Correlation Between Monocyte/High-Density Lipoprotein Cholesterol Ratio,Serum Total Bilirubin And Coronary Slow Flow Phenomenon

Objective:The objective of this study was to investigate the pathophysiological mechanism of monocyte/high-density lipoprotein cholesterol ratio(MHR)and serum total bilirubin(STB)in coronary slow flow phenomenon(CSFP)and its predictive value.Methods:Patients admitted to the cardiovascular department of our hospital due to chest pain from January 2019 to December 2021 were selected,and 160 cases were included as the subjects of this study after strict screening according to inclusion/exclusion criteria.According to the results of coronary angiography(CAG),troponin,electrocardiogram,heart color ultrasound,and TIMI blood flow grading,the patients were divided into two groups.The group with no coronary artery stenosis and normal blood flow was used as the control group,and the group with no coronary artery stenosis but slow blood flow was used as the observation group(CSFP group).General information such as height and weight of the two groups of patients were collected,and electrocardiogram,heart color ultrasound and other relevant examination data were collected.Peripheral blood cell count and classification,high density lipoprotein cholesterol(HDL-C),total cholesterol(TC),total bilirubin,triglyceride(TG),homocysteine(HCY),low density lipoprotein cholesterol(LDL-C)and other indicators were detected in the two groups,respectively.MHR and body mass index(BMI)were calculated,and the above indexes were analyzed statistically.The pathophysiological mechanism and predictive value of MHR and STB in the pathogenesis of CSFP were analyzed by comparing the general data and relevant examination data of the two groups.Results:1.The comparison of general data showed that compared with the control group,there were more males in CSFP group than females(P<0.05),the proportion of patients with smoking history was significantly higher than that without smoking history(P<0.05).There was no significant difference in age,BMI,drinking history,diabetes mellitus and hypertension between the two groups(P>0.05).2.Comparison of relevant examination data showed that RDW,MPV,HCY and TG levels in CSFP group were significantly higher than those in control group(P <0.05).There were no significant differences in HR,LVEF,WBC,LYM,NEUT,RBC,HCT,MCV,PLT,LDL-C and TC between the two groups(P > 0.05).3.In CSFP group,patients with single vessel slow blood flow were the most(n=49,accounting for 61.25%),followed by patients with double vessel slow blood flow(n=21,accounting for 26.25%)and patients with all three vessels slow blood flow were the least(n=10,accounting for 12.5%).Analysis of the vascularsites involved in CSFP showed that the right coronary artery(RCA)was involved in the vast majority of patients(n=61,accounting for 50.4%),followed by the left anterior descending(LAD)involved in patients(n=44,accounting for 36.4%),and the left circumflex artery(LCX)was least involved(n=16,accounting for 13.2%).4.There was no significant correlation between MHR and STB(P>0.05).Compared with the two groups,the MHR value of CSFP group was significantly higher than that of control group,and the difference was statistically significant(P<0.05).The ROC curve of MHR showed that the best cut-off value of MHR was 0.54,the area under the curve was0.602,the sensitivity was 0.3,and the specificity was 0.887,P=0.027.Compared with the two groups,the STB value of the CSFP group was significantly lower than that of the control group,and the difference was statiscally significant(P<0.05).The reduction of STB could lead to CSFP.Therefore,ROC curve was drawn according to the reciprocal of STB.The results showed that the best cut-off value of STB was 12.25,the area under the curve was 0.675,the corresponding sensitivity was 0.5,and the specificity was 0.8,P=0.000.5.Binary logistic regression analysis showed that male(OR=4.059,P=0.015),HCY(OR=1.087,P=0.034),RDW(OR=3.031,P=0.023),MPV(OR=1.607,P=0.035),and MHR(OR=10.091,P=0.041)were independent risk factors for the occurrence of CSFP,while STB(OR=0.911,P=0.028)was an independent protective factor for the occurrence of CSFP,with a statistically significant difference(P<0.05).Conclusion:There was no significant correlation between MHR and STB.MHR and STB can be important predictors of CSFP,MHR is an independent risk factor for CSFP,the higher the MHR,the higher the risk of CSFP,STB is an independent protective factor for CSFP,within a certain range,the higher the STB,the lower the risk of CSFP.