Correlation Study Of NLR、MHR And The Degree Of Coronary Artery Disease And GRACE Score In Patients With Coronary Heart Disease

Objective: NLR is the Neutrophils /lymphocytes ratio in blood,and MHR is the Monocyte/HDL ratio.NLR and MHR are inflammatory markers that can predict the risk of cardiovascular events in patients with CHD.Objective: To investigate the difference of blood NLR and MHR levels between patients with coronary heart disease and patients without coronary heart disease.Blood NLR and MHR levels in patients with different types of coronary heart disease;Relationship between blood NLR and MHR levels and the degree of coronary artery stenosis determined by coronary angiography in patients with coronary heart disease;Difference of blood NLR and MHR in patients with coronary heart disease with different GRACE scores.Methods:In this study,407 patients with suspected coronary heart disease admitted to a Grade A hospital in Guilin were included.All the inpatients underwent routine blood tests,blood lipidemia,coronary angiography and other examinations during their hospitalization.NLR and MHR were calculated,and Gensini score of the patients with coronary heart disease was calculated according to the angiography report.The severity of coronary artery atherosclerotic stenosis was assessed by Gensini score.The GRACE score was calculated based on the clinical data of patients with CHD.If coronary artery stenosis was not observed by coronary angiography or the stenosis degree was less than 50%,CHD was excluded and non-CHD group was included.Patients with coronary artery stenosis ≥50% indicated by coronary angiography were included in the CHD group.Patients in the coronary heart disease group were divided into ST-segment elevation myocardial infarction(ST-segment elevation myocardial infarction)according to their symptoms and signs,electrocardiogram,myocardial enzyme and other auxiliary examinations.The patients with acute myocardial infarction(STEMI),non-ST-segment elevation myocardial infarction(NSTEMI),,unsteady angina(UA)group and Stable Angina group.The levels of NLR and MHR were compared between CHD group and non-CHD group.The differences of NLR,MHR,Gensini score and Grace score among STEMI group,NSTEMI group,UA group,stable angina pectoris group and non-CHD group were compared.Spearman partial correlation analysis was used to evaluate the correlation between NLR and MHR levels and the degree of coronary artery lesions.According to GRACE score,CHD patients were divided into low-risk group,medium-risk group and high-risk group,and the differences in NLR and MHR levels among each group were compared.Results:(1)The levels of NLR and MHR in CHD patients were higher than those in non-CHD patients(P < 0.01);(2)The levels of NLR in the STEMI and NSTEMI groups were higher than those in the UA group,stable angina pectoris group and non-CHD group(P < 0.01).(3)The MHR level of STEMI group was higher than that of UA group,stable angina pectoris group and non-CHD group(P < 0.01).(4)The level of MHR in the NSTEMI group was higher than that in the non-CHD group(P < 0.01).(5)The higher the levels of NLR and MHR in the blood of patients with CHD,the higher the Gensini score,indicating the more serious the coronary artery disease of the patients.After adjusting for other confounding factors,increased blood NLR level was still correlated with Gensini score(r=0.211,P < 0.01).The correlation between MHR level and Gensini score decreased;(6)The level of NLR in GRACE high-risk group was higher than that in GRACE medium-risk group and low-risk group;The level of NLR in GRACE medium-risk group was higher than that in GRACE low-risk group(P < 0.01).(7)The MHR level in GRACE high-risk group was higher than that in GRACE medium-risk group(P < 0.01).Conclusions: The levels of NLR and MHR in patients with coronary heart disease were higher than those in patients without coronary heart disease.The levels of NLR and MHR were different in patients with different types of coronary heart disease.The higher the levels of NLR and MHR,the greater the possibility of myocardial infarction in patients with suspected coronary heart disease.Patients with higher NLR and MHR levels are likely to have more severe coronary artery disease.NLR and MHR levels can reflect the severity of coronary atherosclerosis.After adjusting for other factors,NLR is still positively correlated with the degree of coronary artery disease.The higher the risk grade of GRACE score,the higher the NLR and MHR level...