Relationship Between Monocyte Count/high Density Lipoprotein Ratio And Coronary Artery Disease In Patientswith Acute Myocardial Infarction Combined With Hypertension

Objective: Acute myocardial infarction(AMI)is the most severe and ordinary type of coronary atherosclerosis heart disease(CHD),hyperten-sion(HTN)is a common risk factor for coronary heart disease(CHD),CHDand HTN are chronic vascular inflammatory disease.Monocyte to high den-sity lipoprotein ratio(MHR)is a newly discovered indicator of inflamma-tion and oxidative stress.Methods: A total of295 patients with cornary arteriography(CAG)were enrolled in the cardiovascular ward of affiliated hospital of guilin medical college from2017-11 to 20119-11.Patients was meeting the diagnostic and inclusion criteria were divided into AMI combined with HTN group(100 cases in total),there were 95 cases in the A-MI group,the Control group: CAG normal or coronary artery plaque,thatnot have history of hypertension or have normal blood pressure,a total of 100 cases.The basic clinical data were recorded,Meanwhile,fasting el-bow venousblood was collected to detect the leukocyte count and its cla-ssification,blood lipid,total bilirubin(TBi L),uric acid(UA),serum cre-atinine(SCr)and other laboratory indicators.Left ventricular ejection fraction(LVEF)and CAG results and were recorded,Gensini scores were calculated.Baseline data and indicators were compared between groups.Receiver operating ch-aracteristic curve(ROC)evaluated the efficiency of MHR in diagnosing AMI.Spearman correlation analysis of the relationship between MHR and other respective variables and Gensini score.Multiple linear regression was performed to analyze the linear correlation of coronary artery disease(Gensini score)in AMI combined with HTN patients and Independent ri-sk factors for AMI were screened by binary logistic regression.Results:The MHR value of patients with AMI combined with HTN and AMI wa-s significantly higher than that of the Control group,and the difference was statistically significant(p < 0.05).The MHR of patients with AMI combined with HTN was positively correlated with the Gensini score of coronary artery disease(r=0.425,p<0.001).Multiple linear regression analysis of patients with AMI combined with HTN showed that MHR(Partial regression coefficient=4.491,p<0.001)and age(Partial regression coeffici-ent=0.723,p=0.016)were independently correlated with the Gensini sco-re of coronary artery lesions.MHR and Gensini score showes a positive linear correlation,and Gensini score gradually increased with the increase of MHR value.ROC showed that the area under the AMI curve of MHR diagnosis(AUC)was 0.803,the optimal threshold was 0.49,the sen-sitivity was 73.7%,and the specificity was 75%.Age(OR=1.060,95%CI:1.023～1.078,p < 0.001),smoking(OR=4.207,95%CI :2.309～7.666,p=0.014),male(OR=4.286,95%CI :1.926～9.583,p < 0.001),MHR(OR=2.008,95%CI:1.618～2.492,p < 0.001),LDL(OR=1.931,95%CI :1.239～2.952,P =0.003),NEU(OR=1.511,95%CI :1.276～1.789,p < 0.001),Hcy(OR=1.111,95%CI:1.042～1.184,p=0.001),were independent risk factors for AMI.Conclusion:(1)The MHR value of patients in the AMI combined with HTN group and the AMI group was significantly higher than the healthy patients.(2)In the patients of AMI combined with HTN,MHR is independently correlated with the Gensini score of coronary artery lesions,the MHR are linearly positively correlated with Gensini score,MHR may become a clinical indicator for the evaluation of the AMI combined with HTN patient’s coronary artery lesions.(3)MHR may be an independent risk factor for acute myocardial infarction,MHR may have reference value in the diagnosis of acute myocardial infarction.