Monocyte-to-High Density Lipoprotein Cholesterol Ratio Positively Predicts Coronary Artery Disease and Multi-Vessel Lesions in Acute Coronary Syndrome

Guo-Li Du; Fen Liu; Hua Liu; Qi Meng; Ran Tang; Xiao-Mei Li; Yi-Ning Yang; Xiao-Ming Gao

doi:10.2147/IJGM.S419579

Monocyte-to-High Density Lipoprotein Cholesterol Ratio Positively Predicts Coronary Artery Disease and Multi-Vessel Lesions in Acute Coronary Syndrome

Int J Gen Med. 2023 Aug 28:16:3857-3868. doi: 10.2147/IJGM.S419579. eCollection 2023.

Authors

Guo-Li Du^#^{1

2}, Fen Liu^#^{1

3

4}, Hua Liu^#^{1

2}, Qi Meng^{1

2}, Ran Tang^{1

2}, Xiao-Mei Li^{1

3}, Yi-Ning Yang^{1

5}, Xiao-Ming Gao^{1

3

4}

Affiliations

¹ State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People's Republic of China.
² Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
³ Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
⁴ Xinjiang Key Laboratory of Medical Animal Model Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
⁵ People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: We investigated the hypothesis that MHR (monocyte-to-high density lipoprotein cholesterol ratio) is related to the severity of coronary artery in ACS (acute coronary syndrome).

Methods: In this case-control study, we recruited 15,853 participants undergoing the first time percutaneous coronary intervention (PCI) including 4093 normal controls, 10,518 chronic coronary artery disease (CAD), and 1242 ACS cases. Examination of demographic clinical data and biochemical profiles, as well as MHR values, were performed before PCI. The relationship between MHR and severity of coronary artery lesion in ACS was analyzed. We also used a flow cytometric assay to distinguish CD14+/CD16- classical monocyte subsets in peripheral blood mononucleated cells from CAD patients.

Results: MHR was higher in patients with ACS compared with MHR in normal control and chronic CAD (normal control vs chronic CAD vs ACS: 0.46 ± 0.27 × 10⁹/mmol vs 0.53 ± 0.29 × 10⁹/mmol vs 0.73 ± 0.47 × 10⁹/mmol, P < 0.001). MHR showed a significantly progressive increase as the angiographic severity of coronary lesions increased (single vessel lesion vs multi-vessel lesions in ACS: 0.54 ± 0.31 × 10⁹/mmol vs 0.58 ± 0.35 × 10⁹/mmol, P < 0.001), and classical monocyte subset to HDL-C ratio (CMHR) was increased in with CAD patients compared with control [4.69 (IQR, 1.06, 2.97) × 10³/mmol vs 1.92 (IQR, 0.92, 3.04) × 10³/mmol, P = 0.02]. Using a multivariate analysis, after adjusting for age, gender, body mass index (BMI), diabetes, and dyslipidemia, MHR was positively associated with multi-vessel lesions in ACS [OR (odds ratio): 1.28 (95% CI: 1.03-1.59, P = 0.029)].

Conclusion: MHR level could be a potential predictor of coronary artery lesion severity in ACS.

Keywords: ACS; CAD; CMHR; MHR; multi-vessel lesions.

Grants and funding

This study was supported by Xinjiang Science and Technology Support Project (XJTSP, 2016E02072). National Natural Science Foundation of China (No. 81960078, No. 81870272), Natural Science Foundation of Xinjiang Uygur Autonomous Region, Outstanding Youth Science Foundation Project (2021D01E28), opening project of the Xinjiang Key Laboratory (2021D04020) and State Key Laboratory of Pathogenesis, Prevention and Treatment of Central Asia High Incidence Diseases (SKL-HIDCA-2021-2, SKL-HIDCA-2021-XXG1 and SKL-HIDCA2022-XXG).