Research On The Association Of Monocyte/Lymphocyte Ratio With The Severity Of Coronary Artery Disease And The Function Of Left Ventricular

Objectives:To investigate the association of monocyte/lymphocyte ratio with the severity of coronary artery disease and the left function of ventricular of patients with the cornary heart disease(CHD).Methods:A total of 668 patients(age range:29-93,mean age:63.57±11.06)who undergone Coronary angiography(CAG)in The First Affiliated Hospital of Soochow University from January 2017 to March 2018 were enrollMed in the study.490 of those patients which account for 73.4%are male(mean age:62.37± 11.34),and the rest 178 patients are female(mean age:66.89+9.52).Those patients were divided into groups of stable angina,unstable angina and acute myocardial infarction based on the clinical circumstance.The related clinical data of all patients was collected:the blood routine examination results before the CAG operation of patients within 24 hours after admission,thecalculated MLR,the biochemical criterion and Hypersensitive-troponin I(hs-cTnI),theN-terminalpro-B-typenatriureticpeptide(NT-ProBNP),the echocardiography and the calculated scores of the Left ventricular ejection fraction(LVEF),and the Gensini score based on the evaluation of the coronary angiography.Accoding to the MLR level,those patients were divided into two groups including the high MLR group(MLR>0.31)and the low MLR group(?0.31).Results:1.The following results were caused by comparing the differences of the severity of coronary lesions and the Gensini score between among different MLR levels and analyzing the relationship between the MLR and the Gensini score,LVEF and NT-ProBNP.1)Among the six hundred and sixty-eight patients,the high MLR group showed higher proportion of male(P=0.008),higher NT-ProBNP level[556.00(137.50,2345.00)vs 124.00(54.00,345.00),P<0.001]and Hs-cTnI level[1.31(0.01,27.95)vs 0.01(0.01,3.00),P<0.001],and lower LVEF[(56.43.± 10.59)vs(62.65±8.42),P<0.001]than the low MLR group.In the comparison of the severity of coronary artery,the high MLR group displayed higher proportion of multi-vessel lesions and left main trunk(LMT)than low MLR group,among which,the proportion of LMT,double-vessel lesions and thriple-vessel lesions were significantly higher(P=0.021,P<0.001 and P=0.002).The proportion of single-vessel lesions was lower than that of the group with low MLR level(P<0.001).Gensini scores were significantly higher in high MLR group than that in low MLR group[45.50(21.00,72.00)vs 24.00(12.00,47.75),P<0.001].The results showed that the MLR was positive correlated to the NT-ProBNP(r=0.406,P<0.001)and Gensini score(r=0.304,P<0.001),and negative correlated to the LVEF(r=-0.336,P<0.001).2.In the SAP group,the proportion of male and the monocyte counts were higher,while the lymphocyte counts were lower in high MLR group than those in the low MLR group(P=0.009).There was no significant difference in coronary artery lesions between the two groups(P>0.05).The results showed that the MLR was unrelated to the LVEF,NT-ProBNP and Gensini score.3.In the UA group,compared with the low MLR group,the high MLR group showed older age(P=0.011),higher NT-ProBNP level(P=0.024)and lower LVEF(P=0.046).In the aspect of severity of coronary lesions,the proportion of single-vessel lesion was lower in the high MLR group(P<0.001),while the proportion of multi-vessel lesions and LMT were higher(double-vessel lesions P=0.039,thriple-vessel lesions P=0.023 and LMT P=0.001).The Gensini score was significantly higher in high MLR group than that in the low MLR group(P=0.003).The results showed that the MLR was positive correlated to the NT-ProBNP(r=0.315,P<0.001)and Gensini score(r=0.221,P=0.001),and negative correlated to the LVEF(r=-0.202,P=0.002).4.In the AMI group,compared with the low MLR group,the high MLR group had a higher proportion of diabetes(P=0.033),NT-ProBNP and Hs-cTnI levels(P=0.001 and P=0.001),and lower LVEF levels(P<0.001).In terms of the severity of coronary artery,the proportion of single-vessel lesion in the group with high MLR level was lower(P<0.001),and the proportion of double-vessel lesions(P=0.036)and triple-vessel lesions(P=0.015)were higher.There was no significant difference in LMT(P>0.05)between the two groups.Gensini score was significantly higher in the high MLR group than in the low MLR group(P=0.001).Correlation analysis showed that the MLR was positively correlated to the Gensini score(r=0.321,P<0.001)and NT-ProBNP(r=0.310,P<0.001),and negatively correlated to LVEF(r=-0.323,P<0.001).Conclusions:1.The severity of coronary artery lesionsin in CHD patients with high MLR level was more serious and showed higher Gensini score than those with low MLR level.MLR was positively correlated to the Gensini score.This phenomenon was shown in UA and AMI patients,but not SAP patients.2.There were significant differences between the levels of NT-ProBNP and LVEF in CHD patients with high MLR level and those with low MLR level.MLR was negatively correlated to LVEF and positively correlated to NT-ProBNP.This phenomenon was showed in patients with UA and AMI than in patients with SAP.