Monocyte To High-density Lipoprotein Ratio Research Articles

The association between monocyte HDL ratio and albuminuria in diabetic nephropathy.

Objectives:We aimed to investigate whether Monocyte-to-HDL ratio (MHR) had an association with albuminuria in patients with diabetic nephropathy (DN).Methods:Diabetic patients, who had admitted to the outpatient clinic of general internal disease department between September 2017 - February 2018 and had their spot urinary albumin/creatinine ratio measured, were examined retrospectively. Patients were separated based on the presence of DN. Patients with DN were grouped as Stage-I, Stage-II and Stage-III chronic kidney disease (CKD). Groups were compared in terms of MHR. The presence of a correlation between MHR and albuminuria was investigated.Results:MHR was found to be higher in the DN (n=85) group compared to Non- DN group. (16.2±5.5 vs. 14.3±4, p=0.037) And there was no significant difference in Stage-I, Stage-II and Stage-III CKD groups in terms of MHR. (15.2± 3.4, 16.1±6.0, 17.1±6.0, p=0.485). No significant correlation was found between MHR and albuminuria in DN and non-DN groups (p=0.634, r=0.052; p=0.553, r=-0.059).Conclusions:DN group had higher MHR than non-nephropathy group, whereas, there was no correlation between albuminuria and MHR.

Can Monocyte to HDL Ratio be a new Marker for Severity of Obstructive Sleep Apnea Syndrome?

Background: This study aimed to investigate the relation of serum monocyte to serum HDL cholesterol ratio (MHR) with obstructive sleep apnea syndrome (OSAS). A total of 62 patients with an apnea hypopnea index (AHI > 5) and excessive daytime sleepiness were included in this study as OSAS group. The individuals with (AHI) < 5/h were included in the study as controls. OSAS patients were compared with the control group for high density lipoprotein (HDL) levels, serum monocyte count, and monocyte to HDL ratio (MHR). Mild, moderate and severe OSAS subgroups were compared for the same parameters. Results: MHR was 11.93 ± 6.52 in the control group while it was 14.87 ± 6.98 in OSAS group, with a statistically significant difference in between them (p= 0.016). The MHR were positively correlated with AHI and the minimum oxygen saturation (p = 0.003 and p = 0.012, respectively). Conclusion: serum monocyte to serum HDL cholesterol ratio increased as OSAS severity increased. MHR is an easy and available biomarker. It can be used as a new marker for severity of OSAS

Genomic and Proteomic Study of the Inflammatory Pathway in Patients With Atrial Fibrillation and Cardiometabolic Syndrome.

Atrial fibrillation (AF) and cardiometabolic syndrome (CMS) have been linked to inflammation and fibrosis. However, it is still unknown which inflammatory cytokines contribute to the pathogenesis of AF. Furthermore, cardiometabolic syndrome (CMS) risk factors such as obesity, hypertension, insulin resistance/glucose intolerance are also associated with inflammation and increased level of cytokines and adipokines. We hypothesized that the inflammatory immune response is exacerbated in patients with both AF and CMS compared to either AF or CMS alone. We investigated inflammatory cytokines and fibrotic markers as well as cytokine genetic profiles in patients with lone AF and CMS. CMS, lone AF patients, patients with both lone AF and CMS, and control patients were recruited. Genetic polymorphisms in inflammatory and fibrotic markers were assessed. Serum levels of connective tissue growth factor (CTGF) were tested along with other inflammatory markers including platelet-to-lymphocyte ratio (PLR), monocyte-to-HDL ratio (MHR) in three groups of AF+CMS, AF, and CMS patients. There was a trend in the CTGF levels for statistical significance between the AF and AF+CMS group (P = 0.084). Genotyping showed high percentages of patients in all groups with high secretor genotypes of Interleukin-6 (IL-6) (P = 0.037). Genotyping of IFN-γ and IL-10 at high level showed an increase in expression in the AF + CMS group compared to AF and CMS alone suggesting an imbalance between the inflammatory and anti-inflammatory cytokines which is exacerbated by AF. Serum cytokine inflammatory cytokine levels showed that IL-4, IL-5, IL-10, IL-17F, and IL-22 were significant between the AF, AF+CMS, and CMS patients. Combination of both CMS and AF may be associated with a higher degree of inflammation than what is seen in either CMS or AF alone. Thus, the identification of a biomarker capable of identifying metabolic syndrome associated with disease will help in identification of a therapeutic target in treating this devastating disease.

