Correlation Between Monocyte To High-density Lipoprotein Cholesterol Ratio, Platelet To Lymphocyte Ratio And Premature Coronary Artery Disease

Objective:Correlation between monocyte/high-density lipoprotein cholesterol ratio,platelet/lymphocyte ratio and premature coronary artery disease.Methods:This study retrospectively included 211 patients(male ≤55 years old,female≤65 years old)diagnosed with premature coronary artery disease due to suspected chest pain and tightness from February 2022 to August 2022.Baseline data and laboratory test indicators of patients were collected.According to the results of coronary angiography,162 patients were divided into the premature coronary artery disease group and 49 patients in the control group.According to the clinical classification of premature coronary artery disease,the patients were divided into three groups: stable angina pectoris(SAP),unstable angina pectoris(UAP),acute myocardial infarction(AMI),44 cases,35 cases,83 cases,respectively.The differences of baseline data,laboratory test indexes,monocyte to high-density lipoprotein cholesterol ratio(MHR)and platelet to lymphocyte ratio(PLR)among the three clinical types of PCAD group and control group were compared.Multivariate logistic regression was performed to screen independent risk factors of premature coronary artery disease,and receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of MHR and PLR in diagnosing premature coronary artery disease.According to Gensini score,PCAD was divided into low Gensini group(74 cases)and high Gensini group(88 cases).The differences of baseline data and laboratory test indexes between the low Gensini group and the high Gensini group were compared,and the correlation between MHR,PLR and Gensini score was analyzed.Multivariate logistic regression analysis was performed to understand the independent risk factors of severe coronary artery disease in premature coronary artery disease,and receiver operating characteristic curve was drawn to analyze the efficacy of MHR and PLR in diagnosing severe coronary artery disease in premature coronary artery disease.Results:(1)PCAD compared with control,the proportion of male,smoking,history of hypertension,history of diabetes,WBC,NEU,MONO,PLT,CR,BUN,UA,TC,LDL-C,CK,CK-MB,PLR,and MHR in PCAD patients were higher than those in the control group,the levels of LYM and HDL-C in PCAD patients were significantly lower than those in the control group(P < 0.05).(2)High Gensini score group compared with low Gensini score group,the proportion of male,smoking history,diabetes history,WBC,NEU,MONO,PLT,CR,BUN,UA,TC,LDL-C,CK,CK-MB,PLR,and MHR in the high Gensini score group were higher than those in the low Gensini score group,and the differences were statistically significant(P < 0.05).HDL-C in high Gensini score group were lower than those in low Gensini score group,and the difference was statistically significant(P < 0.05).(3)Comparing MHR and PLR in three different clinical types(P <0.05).The results of pairwise comparison showed that the level of MHR was in AMI group > SAP group > UAP group,and the differences were statistically significant(P < 0.05).The PLR level was in the order of AMI group > UAP group > SAP group,and the differences were statistically significant(P < 0.05).(4)Smoking,diabetes,WBC,NEU,PLT,CK-MB,BUN,CR,TC,UA,PLR,MHR are risk factors for PCAD(P < 0.05).Male gender,smoking history,diabetes mellitus,WBC,BUN,CR,TC,LDL-C,HDL-C,CK-MB,UA,PLR,MHR were risk factors for severe coronary lesions(P < 0.05).(5)The cut-off point of MHR for the diagnosis of PCAD was 0.328,the area under the ROC curve was 0.743(95%CI: 0.634-0.791,P < 0.05),the sensitivity was0.776,and the specificity was 0.308.The cut-off value of PLR for diagnosis of PCAD was0.419,the area under the ROC curve was 0.791(95%CI: 0.659-0.803,P < 0.05),the sensitivity was 0.692,and the specificity was 0.103.(6)The cut-off point of MHR for the diagnosis of severity of PCAD was 0.309,the area under the ROC curve was 0.737(95%CI:0.636-0.778,P < 0.05),the sensitivity was 0.698,and the specificity was 0.189.The cut-off value of PLR for diagnosis of severity of PCAD was 0.263,the area under the ROC curve was0.704(95%CI: 0.585-0.794,P < 0.005),the sensitivity was 0.597,and the specificity was0.104.(7)PLR was positively correlated with Gensini score(r = 0.695,P=0.013),MHR was positively correlated with Gensini score(r = 0.585,P < 0.001).With the increase of PLR and MHR levels,Gensini score gradually increased.Conclusion:(1)PLR and MHR are predictors of coronary artery and severity of PCAD.(2)PLR and MHR have certain value in predicting the severity of PCAD and PCAD.(3)The higher the PLR and MHR levels,the more severe the coronary severity was positively associated with the Gensini score of PCAD.(4)PLR is related to the clinical type of PCAD,the higher the PLR level,the more severe the clinical type.