Association Between Monocyte Count/HDL Cholesterol Ratio And Premature Coronary Heart Disease

Objective The aim of present research is to investigate the relationship of MHR with premature coronary artery disease and the severity of coronary lesion in young patients.Method A total of 339 participants(male 197(57.6219.83),female 142(62.7417.49))hospitalized in Xinhua hospital affiliated to shanghai Jiaotong university school of medicine during October 2018 to April 2019,who are received coronary angiography for the first time-included 126 subjects had premature coronary artery disease,106 subjects had late onset coronary heart disease and 106 young subjects had no coronary lesion were enrolled in this study.Collect all participants’ data about general clinical data、laboratory data and the results of coronary angiography、according the monocyte counts and HDL data to calculate the MHR and according the extent of the coronary lesions to evaluate Gensini score.Then divided groups and compare:According to the form of the disease onset,patients with PC AD were enrolled in SCAD and ACS group differently;PC AD patients in accordance with the Gensini score were divided into low(<25,n=41)、median(25-53,n=43)\high(>53,n=42)group.Compare and analyze the differences of data among the above groups,and use logistic regression to investigate the correlation between MHR and early coronary heart disease,and use ROC curve to evaluate the predictive value of MHR on the degree of stenosis of premature coronary heart diseaseResults 1.Compared with the control group,MHR、leukocyte count、neutrophil count and monocyte count were increased in PCAD group(P<0.001).In addition,there were no difference in LDL between two groups(P=0.46)2.Set premature coronary artery disease as dependent variable,and set risk factors as independent variables,the results showed that high blood pressure HbAlC%、MHR、NLR were independent risk factors for premature coronary artery disease3.Divided patients with premature coronary artery disease into SCAD and ACS two groups,MHR、leukocyte count、monocyte count in ACS are higher than SCAD,and HDL in ACS is lower than SCAD4.There is a positive correlation between MHR and high Gensini score(r=0.664,P<0.001)5.Drawing the ROC curve to evaluate the prediction value of MHR for high Gensini score,the area under curve(AUC)is 0.813(95%CI=0.740-0.886,P<0.001).When MHR is 0.362,the Youden index is the highest which means that the highest predictive value for high Gensini score.And the sensitivity and specificity were 69.05%and 92.86%respectively6.There are no difference between PCAD and non-CAD in LDL-c count.(P>0.05)Conclusion1.MHR is an independent risk factor in PCAD2.MHR is positively related with the Gensini score in patients with premature coronary artery disease.It can reflect the severity of coronary lesions and its predictive value is higher than monocyte count3.Diabetes,hypertension and smoking history are still the risk factors for premature coronary artery disease.There is no significant difference in LDL among all groups,suggesting that the control of blood glucose,blood pressure and smoking is more important than that of blood lipid for patients with premature coronary artery disease.