Diagnostic value of monocyte to high-density lipoprotein ratio in acute aortic dissection in a Chinese han population

ABSTRACT Background: Recently, considerable evidence pointed out monocyte to high-density lipoprotein ratio (MHR) is highly related to inflammatory related diseases. We aim to explore the level of MHR in acute aortic dissection (AAD) patients and determine whether MHR can be a novel diagnostic marker of AAD. Research design and methods: A total of 228 subjects including 128 AAD patients and 110 healthy control were enrolled. MHR levels and other serum samples were obtained at admission. Results: The baseline MHR levels were significantly higher in patients with AAD (p < 0.0001). A cutoff value of MHR >0.37 was associated with a sensitivity of 86.70% and a specificity of 93.60% for AAD. MHR levels were positively correlated with the time from symptom onset (R2 = 0.0318, p = 0.0003). Additionally, the area under the curve (AUC) was increased to 0.979 in patients whose time from onset of symptoms >24 h, with a sensitivity of 98.04% and a specificity of 93.64%. Multivariate logistic regression demonstrated that MHR levels, history of hypertension, and coronary artery disease (CHD) emerged as independent predictors of AAD. Expert Opinion: MHR has a high diagnostic value in AAD patients, especially in those whose time from onset of symptoms >24 h.

Inflammatory Markers Predicting Pathological Complete Response in Cases with Breast Cancer Treated by Neoadjuvant Chemotherapy.

Response to neoadjuvant chemotherapy (NAC) is predictive for survival times in some patients with breast cancer (BC). The aim of this study is to explore the predictive value of some inflammatory markers including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-high density lipoprotein ratio (MHR) and prognostic nutritional index (PNI) in cases with BC treated with NAC. One hundred and ten patients with BC treated with NAC were included in the study. Measurements for NLR, dNLR, MHR and PNI were calculated with available formulas. The value of NLR, dNLR, MHR and PNI in predicting pCR to NAC in BC was analyzed using receiver operating characteristic (ROC) curve analysis. All analyses were performed using the SPSS statistical software package (SPSS statistics 21.0). Mean NLR values were 2.2±0.8 vs. 2.6±1.3 for pCR (+) and pCR (-) groups (p=0.603). Mean dNLR values were 1.5±0.5 vs. 1.9±0.8 for pCR (+) and pCR (-) groups, respectively and this was statistically significant (p=0.022). Mean MHR values were 15.4±17.2 vs. 13.2±10.1 for pCR (+) and pCR (-) groups (p=0.406). Mean PNI values were 52±5.1 vs. 49±5.8 for pCR (+) and pCR (-) groups, and this was statistically significant (p=0.015). In multiple logistic regression analysis PNI was found to be independent factor for pCR. In this study pre-treatment dNLR and PNI were found to be predictive for pCR while NLR and MHR were not found to be associated with pCR. PNI and dNLR are simple but useful biomarkers predicting response to NAC.

Lipid profile and atherogenic indices in patients with stable chronic obstructive pulmonary disease

Background and aimsLimited number of studies investigated lipid profile in chronic obstructive pulmonary disease (COPD) with inconsistent results. This study aimed to investigate lipid parameters in sera of patients with stable COPD and their associations with disease severity, smoking, comorbidities and therapy. Methods and resultsThe study included 137 COPD patients and 95 controls. Triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed. Non-HDL-C (NHC), atherogenic coefficient (AC), TG/HDL-C, atherogenic index of plasma (AIP), Castelli's risk index I and II (CRI-I, CRI-II), and monocyte to HDL ratio (MHR) were calculated.HDL-C and MHR were increased, while other lipid parameters and indices were decreased in COPD patients compared to healthy individuals. Smoking did not influence lipid parameters. However, lipid profile was altered only in more severe disease stages. AC, CRI-I and CRI-II showed positive association with lung function parameters in COPD patients, and negative with COPD multicomponent indices (ADO, BODCAT, BODEx, CODEx and DOSE). Combined model that included CRI-II, C-reactive protein, fibrinogen and white blood cells showed great diagnostic performances, and correctly classified 72% of study participants with an AUC of 0.800 (0.742–0.849), P < 0.001. Bronchodilator monotherapy and statins have opposite impact on TC, LDL-C and NHC, while TG, TG/HDL-C and AIP were increased in COPD patients with cardiovascular diseases. ConclusionLipid disbalance is present in COPD, and it seems to occur later as the disease progresses. Further studies are needed to illuminate the underlying mechanism of dyslipidaemia.

