Study On The Correlation Between MHR And Plaque Stability Based On Intravascular Ultrasound

Objective Intravenous ultrasound(IVUS)was used to investigate the correlation between the monocyte to high density lipoprotein cholesterol ratio(MHR)and the stability of coronary atherosclerotic plaques。To evaluate the predictive value of MHR in 12 months of major adverse cardiovascular events(MACEs)in patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 132 patients with coronary heart disease who underwent PCI and IVUS in the First Affiliated Hospital of Bengbu Medical College from June 2017 to June 2019 were selected.Clinical data of patients were recorded in detail after admission:gender,age,history of hypertension,Diabetes history,smoking history,left ventricular ejection fractions,neutrophil count,monocyte count,total cholesterol,triglycerides,low density lipoprotein cholesterol,high density lipoprotein cholesterol,C-reactive protein,and the value of MHR was calculated.Patients were regularly followed up for 12 months to record the occurrence of MACES: cardiac death,target vessel re-revascularization,non-fatal myocardial infarction,stent restenosis,stent thrombosis,etc.In order to identify the plaque stability of culprit vessels,we analyzed IVUS images and divided the results into stable plaque group(n=35)and unstable plaque group(n=97).In order to identify the plaque stability of culprit vessels,we analyzed IVUS images and divided the results into stable plaque group(n=35)and unstable plaque group(n=97).To evaluate the diagnostic value of MHR in coronary heart disease patients with plaque stability,and to analyze the correlation between MHR and MACE occurrence within 12 months after PCI.Results 1.According to the analysis of the baseline data of the enrolled patients,the average age,percentage of smoking,proportion of diabetes history and the value of monocyte count,HDL-C,MHR,CRP of the patients in unstable group are significantly higher than those of the plaque stable group(P<0.05).There were differences statistically significant(all P<0.05).There were no significant differences between the two groups in gender,proportion of hypertension,systolic blood pressure,diastolic blood pressure,LVEF,neutrophil ratio,total cholesterol,triglyceride,LDL-C and HDL-C indexes(all P>0.05).There was no statistical significance in the number of stents implanted,the length of stents,the diameter of stents,the proportion of criminal vessels and the IVUS index between the two groups(all P>0.05).2.In order to compare the value of neutrophil count,monocyte count,total cholesterol,triglycerides,LDL-C,HDL-C,MHR,CRP and MHR combined with CRP in assessing plaque stability,we performed ROC curve analysis.The results showed that the area under the curve of neutrophil count,monocyte count,total cholesterol,triglyceride,LDL-C,HDL-C were all less than 0.7,and the area under the curve of MHR,CRP and MHR combined with CRP were 0.726,0.710 and 0.732 respectively.3.The ROC curve was used to analyze the predictive power of MHR levels for MACE in patients with coronary heart disease within 12 months after PCI.The area under the curve is 0.794(95%CI: 0.715～0.859,P<0.001),and the cut-off point is at The prediction was the largest at 19.31,with a diagnostic sensitivity of 68.42% and a specificity of 83.19%.4.The common clinical cardiovascular risk factors were subjected to single-factor Logistic regression analysis,and the results showed that smoking,type 2diabetes,LDL-C,HDL-C,CRP,MHR and coronary atherosclerotic plaque stability were significant Correlation(P<0.05).Incorporating the above indicators and further performing multivariate logistic regression analysis,the results showed that type 2 diabetes,CRP,and MHR are independent risk factors for unstable coronary atherosclerotic plaque(P<0.05).Conclusion MHR has diagnostic value for the stability of plaque in patients with coronary heart disease,is an independent risk factor for unstable plaque,and has predictive value for the occurrence of MACE 12 months after PCI in patients with coronary heart disease.