Association Between Monocyte To High Density Lipoprotein Cholesterol Ratio And Formation Of Coronary Collateral Circulation

Objective: To study the relationship between monocyte to high density lipoprotein cholesterol ratio(MHR)and the formation of CCC in patients with chronic total occlusion(CTO).Materials and methods: a total of 383 patients with chronic occlusion of at least one major coronary artery(left anterior descending branch,circumflex branch and right coronary artery)were selected from January 2016 to December 2018 who met the later criteria and underwent coronary angiography.Selection criteria: 1)meet the CTO diagnostic criteria formulated by the American Heart Association(AHA)/ American Heart Association(ACC)in 2007;2)have complete clinical data.Exclusion criteria: 1)previous coronary intervention or coronary bypass grafting;2)coronary artery malformation or myocardial bridge;3)acute coronary syndrome,acute / chronic infection,blood system disease,malignant tumor,rheumatic immune disease,peripheral vascular disease.The basic clinical data,auxiliary examination data and coronary angiography data were collected.MHR was calculated according to blood routine and blood lipid.According to the results of coronary angiography,the patients were divided into two groups according to Rentrop grading standard: the group with poor CCC(Rentrop 0-1,n = 231)and the group with good CCC(Rentrop 2-3,n = 152).Spss25.0 and graphpad prism 7.0 were used for statistical analysis.If the measurement data conform to the normal distribution,± s is used,and independent sample t test is used for the comparison between groups;if the normal distribution is not conformed,m(Q25,Q75)is used,and Mann Whitney U test or Kruskal Wallis rank sum test is used for the comparison between groups.The counting data were expressed by n(%),and the comparison between groups was made by test or Fisher exact probability method.Binary logistic regression analysis was used to study the independent factors influencing the formation of coronary collateral circulation.When p < 0.05,the difference was statistically significant.Results: There were significant statistical differences in sex ratio[76.3% vs 64.5%,P=0.014],diabetes mellitus ratio[36.8% vs 50.6%,P=0.008],white blood cells [6.66(5.92,7.69)vs 6.38(5.49,7.30),P=0.029],monocytes[0.39(0.39,0.46)vs 0.36(0.29,0.45),P=0.032],cholesterol[4.26(3.59,5.20)vs 4.07(3.26,4.75),P=0.033] and MHR[0.40(0.32,0.46)vs 0.34(0.25,0.43),P=0.016] between poor CCC group and good CCC group.Multivariate logistic regression analysis showed that diabetes mellitus[OR:1.755,95%CI:1.139-2.706;P=0.011] and MHR[OR:7.832,95%CI:1.326-46.278;P=0.023] were independent influencing factors of collateral circulation,and there was a positive correlation between MHR and collateral circulation grade [r=-0.273,P<0.05].Conclusion: 1.In CTO patients,MHR level is negatively correlated with CCC formation,MHR and diabetes mellitus are independent risk factors for poor CCC formation.2.It is possible to promote the formation and development of CCC by regulating inflammatory reaction in CTO patients who can not reconstruct blood supply by intervention or surgery.Therefore,it is necessary to further explore the pathophysiological mechanism and influencing factors of CCC formation,and to find a simple and easy method for CCC evaluation.