Monosit/yüksek-dansiteli lipoprotein oranının st elevasyonu olmayan miyokard enfarktüslü hastalarda kontrasta bağlı nefropatiyle ilişkisi

Aim: Contrast-induced nephropathy (CIN) is associated with worse prognosis in patients with non-ST-elevation myocardial infarction (NSTEMI). Early identification patients with a high risk of CIN are very crucial to improve outcomes. The monocyte to high-density lipoprotein ratio (MHR) is a novel inflammatory marker. We aimed to investigate the MHR had a predictive role for CIN development in patients with NSTEMI. Material and Methods: NSTEMI who underwent percutaneous coronary intervention (PCI) were included in the study. MHR was calculated and CIN was defined as an increase in serum creatinine 25% or 0.5 mg/dl from baseline in the first 48- 72 hours. Results: A total of 370(200, 54.1% men) patients were included in this study and 104 (28.1%) of them had DM. 25 (6.7%) of patients had CIN. MHR was significantly higher in patients with CIN (0.014± 0.004 vs 0.011± 0.006-respectively, p: 0.017). MHR was also significantly correlated with creatinine levels after PCI (r:0,104, p: 0.047). CIN group also experienced a more complicated in-hospital clinical course. Additionally; weight and MHR were detected as independent risk factors of CIN in logistic regression analysis.Conclusion: Preprocedural MHR may be used as cheap, easy and simple marker of CIN. It may help with the early identification of patients with NSTEMI who are at high risk of CIN.

Gender, BMI and fasting hyperglycaemia influence Monocyte to-HDL ratio (MHR) index in metabolic subjects.

Metabolic Syndrome (MS) is characterized by a low-grade inflammatory state causing an alteration of non-invasive indexes derived from blood count, namely monocyte-to-HDL ratio (MHR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR). We analyse a population of 771 subjects (394 controls and 377 MS patients) to evaluate the best predictive index of MS. The diagnosis of MS was made according to the 2006 criteria of the International Diabetes Federation (IDF). We performed ROC curve analyses to evaluate the best predictor index of MS. MHR cut-off value was used to classify the population in two different groups and to create the outcome variable of the Recursive Partitioning and Amalgamation (RECPAM) analysis. This method is a tree-structured approach that defines "risk profiles" for each group of dichotomous variables. We showed that MHR index is significantly linked to body mass index (BMI), waist circumference, creatinine, C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR). ROC curve defined an MHR cut-off value of 6.4, which was able to identify two patient groups with significant differences in waist circumference, blood pressure, creatinine, estimated glomerular filtration rate and fasting plasma glucose. RECPAM analysis demonstrated that gender, BMI categorization and hyperglycaemia were the most important risk determinants of increased MHR index that can be considered bona fide a useful and easily obtainable tool to suggest the presence of peculiar metabolic features that predict MS.

Monocyte to High-Density Lipoprotein Ratio (MHR) as a predictor of mortality and Major Adverse Cardiovascular Events (MACE) among ST Elevation Myocardial Infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis

