The Correlation Between Monocyte/High Density Lipoprotein And Clinical SYNTAX Scores In Coronary Heart Disease

Object:To study the correlation between monocyte / high density lipoprotein and other inflammatory indexes and clinical SYNTAX score in patients with coronary heart disease,so as to provide an certain valuable reference for predicting the severity and risk stratification of coronary artery disease in patients with coronary heart disease.Methods:A total of 204 patients with coronary heart disease(CHD)diagnosed by coronary angiography were collected from November 2017 to September 2018 in Dongguan Branch,affiliated Hospital of Yan'an University.Divided into two groups by clinical type:There were 85 patients with stable angina pectoris(SA group)and 119 patients with acute coronary syndrome(ACS group).According to clinical SYNTAX score,(CSS)was divided into low risk group(55 cases),middle risk group(101 cases)and high risk group(48 cases).At the same time,191 healthy people who were negative for coronal CT were selected as control group.After admission,all patients were asked carefully about their age,hypertension,smoking,diabetes,height and weight,and body mass index.The blood routine,CRP,blood lipid,liver function,kidney function were measured in the blood of elbow vein of all the subjects and record monocyte count,neutrophil count,lymphocyte count,MPV,hs-CRP,platelet count,uric acid,TC,TG,HDL,LDL,and calculate MHR,NLR,PLR.All patients with coronary heart disease were selected for emergency or selective coronary angiography if necessary stent implantation according to the condition of admission.The results of angiography were analyzed carefully and the SYNTAX score was used to calculate the value of CSS.Then,compare and analysis :the difference of general clinical data between SA group,ACS group and control group;the difference in MHR,hs-CRP between SA group,ACS group and control group;Correlation between MHR and hs-CRP,NLR,PLR,MPV,N;Differences in general clinical data of CSS low group,middle group and high group;differences in MHR,hs-CRP between Low,medium,high group;Correlation between MHR,hs-CRP and clinical SYNTAX scores in patients with coronary heart disease;correlation between MHR,hs-CRP,NLR,MPV,N,HDL and clinical SYNTAX score;multivariate logistic regression analysis of whether MHR,hs-CRP is an independent risk factor for CHD;The predictive value of MHR andhs-CRP alone and jointly for CSS was evaluated by drawing receiver operating curves.Results:1.LDL,MPV in SA group and ACS group were higher than that in control group(p < 0 05),MPV in ACS group was higher than that in SA group and control group(p < 0 05).The HDL of SA group and ACS group was lower than that of control group(p < 0 05),but there was no difference between two groups(p > 0 05).There was no significant difference in age,sex,smoking history,BMI,history of hypertension,history of diabetes,hemoglobin,platelet and TC,TG,UA,CRE among the three groups(p > 0.05);2.MHR,hs-CRP in SA and ACS group were higher than those in control group(p < 0 01),and MHR,hs-CRP in ACS group was higher than that in SA group and SA group was higher than that in control group(p < 0 01).3.Spearman correlation was used to evaluate the correlation between MHR and CHD biomarkers: there was a positive correlation between MHR and hs-CRP(r = 0.669,p < 0.01),and between MPV,N and MHR(r = 0.462,0.057,p < 0.01).There was no significant difference between PLR,NLR and MHR(p > 0 05).4.In clinical SYNTAX group,MPV in high-risk group was higher than that in low-risk group,and HDL in high-risk group was lower than that in middle-risk,and in middle-risk group was smaller than that in low-risk group(p < 0.05).There was no significant difference in age,BMI,hemoglobin,platelet,TC,TG,LDL,UA,CRE,PLR,NL R,random blood glucose among the three groups(all p > 0 05).5.In the clinical SYNTAX group,the levels of MHR,hs-CRP in the high risk group and the middle risk group were significantly higher than those in the low risk group(p < 0 01),and the MHR,hs-CRP in the high risk group was higher than that in the low risk group(p < 0 05),and that in the middle risk group was higher than that in the low risk group(p < 0 05).6.There was a positive correlation between MHR and CSS(r = 0.614,p < 0.01),and a positive correlation between hs-CRP,NLR,MPV,N and CSS(r = 0.660,p < 0.01).The correlation between MHR and clinical SYNTAX score was significant(r = 0.660,p < 0.01).There was a negative correlation between HDL and CSS(r = 0.521,p < 0.01).7.Logistic analysis showed that except for traditional risk factors such as diabetes mellitus,hypertension,LDL and BMI,MHR?hs-CRP and MPV were independent risk factors for CHD.8.The prediction value of MHR,hs-CRP to CSS is evaluated by drawing ROC curve.When MHR is used to predict CHD alone,the area under curve(AUC)is 0.829(95% CI: 0.767-0.892,p < 0.001).When predicting CHD using hs-CRP alone,AUC was 0.826(95% CI:0.759-0.894,p< 0.001)When MHR and hs-CRP were combined,AUC increased to 0.853(95% CI: 0.794-0.912,p < 0.001).Conclusions:1.MHR is positively correlated with the clinical SYNTAX score of coronary heart disease.It can reflect the severity and complexity of coronary artery disease and is an independent risk factor of CHD.2.When MHR > 0.35 and hs / CRP > 7.55mg/L,the clinical SYNTAX score of coronary heart disease is higher,and MHR is simple,convenient and easy to obtain.It is helpful for clinicians to identify the severity of CHD quickly and early clinical intervention.