The Relationship Between Monocyte And High-density Lipoprotein Ratio And The Degree Of Coronary Artery Disease And Short-term Prognosis In ACS Patients

Objective:Studies of acute coronary syndrome(acute cornary syndrom,ACS)in patients with mononuclear cells-the ratio of HDL(Monocyte to high-density lipoprotein thewire,MHR)with Gensini score,the correlation of CRP,and then judge the severity of coronary artery lesions.At the same time,it was discussed whether the MHR combined with c-reactive protein(CRP)had predictive value for Major adverse cardiovascular events(MACE)in patients with ACS within 6 months.Methods:Selection in September 2015-September 2016 in the department of cardiology by coronary angiography(the CAG)278 cases diagnosed ACS patients,record the object of study of age,sex,medical history,family history,smoking history and other general information,all patients admitted to hospital 24 hours post venous blood specimen collection times,routine blood,c-reactive protein,liver and kidney function,blood glucose,blood lipid,blood clotting tests,according to the monocytes(Mon),high-density lipoprotein(HDL)levels,calculate the ratio of the two,namely MHR value,according to a third digit level will be divided into low,medium and high three groups,respectively,93 people,93 people,92 people.The differences in general clinical data of the three groups were compared,and Pearson correlation was used to analyze the correlation between MHR and Gensini score and CRP to determine the severity of coronary artery.MACE was performed in the patients who were enrolled in the hospital for 6 months,and were divided into MACE group and non-mace group,and the related risk factors were analyzed by multivariate Logistic regression.The ROC curve was drawn to obtain the predictive value of MHR and c-reactive protein for MACE within 6 months after the hospital of ACS.Results:C-reactive protein in patients with high MHR group,Gensini score and the incidence of MACE MHR in higher than group and low MHR group(P < 0.05),while MHR group of CRP,the Gensini score,lower incidence of MACE is higher than MHR group(P < 0.05).Pearson correlation analysis indicated that the MHR value of ACS patients was positively correlated with Gensini score(r=0.620 P < 0.001),and the MHR value was positively correlated with CRP(r=,0.634 P < 0.001)).During the follow-up period,there were 27 patients with MACE,and the incidence rate was 9%.In MACE group,Mon,WBC,MHR,HDL,c-reactive protein and Gensini score were significantly higher than those in the non-mace group(P < 0.05).Multivariate Logistic regression analysis showed that smoking history,MHR and Gensini scores were all related to MACE.Participants working curve drawing,the combination of the judgment MHR,CRP value prediction of MACE,displays MHR single prediction,area under the curve(area under the curve,AUC)was 0.748(95% CI: 0.656-0.838,P < 0.05),The AUC of CRP was 0.876(95% CI: 0.800-0.952,P < 0.05);The AUC of the joint predictors of MHR and CRP was 0.884(95%CI:0.813-0.964,P < 0.05).,the optimal cut-off point value was MHR:0.560(sensitivity:65%,specificity: 66.4%);CRP:14.015(sensitivity 62%,specificity:60.5%);Combined factor: 0.1017(sensitivity: 68%,specificity: 58%);When the above mentioned intercept value was taken,the MACE situation in ACS patients could be predicted to a large extent,but the specificity and sensitivity were low.Conclusion:1.The MHR value of ACS patients was positively correlated with Gensini score and CRP,and the severity of coronary artery disease could be determined.2.The MHR value and CRP of patients with ACS had certain predictive value for MACE in 6 months,and the prediction efficiency increased after the combination.