BackgroundMonocyte to High Density Lipoprotein Ratio (MHR) is a new marker that has been associated with major adverse cardiovascular outcomes among STEMI patients. We sought to strengthen the association between MHR and mortality and major adverse cardiovascular events (MACEs) among STEMI patients who underwent primary percutaneous coronary intervention.MethodsStudies were included if they satisfied the following criteria:1) Observational Studies; 2) Adult patients with ST-elevation Myocardial Infarction (STEMI) who underwent primary percutaneous intervention (PCI); and 3) Reported data on mortality and major adverse cardiovascular events. Using MEDLINE, Clinical Key, Science Direct, Scopus, and Cochrane Central Register of Controlled Trials databases, a search for eligible studies was conducted until September 2017. Our primary outcome of interest was all-cause cardiovascular (CV) mortality. We also investigated the association between MHR and major adverse cardiovascular events (MACEs).ResultsWe identified 3 studies involving 2793 STEMI patients, showing that in STEMI patients who underwent primary PCI, a high admission MHR is associated with a significantly higher in-hospital mortality [RR 4.71, (95% CI 2.36 to 9.39, p < 0.00001] and in-hospital MACE [RR 1.90, (95% CI 1.44 to 2.50), p < 0.00001]. This significant association was not observed in long term mortality or MACE.ConclusionA high admission MHR among STEMI patients who underwent primary PCI is associated with a higher in-hospital mortality and MACE. This novel marker can be used as an inexpensive and readily available tool for risk stratification.

Neutrophil to Lymphocyte Ratio (NLR) is a Better Tool Rather than Monocyte to High-Density Lipoprotein Ratio (MHR) and Platelet to Lymphocyte Ratio (PLR) in Central Retinal Artery Occlusions

ABSTRACT Purpose: To evaluate the predictive value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to high-density lipoprotein (HDL) ratio (MHR) and blood lipid profile in central retinal artery occlusion (CRAO) patients. Methods: We included 37 patients with a diagnosis of CRAO and 36 healthy subjects with similar age-sex in the study. We analyzed the medical records of peripheral blood samples retrospectively. NLR, PLR, MHR were obtained by simple manually calculations. Results: CRAO patients had significantly higher mean NLR in comparison with healthy subjects (p: 0.009). The groups were similar in regard to mean PLR (p: 0.864) and mean MHR (p: 0.581). A cutoff value of >1.62 for NLR was found to be a diagnostic tool in CRAO. The sensitivity and specificity for this cutoff point was 83.8% and 55.6%, respectively. Conclusion: NLR rather than MHR and PLR may be a beneficial marker for the development of CRAO.

The association between monocyte to high-density lipoprotein ratio and hemorrhagic transformation in patients with acute ischemic stroke.

Hemorrhagic transformation (HT) is a common complication in patients with acute ischemic stroke. We investigated whether the monocyte to high-density lipoprotein ratio (MHR) is related to HT. Consecutive patients with ischemic stroke within 24 h of symptom onset were included in this study. HT was diagnosed by follow-up brain imaging after admission, and was classified as asymptomatic or symptomatic according to whether patients showed any neurologic worsening. Logistic regression was performed to estimate the association between MHR and HT. Of the 974 enrolled patients, 148 (15.2%) developed HT, and 24 (2.5%) patients experienced symptomatic HT. Compared to the highest MHR tertile (> 0.37), the lowest MHR tertile (< 0.22) was associated with 1.81-fold increase (95% CI 1.08-3.01, P = 0.024) in the odds of HT and 3.82-fold increase (95% CI 1.04-14.00, P = 0.043) in the odds of symptomatic HT after adjustment for possible confounders. Using a multivariate logistic regression model with restricted cubic spline, we found that elevated MHR was associated with a decreased risk of HT and symptomatic HT. In summary, lower MHR was independently associated with increased risk of HT and symptomatic HT in patients with ischemic stroke.

Prognostic Utility of Monocyte to High-Density Lipoprotein Ratio in Patients With Acute Coronary Syndrome: A Meta-Analysis

