Value Of Monocyte To High-density Lipoprotein Cholesterol Ratio In Predicting In-hospital Death In Acute Type A Aortic Dissection

Objective:The ratio of monocyte to high-density lipoprotein cholesterol(MHR)is one of the novel inflammatory markers that has been shown to predict the prognosis of a variety of cardiovascular diseases.However,there are few studies on the relationship between MHR and aortic dissection.The purpose of this study was to investigate the correlation between MHR and in-hospital death in patients with acute type A aortic dissection(TAAD).Methods:A total of 141 subjects were included in this study.All patients were confirmed by aortic CTA and were divided into survival group(n=103)and death group(n=38)according to different discharge status.The general data,admission blood pressure,and heart rate of all patients were collected.Laboratory indicators such as blood routine,blood lipids,D-dimer and creatinine were recorded,and MHR values were calculated.MHR values and baseline data were compared between the two groups.Binary logistic regression was used to analyze the risk factors for in-hospital death of TAAD.The ROC curve was used to analyze the predictive value of MHR for in-hospital death of TAAD.Results:1.A total of 141 TAAD patients were included,including 103 patients in the survival group and 38 patients in the death group.The mortality rate during hospitalization was 27.0%(38/141).2.The MHR value in the death group was higher than that in the survival group(0.70±0.31 vs 0.51±0.24),and the difference was statistically significant(P<0.05).3.Binary logistic regression analysis showed that MHR might be a risk factor in-hospital death of TAAD,with the original OR value of 12.981(95%CI:2.874-58.637,P=0.001).After adjusting for systolic blood pressure,diastolic blood pressure,heart rate,white blood cell,platelet,and D-dimer,MHR was found to be independently associated with in-hospital death of TAAD,and the adjusted OR was10.868(95%CI:1.223-96.545,P=0.032).4.ROC curve showed that the cut-off value of MHR in predicting in-hospital death of TAAD was 0.707.The sensitivity was 55.3%,the specificity was 78.6%,and the area under the curve(AUC)was 0.672(95%CI:0.568-0.776,P=0.002).Conclusion:MHR levels were associated with in-hospital death of acute type A aortic dissection.MHR may be an independent predictor of in-hospital death in patients with acute type A aortic dissection,and has certain predictive value for short-term prognosis of patients with acute type A aortic dissection,which may help identify patients at high risk of in-hospital death.