Correlation Analysis Between Mononuclear Cells/High Density Lipoprotein Cholesterol And TIMI Score In Patients With Acute ST-segment Myocardial Infarction

Objective:By analyzing the relationship between monocytes/ high density lipoprotein cholesterol(MHR)and TIMI risk score in patients with acute ST-segment elevation myocardial infarction,providing some reference significance to the predictive value of MHR and the prognosis of the eventfor coronary stenosis and cardiovascular dysfunction.Methods: A total of 111 patients diagnosed with STEMI by electrocardiogram and coronary angiography in Hainan General Hospital from 2017.08 to 2019.08 were collected.After admission,TIMI scores were calculated and divided into 2 groups according to TIMI scores: low group(≤4)39 cases,high group(> 4)72 cases.During the same period,50 patients with clinical considerations of acute myocardial infarction but negative coronary angiography were selected as the control group.All subjects asked about the patient’s age,gender,history of hypertension,diabetes,family history of coronary heart disease,smoking history,and blood collection from the elbow vein and collection of relevant laboratory data: blood routine,renal function,electrolytes,liver function,biochemistry.We recorded total cholesterol,hemoglobin,leukocytes,neutrophils,triglycerides,lymphocytes,monocytes,platelets,total protein,albumin,low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),Alanine aminotransferase(ALT),high-density lipoprotein cholesterol(HDL-C),and calculated MHR.All subjects underwent elective or emergency coronary angiography after admission,and PCI if necessary.Comparative analysis:(1)Differences in general clinical data between STEMI and the control group;(2)Differences in general clinical data between TIMI high group and TIMI low group;(3)The correlation between MHR and TIMI score using Pearson linear correlation analysis;(4)Logistic regression was used to analyze whether MHR is STEMI and TIMI high group’sindependent risk factor;(5)The predictive value of MHR to TIMI score using receiver operating characteristic(ROC)curve;(6)The occurrence of cardiovascular adverse events in STEMI group after 3 months of follow-up.Results:(1)The history of smoking,family history of coronary heart disease,history of hypertension,diabetes,gender,age,hemoglobin,platelets,lymphocytes,creatinine,total cholesterol,triglycerides,LDL-C,total protein,albumin,AST,ALT,Na + and K+ have no statistical significance with the control group(p> 0.05),but the HDL-C is significantly lower than the control group(P <0.05),which is statistically significant;The monocyte count,MHR,white blood cell(WBC)and neutrophil count were statistically significant by further analysis of the STEMI group and the control group,P <0.05;MHR(0.47 ± 0.12)was significantly higher than the control group(0.24 ±0.09)(P <0.05);(2)The TIMI high group of history of smoking,family history of coronary heart disease,history of hypertension,diabetes,gender,age,hemoglobin,platelets,lymphocytes,creatinine,total cholesterol,triglycerides,LDL-C,total protein,albumin,AST,ALT,Na + and K + have no statistical significance with the TIMI low group(p> 0.05),but the HDL-C level is lower than the TIMI low group and has statistical significance(P <0.05);further analysis of the high group Compared with the low group,the monocyte count,MHR,WBC and neutrophil count were statistically significant,P <0.05;and MHR in the TIMI high group(0.54 ± 0.18)was significantly higher than the TIMI low group(0.38 ± 0.13)(P <0.05);(3)Pearson linear correlation analysis showed that MHR,WBC,neutrophils,monocytes,HDL-C were all related to TIMI score,but MHR and TIMI score were the strongest(r = 0.888,p = 0.000);(4)Logistic regression analysis showed that MHR is an independent risk factor for the high group of STEMI and TIMI;(5)In the ROC curve of MHR predicting TIMI score,the area under the curve is 0.689,the sensitivity is 69.37%,the specificity is 68%,the critical value of MHR is 0.52,95% CI(0.612-0.760;p<0.01);(6)The STEMI group was followed up for 3 months.The incidence of malignant arrhythmia in the TIMI high group was 3.6%,and the incidence of heart failure in the TIMI low group was 0.9%.The number of cases was not statistically analyzed for lacking of many cases.Conclusions:1.MHR of STEMI patients is positively correlated with TIMI score,and MHR is an independent risk factor for STEMI group and TIMI high group,suggesting that MHR can be a simple clinical indicator for evaluating STEMI coronary artery disease;2.When MHR> 0.52,the predicted value of TIMI score is the best;3.The average TIMI score of cardiovascular adverse events in the three months outside the TIMI high group was 11.75 points and the average MHR was 0.73;the TIMI low group was 4 points and the MHR was 0.322.The number of cases was not calculated because of lacking many cases.It is concluded that the higher of MHR value,the greater the tendency of STEMI patients having cardiovascular adverse events.4.The clinical acquisition of MHR is simple,which is helpful for early assessment and intervention of coronary artery disease.