BackgroundThe monocyte to high-density lipoprotein ratio (MHR) has been used to predict adverse clinical outcomes in patients with acute coronary syndrome (ACS). This meta-analysis aimed to evaluate the prognostic utility of MHR in patients with ACS. Materials and MethodsWe comprehensively searched for relevant studies in Pubmed, Embase, CNKI, WanFang and VIP databases until March 12, 2019. Epidemiologic studies investigating the association between MHR and major adverse cardiovascular events (MACE) or all-cause mortality in patients with ACS were included. Pooled effect was expressed as risk ratios (RR) with 95% confidence intervals (CI) for the highest versus the reference lower MHR group. ResultsEight studies involving 6,480 patients with ACS were included and analyzed. Meta-analysis indicated that the highest MHR was significantly associated with higher risk of MACE (RR 1.65; 95%CI 1.36-2.02) and all-cause mortality (RR 2.61; 95%CI 1.29-4.89) after adjusting for the conventional confounders. The prognostic values of MACE with the highest MHR caused no significant changes in the in-hospital follow-up (RR 1.76; 95%CI 1.34-2.32) and >6 months follow-up (RR 1.68; 95%CI 1.08-2.62) subgroups. Furthermore, ST elevation myocardial infarction patients with the highest MHR had a 2.07-fold higher risk of in-hospital MACE (RR 2.07; 95%CI 1.52-2.80). ConclusionsElevated MHR is independently associated with an increased risk of MACE and all-cause mortality in patients with ACS. MHR may serve as a potential prognostic indicator for ACS prognosis.

HIGH RATIO OF MONOSIT: HIGH-DENSITY LIPOPROTEIN AS A RISK FACTOR OFCHRONIC TOTAL OCCLUSION IN PATIENTS CORONARY ARTERY DISEASE

Objective: Chronic total occlusion (CTO) is frequently found in coronary heart disease (CHD) with multivessel lesions. Patients with CTO are associated with an increased mortality rate. Management CTO requires specialized techniques, more resource utilization, and high cost. The progression of atherosclerosis can be prevented by controlling for risk factors. Monocyte to high-density lipoprotein ratio (MHR) is one of the new biomarkers used to assess the incidence of a major adverse cardiovascular event, the severity of coronary lesions, and the incidence of in-stent restenosis. This study was aimed to determine the role of MHR levels as a risk factor for the occurrence of CTO in CAD patients.&#x0D; Methods: This research is a matched case–control located in Sanglah General Hospital from August 2017 until October 2017. This research consisted of 47 cases with CTO and 47 control without CTO. Case and control samples were adjusted by sex, age, and number of blood vessels involved in CAD.&#x0D; Results: The cutoff value of MHR was also determined by analyzing the receiver operating curve. The optimal cut off point was 14.33 with sensitivity 83% and specificity 80.9%. Bivariate analysis showed high MHR was found strongly associated with the risk of CTO in CHD patients with odds ratio (OR)=61; IK 95% (OR)=3.211–114.15; p≤0.001. Multivariate analysis showed that high levels of MHR were significantly associated with risk of CTO after other traditional risk factors such as hypertension, diabetes mellitus, dyslipidemia, and smoking were controlled with OR=20,306; 95% IK (OR)=6.05–68.05; p≤0.001.&#x0D; Conclusion: High levels of MHR were significantly associated with the risk factor of CTO in CAD patients.

Monocyte-to-High-Density Lipoprotein Ratio Predicts the Outcome of Acute Ischemic Stroke.

Aim: Monocyte-to-high-density lipoprotein ratio (MHR) recently emerged as an inflammatory marker and has been reported to be a novel prognostic indicator of cardiovascular diseases. However, the relationship between MHR and prognosis of acute ischemic stroke (AIS) remains unclear.Methods: Consecutive AIS patients were prospectively identified from January 2015 to December 2017. Functional outcome was evaluated by the modified Rankin Scale (mRS). Poor outcome was defined as of mRS 3–6. Multivariate logistic regression analysis was conducted to evaluate the relationship between MHR and poor outcome.Results: A total of 1090 AIS patients within 24 hours of the onset of symptoms were recruited. MHR was higher in poor outcome group compared to that in good outcome group [0.53 (0.37–0.69) vs. 0.48 (0.33–0.60), P = 0.007]. Multivariate logistic regression analysis indicated that higher MHR level was independently associated with the poor outcome at 3 months (OR 2.58, 95% CI, 1.21–5.51, P = 0.015), especially the stroke subtype of large artery atherosclerosis (OR 2.52, 95% CI, 1.03–6.19, P = 0.034). Receiver operating curve (ROC) analysis showed that the area under the ROC curves for MHR was 0.67 and the best predictive cutoff value of MHR was 0.51, with a sensitivity of 62.3% and a specificity of 66.5%.Conclusions: MHR may be a significant and independent predictor of poor functional outcome in patients with AIS.

