The Correlation Between Lymphocyte/monocyte Ratio And Coronary Collateral Circulation In Chronic Total Occlusion Patients

Purpose: This study graded coronary collateral circulation in patients with chronic total occlusion(CTO),and explored the correlation between LMR and the formation of coronary collateral circulation in CTO.Patients and Methods: 314 patients with chronic total occlusion(CTO)from January 1,2017 to December 31,2018 at the Cardiovascular Medicine Center of the First Hospital of Jilin University were enrolled in this study.CTO were defined by the present of at least one coronary artery left anterior descending branch,left circumflex Branch and right coronary artery total occlusion on coronary angiography(CAG),with estimated occlusion time over 3 months.Patient characteristics and lab results were collected.According to the results of coronary angiography,patients were divided into CCC good group and CCC bad group according to Rentrop classification.The statistical analysis software SPASS 22.0 was used to analyze and study the data obtained by the two groups of patients.Result:(1)In terms of clinical baseline data: There was no significant difference in gender,age,smoking and alcohol consumption,and hypertension between different CCC groups(both P> 0.05);the proportion diabetes in CCC well-formed group was significantly lower than that of CCC poorly-formed group(P <0.05).(2)Biochemical indicators: The results of univariate analysis showed that the LMR level of the well-formed CCC group was significantly higher than that of the poorly-formed CCC group(P<0.001).The absolute value of monocytes in the wellformed group of CCC was significantly lower than that of the poorly formed group(P<0.001);there were no significant differences in triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,fasting blood glucose,white blood cell count,red blood cell count,hemoglobin,platelets,and creatinine(P> 0.05).(3)Correlation between LMR and coronary collateral circulation grade: Spearman correlation analysis revealed that LMR was positively correlated with coronary collateral formation grade(r = 0.262,P <0.001).(4)Multivariate regression analysis of related influencing factors: Logistic regression analysis showed that after adjusting for factors such as clinical baseline data and various biochemical indicators,LMR(OR = 1.661;95%CI = 1.071 ~ 2.574;P<0.05)and diabetes(OR=0.398;95%CI=0.176~0.903;P<0.05)is an independent factor affecting the formation of coronary collaterals.(5)Good relationship between LMR and CCC generation: The best "demarcation" point for predicting good coronary collateral formation by LMR obtained through ROC curve is 5.35,and the area under the curve is 0.663(95% CI = 0.602 ~ 0.725,P <0.001),With a sensitivity of 62.20% and a specificity of 64.20%.Conclusion: 1.LMR level is related to CCC formation in CTO patients,and LMR level is positively correlated with CCC grade.High levels of LMR are good independent predictors of CCC formation in CTO patients.2.Diabetes is not conducive to the formation of good coronary collateral circulation in CTO patients.