| ObjectiveVenous thromboembolism(VTE)includes pulmonary thromboembolism(PTE)and deep venous thrombosis(DVT).Although the diagnosis and treatment methods have progressed in recent years,the mortality rate is still about 8-30 %.D-dimer is currently widely used as a blood biomarker for VTE in clinical practice.However,many pathophysiological processes may lead to an increase in D-dimer,such as inflammation and tumors,so the specificity of D-dimer is poor.Therefore,more and more scholars are trying to identify new biomarkers as a supplement to D-dimer to balance sensitivity and specificity.Systemic inflammation has been shown to contribute greatly to thrombosis and is currently considered a risk factor for VTE.The ratio of monocytes to high density lipoprotein cholesterol(HDL-C)(MHR)is an emerging inflammatory marker,which is easy to obtain and economical.It is widely used in clinical practice for inflammation and atherosclerosis.Existing studies have shown that arterial thrombosis and venous thrombosis have the same risk factors,and MHR values may also have good evaluation efficacy in venous thrombosis.Therefore,the purpose of this study is to evaluate the role of MHR in the prognosis of VTE patients.Materials and MethodsThis retrospective study finally included 442 VTE patients,including 298 DVT patients and 144 PTE patients.The white blood cell count,monocyte count,D-dimer,high density lipoprotein cholesterol(HDL-C)and other laboratory examination data of VTE patients were collected to calculate the MHR value of the patients.Risk stratification and simplified pulmonary embolism severity index(s PESI)score were performed in all PTE patients.DVT patients were divided into simple DVT group and DVT complicated with PTE group by whether they were complicated with PTE during hospitalization,and the differences of each index between the two groups were compared.For PTE patients,by observing whether the patients died during hospitalization,they were divided into PTE survival group and PTE death group,and the differences of various indicators between the two groups were compared.The correlation between MHR and PTE patients and its predictive value were evaluated by logistic regression analysis and receiver operating characteristic(ROC)curve,respectively.In addition,the relationship between MHR value and PTE risk stratification was compared to determine whether the value increased with the increase of risk stratification.ResultsIn DVT patients,there was a significant difference in MHR between patients with DVT complicated with PTE and patients with DVT alone(P < 0.01).The ROC curve showed that the MHR value of DVT patients had certain value in predicting DVT complicated with PTE,and the area under the curve(AUC)was 0.659.In PTE patients,there was a significant difference in MHR between in-hospital death and survival patients(P < 0.01).Multivariate logistic regression analysis showed that MHR was an independent risk factor for in-hospital death in PTE patients(OR = 7.503,P = 0.012).In predicting the in-hospital mortality of PTE patients,the MHR value also performed well,and the area under the ROC curve was 0.7742(P < 0.01).By risk stratification of PTE patients,we also found that as the risk level of PTE patients increased,the MHR value also increased(P < 0.01).Therefore,the MHR value also has application value in the risk stratification of PTE patients.ConclusionsThe use of good predictors is important for the prognosis of VTE patients.For DVT patients,MHR value can predict whether they are complicated with PTE.At the same time,for patients with PTE,MHR value is an independent prognostic factor.In general,whether it is DVT or PTE,the MHR value has a good predictive ability for its prognosis.This can help clinicians to better assess the patient ’s condition and start early intervention.According to the experimental results of this study,we believe that MHR value can be used as a powerful predictor of prognosis in patients with VTE. |
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