Does tadalafil 5 mg/day affect lymphocyte to monocyte and monocyte to high-density lipoprotein ratios in patients with erectile dysfunction?

Aim: To investigate the effects of using 5 mg/day tadalafil on inflammatory indicators including lymphocyte to monocyte ratio (LMR) and monocyte to high-density lipoprotein ratio (MHR) in patients with erectile dysfunction (ED).Material and Methods: This retrospective study included 62 subjects that 31 patients with ED and 31 healthy controls with a normal erectile function. The patients with ED were given a daily 5 mg dose of tadalafil over eight weeks. Baseline and post-treatment erectile function was evaluated using the International Index of Erectile Function (IIEF-5). Changes in IIEF-5 score and inflammatory indicators including LMR and MHR have compared both in ED patients and with controls.Results: The patients and the controls were statistically comparable with respect to age, Diabetes Mellitus, hypertension, coronary artery disease, CRP, testosterone, serum creatinine, lipid profile, LMR, and MHR. The mean IIEF-5 score was 22.97 vs 14.32 (p=0.001) in control and patients with ED, respectively. Having been used 5 mg of tadalafil per day over 8 weeks, an increase in IIEF-5 score (p=0.001) and a decrease in the number of monocytes (p=0.008) were detected in patients with ED. However, there was no statistically significant difference found in LMR and MHR before and after the treatment.Conclusion: According to the results of this study, no significant effect was found daily use of 5mg tadalafil on inflammatory indicators including LMR and MHR. The decrease in the number of monocytes that play a key role in inflammation may have been considered a response to treatment, however, randomized prospective studies are needed to evaluate the relationship among LMR, MHR and tadalafil treatment.

Monocyte to high-density lipoprotein ratio (MHR) as a predictor of mortality and major adverse cardiovascular events (Mace) among ST elevation myocardial infarction (Stemi) patients undergoing primary percutaneous coronary intervention: A meta-analysis

Monocyte to high-density lipoprotein ratio (MHR) as a predictor of mortality and major adverse cardiovascular events (Mace) among ST elevation myocardial infarction (Stemi) patients undergoing primary percutaneous coronary intervention: A meta-analysis

Novel inflammatory biomarkers may reflect subclinical inflammation in young healthy adults with obesity.

Obesity is often accompanied by low-grade inflammation. In recent years a few blood-based inflammatory markers - neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein ratio (MHR) - have been identified. They have been proven to correlate well with established inflammatory markers such as hsCRP and have a prognostic value among others in patients with coronary artery disease, heart failure, and malignancies. The aim of the study was to find markers associated with obesity in young heathy adults. The study group included 321 young healthy adults aged 18-35 years (210 males and 111 females). Partial least squares regression analysis was used to find variables associated with body mass index (BMI), except MHR. Analysed variables included complete blood count, lipid profile, sex hormone levels, acute-phase protein levels, and blood-based inflammatory markers. Variables with the strongest association with BMI in the group of men were HDL% and apolipoprotein B, and in the group of women, HDL, HDL%, triglycerides, and MHR. Novel inflammatory markers were not associated with BMI. We found significant (p < 0.001) correlations between novel biomarkers (NLR, dNLR) and hsCRP and fibrinogen levels in the group of subjects with obesity. Blood-based inflammatory markers significantly correlate with hsCRP and fibrinogen in young healthy adults with obesity, which may reflect the subclinical inflammation in this group of individuals.

