.8%.Among them,108 patients had major adverse cardiovascular and cerebrovascular events(MACCE(9 cases of all-cause death,32 cases of target vascular disease reconstruction,45 cases of angina pectoris,22 cases of stroke or transient ischemia attack,patients were divided into two groups: MACCE group and non-MACCE group.The age,white blood cell count,neutrophil count,monocyte count,monocyte ratio,direct bilirubin,MHR,LV,SYNTAXscores,SYNTAX Ⅱ scores in the MACCE group were higher than that of the non-MACCE group(P<0.05,while the lymphocyte count,lymphocyte ratio,HDL-C,and EF values were lower than those in the non-MACCE group(P<0.05.(6 Binary logistics regression analysis of 108 patients in the MACCE group and 278 patients in the non-MACCE group was porformed.After adjusting for gender,age,history of hypertension,history of diabetes,smoking history and other factors,MHR(OR = 21.362,p <0.01 and EF(OR = 0.098,p = 0.05 were independent risk factors for MACCE in patients with UA(p < 0.05.Conclusion(1 In UA patients,the SYNTAXscores and SYNTAX Ⅱ scores were higher in the high-risk group and the moderate group than in the low-risk group,and the MHR level was positively correlated with the SYNTAX score in the coronary lesions.The higher the MHR,the more severe the coronary lesions were.(2 MHR and EF values were risk factors for MACCE in UA patients.MHR can be used as an effective tool to assess the severity of coronary artery diseases.