Relationship Between Monocyte/high-density Lipoprotein Cholesterol Ratio And Degree Of Coronary Artery Stenosis

Background:With the continuous development of China’s economy,the burden of cardiovascular disease is increasing,and it has become a major public health problem.It is imperative to prevent and treat cardiovascular diseases.Although direct percutaneous coronary intervention(PCI)has become popular,it has become the gold standard for the diagnosis and treatment of coronary heart disease.However,there is still a need for a simple and quick way to predict the extent of coronary artery disease.At present,there is a lack of biochemical indicators that can objectively and accurately assess the degree of lesion stenosis.Monocyte count to HDL-C ratio(MHR)is a new inflammatory marker in recent years and is expected to be a new predictor and prognostic indicator of cardiovascular disease.Purposes:To investigate the relationship between monocyte and high-density lipoprotein cholesterol ratio(MHR)and the degree of coronary artery disease.Method:1.From October 2017 to May 2018,1267 patients were enrolled in the Cardiovascular Department of the First Affiliated Hospital of Suzhou University due to chest tightness or chest pain.Among them,792(62.51%)were males and 475(37.49%)were females.The age range was 21 to 90 years old,average(64.26±11.17)years old,846(66.77%)cases with hypertension,287(22.65%)cases of diabetes,448(35.36%)cases of smokers.According to the angiographic results,156(12.31%)cases in the normal coronary artery group,265(20.92%)cases in the coronary atherosclerosis group,and 846(66.77%)cases in the coronary heart disease group,combined with clinical features,the components of coronary heart disease were ACS group 224(17.68%)cases and 622(49.09%)cases in non-ACS group.2.The general clinical data of patients admitted to the hospital were retrospectively collected,including the patient’s gender,age,history of hypertension,history of diabetes,and history of smoking.Simultaneous detection of left ventricular ejection fraction,left atrial size,left ventricular end-diastolic volume,left ventricular end-systolic volume,hemoglobin,platelet count,white blood cell count,neutrophil count,monocyte count,total cholesterol,low density Lipoprotein cholesterol,high-density lipoprotein cholesterol,triglyceride,high-sensitivity troponin,B-type amino-terminal natriuretic peptide,creatine kinase,creatine kinase isoenzyme,lactate dehydrogenase,alanine aminotransferase,aspartate aminotransferase,creatinine,serum potassium,fasting blood glucose and other indicators.3.The coronary angiographic features of the selected patients were collected,such as the location of the vascular lesion,the extent of the lesion,and the number of lesions.The degree of coronary artery stenosis was calculated using Gensini score.4.The relationship between general clinical data and cardiac hyperactivity index,laboratory parameters and coronary artery lesions in the three groups was analyzed and compared.The relationship between monocytes,high-density lipoprotein cholesterol,monocyte/high-density lipoprotein cholesterol and coronary Gensini scores was analyzed respectively.Results:1.There were significant differences in gender,age,hypertension,diabetes and smoking history among the three groups(P<0.05).There were significant differences in gender,age,hypertension and smoking history between the ACS group and the non-ACS group(P<0.05),but there was no significant difference in diabetes(P>0.05).2.There were significant differences in white blood cells,neutrophils,monocytes,high-density lipoprotein cholesterol,triglycerides,high-sensitivity troponin,B-type amino-terminal natriuretic peptidecreatine kinase,creatine kinase isoenzyme,lactate dehydrogenase,aspartate aminotransferase,alanine aminotransferase,creatinine and blood glucose among the three groups(P<0.05),but there was no significant difference in hemoglobin,platelet,total cholesterol,low density lipoprotein cholesterol and serum potassium(P>0.05).There were significant differences in platelet,white blood cells,neutrophils,monocytes,total cholesterol,low density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglycerides,high-sensitivity troponin,B-type amino-terminal natriuretic peptidecreatine kinase,creatine kinase isoenzyme,lactate dehydrogenase,aspartate aminotransferase,alanine aminotransferase,creatinine and blood glucose between the ACS group and the non-ACS group(P<0.05),but there was no significant difference in hemoglobin and serum potassium(P>0.05).3.There were significant differences in LVEF and LVS among the three groups(P<0.05),but there was no significant difference in LA and LVD(P>0.05).There were significant differences in LVEF,LA,LVD and LVS between the ACS group and the non-ACS group(P<0.05).4.The MHR level in patients with coronary heart disease was higher than that in normal coronary artery and coronary sclerosis group.The MHR level in the ACS group was higher than that in the non-ACS group,and the difference was statistically significant(P<0.05).5.The levels of monocytes and MHR in the patients with coronary heart disease gradually increased with the increase of Gensini score,and there was a positive correlation(r=0.179,P<0.01;r=0.171,P<0.01).The level of high-density lipoprotein cholesterol decreased gradually with the increase of Gensini score,which was negatively correlated(r=-0.080,P<0.05).Conclusion:Monocytes,MHR and Gensini scores were positively correlated with coronary heart disease,and high-density lipoprotein cholesterol was negatively correlated with Gensini score.MHR can be used as a biochemical indicator of the severity of coronary heart disease.