The Relation Between Monocyte to High-Density Lipoprotein Cholesterol Ratio and Short Term Outcome in Patients with Acute ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

AbstractBackground: Ischemic heart disease is considered the most common cause of death worldwide. Inflammation and oxidative stress play an important role in the pathogenesis of all phases of atherosclerosis and atherosclerotic plaque rupture which are the main mechanisms in the pathophysiology of acute ST-segment elevation myocardial infarction (STEMI). Monocyte to HDL ratio (MHR) was defined as a novel potential marker to determine inflammation and used to predict clinical outcome in patients with STEMI.Objectives: To study the relation between monocyte to high-density lipoprotein cholesterol ratio and short-term outcome in patients with acute ST-segment elevation myocar-dial infarction undergoing primary percutaneous coronary intervention (PCI).Methods: This study was conducted on a number of 100 patients diagnosed with STEMI and underwent primary PCI in Tanta University Hospitals, Cardiovascular Department, from June 2017 to December 2017. The primary end points were all cause mortality and major adverse cardiovascular events (MACE) including a composite of death, nonfatal re-infarction, target vessel re-vascularization, or new onset congestive heart failure during hospitalization and during the 3-months clinical follow-up.Patients were divided into 3 tertiles according to the monocyte to high- density lipoprotein cholesterol ratio (MHR); Tertile 1: MHR20 (number of patients=23).Results: Patients in the high MHR tertile showed signif-icantly lower systolic blood pressure, higher Killip class II-IV, lower final angiographic TIMI flow, higher WBCs, neu-trophils and monocytes count, higher serum LDL level and lower HDL levels, higher ejection fraction, higher all the composite endpoints of MACE including death, reinfarction and CHF. The study showed that MHR level >12.3 predicted the overall MACE following STEMI with a sensitivity and specificity above 75%. Conclusion: Monocyte to high-density lipoprotein cho-lesterol ratio is an independent prognostic factor for both in-hospital adverse outcomes, as well as, short-term adverse outcomes among STEMI patients who underwent primary PCI.

Association of monocyte to high-density lipoprotein ratio with bare-metal stent restenosis in STEMI patients treated with primary PCI.

OBJECTIVE:Monocyte to high-density lipoprotein ratio (MHR) has recently been postulated as a novel parameter related to adverse cardiovascular outcomes. In this study, we aimed to investigate the correlation of MHR with stent restenosis (SR) rates after the primary percutaneous coronary intervention (PCI) and bare-metal stent (BMS) implantation.METHODS:In this study, patients who had undergone primary PCI for STEMI and had a control angiogram during follow-up were retrospectively recruited. Patients were categorized according to admission MHR tertiles, clinical and angiographic data were compared. In addition, predictors of SR were evaluated with logistic regression analysis.RESULTS:A total number of 448 patients (240 patients with SR and 208 patients without SR) were included in this study. Patients were categorized into three groups according to tertiles of admission MHR. During a follow-up period of median 12 months, the rate of SR was significantly higher in patients with higher MHR levels (45% in tertile 1, 54% in tertile 2 and 62% in tertile 3, p<0.01). In multivariate Cox regression analysis, male gender, stent length, admission NLR levels and MHR levels (HR 1.03, 95% CI 1.02–1.06, p<0.01) remained as the independent predictors of SR in the study population.CONCLUSION:Gender, stent length, higher MHR and NLR levels are correlated to SR after primary PCI.

Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy.

The monocyte-to-high density lipoprotein ratio (MHR) has recently been implemented as an indicator of inflammation and oxidative stress. The present study characterized MHR in patients with diabetic polyneuropathy (DPN), in which oxidative stress and microvascular damage play a role in pathogenesis, relative to patients with non-DPN, diabetic patients without polyneuropathy, and healthy individuals. We further aimed to evaluate the association between MHR and the decreased compound muscle action potential (CMAP) amplitude of patients with diabetic axonal polyneuropathy.We enrolled 90 patients with DPN, 75 patients with nonDPN, 92 diabetic patients without polyneuropathy, and 67 healthy individuals; The monocyte, high-density lipoprotein cholesterol (HDL-C) values were obtained for all participants and MHR was calculated for each individual. Intergroup comparison was performed. The relationship between MHR and the posterior tibial nerve CMAP amplitudes was examined.Statistically significant negative correlation was observed between MHR and the posterior tibial nerve CMAP amplitudes of patients with DPN. The MHR values of the patients with DPN were significantly higher than those of the patients with non-DPN, diabetic patients without polyneuropathy and the control group.This study demonstrated that diabetic patients with higher MHR values may be more likely to develop polyneuropathy.