Correlation Between Monocyte To High-Density Lipoprotein Cholesterol Ratio And Neutrophil Count And Premature Coronary Heart Disease

ObjectiveInflammatory response plays an important role in the pathogenesis of coronary atherosclerosis.Monocyte to high-density lipoprotein cholesterol ratio(MHR)and neutrophil count(NEUT)are both indicators of inflammation,and their role in predicting the occurrence,severity,and prognosis of coronary artery disease has been demonstrated in numerous studies.However,few studies have combined these two indicators and investigated their relationship with premature coronary artery disease.METHODSA total of 330 patients who underwent coronary angiography and were diagnosed with coronary artery disease in The Second Affiliated Hospital of Guangzhou Medical University from January 1,2021 to June 30,2021 were included in this study.According to the diagnostic criteria of premature coronary artery disease(male patients who are under 55 years old and female patients who are under 65 years old),the coronary artery disease group was subdivided into premature coronary artery disease group(111 cases)and non-premature coronary artery disease group(219cases).According to the diagnostic criteria of premature coronary artery disease,we also selected 142 patients who underwent coronary angiography and was excluded from the diagnosis of coronary artery disease in our hospital during the same period as a control group.Clinical data of patients including basic information,past medical history,laboratory indices and results of coronary angiography are collected through outpatient and inpatient systems.The statistical software SPSS 26.0 was used to compare the clinical data of the control group with that of the premature coronary artery disease group.Logistic regression analysis was used to further determine the risk factors of premature coronary artery disease.And ROC curve was used to evaluate the predictive efficacy of MHR,NEUT,and the composite indicator of MHR and NEUT on premature coronary artery disease respectively.The result of coronary angiography of patients with premature coronary artery disease were evaluated using the Gensini scoring system.Based on the Gensini score,we divided patients with premature coronary artery disease into mild coronary artery stenosis group(Gensini score ≤39,57 cases)and severe coronary artery stenosis group(Gensini score >39,54cases).The clinical data of patients with low Gensini score and patients with high Gensini score were compared,and logistic regression analysis was used to further determine the diagnostic value of MHR and NEUT in patients with premature coronary artery disease who have high Gensini score.Diagnostic efficacy of MHR,NEUT,and the composite indicator of MHR and NEUT in predicting in patients with premature coronary artery disease who have high Gensini score was assessed separately by ROC curve.Spearman correlation analysis was used to investigate the relationship between MHR,NEUT and the Gensini score in patients with premature coronary artery disease,respectively.Finally,clinical data between patients with premature coronary artery disease and patients with non-premature coronary artery disease group were compared.Results1.When we compared the clinical data of the premature artery disease group with those of the control group,we found statistically significant differences(P<0.05)in gender,history of type 2 diabetes,smoking history,white blood cell count,hemoglobin,NEUT,monocyte count,triglycerides,high density lipoprotein cholesterol,total bilirubin,fasting blood glucose,creatinine,uric acid,glycosylated hemoglobin,and MHR.The univariate logistic regression analysis showed that sex,history of type 2 diabetes,smoking history,white blood cell count,NEUT,monocyte count,triglycerides,total bilirubin,fasting glucose,uric acid,glycated hemoglobin,and MHR were risk factors for premature coronary heart disease and high-density lipoprotein cholesterol was a protective factor for premature coronary heart disease.The multifactorial logistic regression analysis showed that history of smoking(OR=4.352,P=0.002),NEUT(OR=1.886,P=0.005),glycated hemoglobin(OR=1.709,P=0.040),and MHR(OR=8.740,P=0.020)were independent risk factors for premature coronary disease.We used ROC curves to analyze and compare the efficacy of NEUT,MHR,and the composite indicator of MHR and NEUT in predicting premature coronary artery disease,and it showed that the area under the curve(AUC)of NEUT was 0.666,the AUC of MHR was 0.666,while the AUC of the composite indicator of MHR and NEUT was 0.703.2.We compared the clinical data of mild coronary stenosis group with those of the severe coronary stenosis group and found statistically significant differences(P<0.05)between the two groups in the proportion of men,history of smoking,proportion of myocardial infarction,white blood cell count,NEUT,monocyte count,MHR,and coronary Gensini score.Univariate logistic regression analysis showed that male,smoking history,proportion of myocardial infarction,white blood cell count,NEUT,monocyte count,and MHR were risk factors for severe coronary artery stenosis in patients with premature coronary artery disease.Multifactorial logistic regression analysis showed that NEUT(OR=2.155,P=0.023)and MHR(OR=11.268,P=0.041)remained independent risk factors for severe coronary artery stenosis in patients with premature artery disease.We used ROC curves to compare the diagnostic efficiency of NEUT,MHR and the composite indicator of MHR and NEUT in predicting high Gensini score in patients with premature coronary artery disease,and the result showed that the AUC of NEUT was 0.719,the AUC of MHR was 0.677,and the AUC of the composite indicator of MHR and NEUT was 0.733.Spearman correlation analysis showed a positive correlation between NEUT(r=0.347)and Gensini score in patients with premature coronary artery disease,and we also found a positive correlation between MHR(r=0.317)and Gensini score in patients with premature artery disease.3.When we compared the clinical data of premature coronary artery disease group with the non-premature coronary artery disease group,there were statistically significant differences(P<0.05)in age,history of hypertension,hemoglobin,platelet,lymphocyte,total cholesterol,triglycerides,total bilirubin,creatinine,and free triiodothyronine between the two groups.Conclusion1.MHR and NEUT were independent risk factors for premature coronary artery disease,and the composite indicator of MHR and NEUT has higher diagnostic efficiency for premature coronary artery disease.2.MHR and NEUT were independent risk factors for higher Gensini score in patients with premature coronary artery disease,and the composite indicator of MHR and NEUT has higher diagnostic efficiency for patients with higher Gensini score.Both indicators are positively correlated with Gensini score.