Analysis Of The Value Of MHR And FAR In Predicting Coronary Heart Disease And Evaluating The Coronary Stenosis Degree

Background:Coronary heart disease(CHD)is widely concerned because of its high incidence rate and high mortality.At present,coronary angiography(CAG)remains the gold standard for the diagnosis and prognosis evaluation of CHD.However,as it is an invasive operation and has certain limitations,the exploration of non-invasive auxiliary diagnosis and lesion severity evaluation methods is a current research hotspot.Currently,many scholars believe that plaque deposition in coronary arteries is an inflammatory disease,and some inflammatory indicators,such as fibrinogen(Fib),monocyte(Mon),albumin(Alb),high-density lipoprotein choles-terol(HDL-C),have been proven to be important for the diagnosis and management of patients with coronary heart disease.HDL-C can inhibit the aggregation,adhesion,and activation of monocytes,and decreased serum albumin can stimulate the compensatory synthesis of more lipoproteins and coagulation factors in the liver,leading to an increase in plasma fibrinogen level.Monocyte to high-density lipoprotein cholesterol ratio(MHR)and fibrinogen to albumin ratio(FAR)are two new types of combined inflammatory markers,which are simple and convenient to obtain.Currently,researches had found that MHR and FAR have certain predictive values for cardiovascular disease and tumor prognosis.Studies on the correlation between MHR and FAR in the prediction of CHD and the degree of coronary stenosis are still in the initial stage.Purpose:In this study,we analyzed the predictive efficacy and diagnostic cut-off values of MHR and FAR for CHD,as well as the correlation of MHR,FAR,and Gensini score in patients with CHD.This study aimed to investigate the value of MHR and FAR for predicting CHD and assessing the coronary stenosis degree,with purpose of providing a reference for clinical evaluation of patients with CHD.Methods:This study recruited patients who were hospitalized in the Cardiovascular Department at our hospital from January 2020 to December 2020,and cardiovascular interventionalists perform coronary angiography through the radial or femoral arteries of these patients.We divided the 340 subjects into two groups according to the inclusion and exclusion criteria: 269 patients in the coronary heart disease group,and 71 patients in the control group.Collecting patients’ basic information,laboratory index data,and coronary angiography results,and calculating the Gensini score for assessing the degree of coronary stenosis in patients in the CHD group.The baseline and clinical data between the two groups were compared.The independent influencing factors of CHD according to Logistic regression analysis were analyzed.The predictive value of MHR and FAR for CHD and the cut-off values for diagnosing CHD were explored according to the ROC curves.Spearman correlation analysis was used to discuss the relationship between MHR,FAR and Gensini scores.Results:1.Age,gender(male),hypertension,diabetes,fibrinogen(Fib)level,monocyte(Mon),lowdensity lipoprotein cholesterol(LDL-C),MHR,and FAR in the CHD group were higher than those in the control group,differences were statistically significant(P<0.05);while high-density lipoprotein cholesterol(HDL-C)and albumin(Alb)in the CHD group were apparently lower than those in the control group(P<0.05).2.Logistic regression analysis of statistically different indicators in the univariate analysis showed that hypertension(OR=1.818,P=0.003),gender(male)(OR=1.575,P=0.015),LDL-C(OR=1.707,P=0.013),MHR(OR=3.432,P<0.001)and FAR(OR=4.916,P<0.001)were independent risk factors for the development of coronary heart disease.3.The ROC curve analysis showed that the sensitivity of MHR and FAR for diagnosing CHD was 75.5% and 74.7%,and the specificity were 80.3% and 87.3%,meanwhile the area under the curves were 0.815(95% CI: 0.763～0.866)and 0.850(95% CI: 0.803～0.897),suggesting that MHR and FAR have predictive value for diagnosing coronary heart disease,and the cut-off values for the diagnosing CHD were0.309 and 0.069.The sensitivity,specificity,and area under the ROC curve of the two combined indicator for diagnosing CHD were 77.0%,85.9%,and 0.884(95% CI:0.846～0.921),which had a higher diagnostic value compared with the single index.4.According to the Spearman correlation coefficient analysis,in the CHD group,MHR and FAR were positively correlated with the Gensini scores,with correlation coefficients of 0.441 and 0.471,respectively(P<0.05).Conclusions:1.MHR and FAR have predictive value for coronary heart disease.2.The levels of MHR and FAR are positively correlated with the coronary stenosis degree in patients with CHD.