Study On The Relationship Between MHR Combined With MLR CRP And Critical Coronary Artery Disease

Introduction:Coronary atherosclerotic heart disease(CHD)is a dynamic chronic inflammatory reaction process characterized by changes in coronary circulation function and accumulation of atherosclerotic plaques.It has a relatively stable period,but can also be unstable due to factors such as plaque rupture,plaque erosion and calcified nodules.CHD has a dynamic evolution.The critical lesion of coronary artery is the lesion with the stenosis degree of 50%～70%,which is the specific stage of the development of coronary atherosclerosis.The occurrence,development and prognosis of cardiovascular diseases are closely related to inflammation and oxidative damage,in which monocytes(MON),lymphocytes(LYM),high-density lipoprotein cholesterol(HDL-C)and C-reactive protein(CRP)are involved and play an important role.MON and LYM are important inflammatory cells in the body.Studies have shown that they are involved in the whole process of the formation,progression and rupture of coronary atherosclerotic plaques.Hdl-c is negatively correlated with the occurrence of atherosclerosis and has anti-inflammatory,antioxidant and antithrombotic effects.CRP is widely used in CHD screening and risk classification.In the process of atherosclerosis formation and plaque rupture,MON,LYM,HDL-C,CRP and so on participate in the inflammatory reaction process of atherosclerosis and interact with each other.Monocyte to HDL cholesterol ratio(MHR)refers to the ratio of plasma Monocyte count(109/L)to serum HDL-C level(Mmol/L),which is found to be an inflammatory indicator related to the prognosis of cardiovascular diseases in recent years.Monocyte to lymphocyte ratio(MLR)refers to the ratio of plasma Monocyte count(109/L)to plasma lymphocyte count(109/L),which is a novel inflammatory marker after integration of Monocyte and lymphocyte.At present,there have been no reports on the relationship between MHR combined with MLR,CRP and coronary artery critical lesions.Purpose:To investigate the relationship between inflammatory markers MHR,MLR,CRP and coronary artery critical lesions.Multivariate logistic regression was used to analyze the possible related factors of critical coronary artery lesions.ROC curve was drawn to determine the value of combined prediction of critical coronary lesions.Methods:1.clinical data In strict accordance with the included and exclusion criteria,the group between January 2018 and December 2019 treatment in shandong provincial hospital emergency center line of Coronary arteriography(Coronary angiography,the CAG)of patients with acute Coronary syndrome(ACS),according to the situation of intraoperative vascular stenosis patients divided into critical Coronary artery lesion group(vascular stenosis 50%to 70%,n=54)and Coronary artery stenosis group(vascular stenosis 0%,n=31)as control group.Due to coronary artery stenosis of more than 70%of patients,relevant studies have been available in the literature,so this study was not repeatedly included.2.research methods The gender,age,previous history of hypertension,diabetes,hyperlipidemia,smoking and alcohol consumption were recorded as general information.Peripheral venous blood tests of patients were collected and the relevant indicators were recorded:D-Dimer,HbA1C,TP,ALB,GLO,TG,CHOL,HDL-C,LDL-C,SDLDL-C,APOA,APOB,APOA/APOB,LPa,LP-PLA2,HCY,NEFA,GA,Bata-Hb,WBC,PLT,LYM,MON,NEU,CRP,and MHR and MLR were calculated.The MHR,MLR and CRP levels at admission were compared between the critical coronary artery lesion group(50%-70%stenosis,n=54)and the non-coronary artery stenosis group(0%stenosis,n=31),and the correlation between intraoperative coronary angiography(CAG)stenosis and the above factors was analyzed.3.statistical approach SPSS 22.0 statistical software was used for statistical analysis of the above data:measurement data were expressed as mean ± standard deviation(x±s),and comparison of indicators between groups was performed by T test.The counting data were represented by frequency and percentage,and the chi-square test was used for the comparison between groups.Multivariate logistic regression was used to analyze the risk factors of coronary critical disease,and receiver operating characteristic curve(ROC)was used to analyze the predictive value of MHR,MLR and CRP in predicting coronary critical disease and the combination of the three,and the cut-off value,sensitivity,specificity,and Jorden index were calculated.All hypothesis tests were statistically significant with P<0.05.Results:Basic clinical characteristics of patients in the two groups:the proportion of patients with a history of hypertension in the group with critical coronary artery lesions was higher than that in the group without coronary artery stenosis,and the difference was statistically significant(P<0.05).Laboratory examination indexes of patients in the two groups:LYM,MON,NEU,CRP,MHR and MLR in the group with critical coronary artery lesions were higher than those in the group without coronary artery stenosis,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that MHR,MLR,CRP and LYM were correlated with critical coronary lesions(P<0.05).The ROC curve showed that the area under the curve(AUC)predicted by MHR for critical coronary artery lesions was 0.686(95%CI:0.575-0.797,P=0.004).The AUC predicted by MLR was 0.647(95%CI:0.531-0.762,P=0.025).CRP predicted the subcurve area(AUC)of critical coronary artery lesions to be 0.665(95%CI:0.550-0.781,P=0.011).The AUC of CRP+MHR+MLR combined to predict critical coronary lesions was 0.792(95%CI:0.698-0.885,P<0.001).MHR,MLR and CRP have predictive efficacy for critical coronary lesions.The efficacy of MHR combined with MLR and CRP in predicting critical coronary lesions was better than that of CRP,MHR and MLR alone.Conclusions:1.MHR,MLR,CRP and LYM were correlated with critical coronary lesions(P<0.05).2.MHR,MLR and CRP have predictive efficacy for critical coronary lesions.3.The efficacy of MHR combined with MLR and CRP in predicting critical coronary lesions was better than that of CRP,MHR and MLR alone.