Monocyte/high-density lipoprotein cholesterol ratio is superior to neutrophil/lymphocyte ratio in the prediction of 3-month overall death in patients with acute ST-elevation myocardial infarction treated with percutaneous coronary intervention

Yıl 2019, Cilt: 10 Sayı: 4, 459 - 466, 31.12.2019

Erdoğan Sökmen , Mustafa Çelik

https://doi.org/10.18663/tjcl.541023

Cited By: 1

Öz

Aim: Although 30-day mortality rates were improved in the
setting of acute ST-elevation myocardial infarction (STMI), the same does not
hold true for longer-term mortality rates. The ratios of monocyte to
high-density lipoprotein cholesterol (MHR) and neutrophil to lymphocyte (NLR)
are novel markers with diagnostic and prognostic significance in various
disease conditions. Our aim was to evaluate the predictive role of MHR and NLR
in in-hospital and 3-month overall death in STMI patients treated with percutaneous
coronary intervention (PCI). 

Material and Methods: A total of 184 consecutive STMI patients undergoing
PCI were included. NLR, MHR, clinical and demographic characteristics, and
syntax scores were recorded. The patients were divided into two groups
according to the median MHR (group 1, n=92; group 2, n=92). In-hospital and
3-month overall death were noted as the primary outcome.

Results: Median MHR was 19.31. In-hospital mortality and 3-month mortality occurred in 14 (15.2%)
and 21 (22.8%) patients, respectively. NLR and number of the patients with
cardiogenic shock on admission were greater in group 2. No mortality occurred
in group 1. In multivariate logistic regression analysis, higher low-density
lipoprotein cholesterol level, higher syntax score and MHR, but not NLR, were
independently associated both with in-hospital and 3-month overall death. In
ROC analysis, MHR >36.6 and MHR >46.81 emerged as cut-off values for
in-hospital and 3-month mortality, respectively.

Conclusion: MHR but not NLR may be utilized in the prediction of
in-hospital and 3-month overall death in acute STMI patients treated with
primary PCI. 

Anahtar Kelimeler

monocyte to HDL ratio, neutropil to lymphocyte ratio, mortality

Monosit/Yüksek-yoğunluklu lipoprotein kolesterol oranının, perkütan koroner girişim uygulanan akut st-elevasyonlu miyokard enfarktüsü hastalarında 3- aylık mortaliteyi öngördürmede nötrofil/lenfosit oranına üstünlüğü

Öz

Amaç: Akut ST-elevasyonlu
miyokard enfarktüsünde (STME) 30-günlük mortalite oranlarında iyileştirme
sağlanabilmiş olmasına rağmen, aynı durum daha uzun sureli mortalite
oranlarında sağlanamamıştır. Monosit/yüksek yoğunluklu lipoprotein kolesterol
(MHO) ve nötrofil/lenfosit (NLO) oranları, çeşitli hastalık durumlarında
prognostik ve tanısal öneme sahip yeni belirteçler arasındadır. Bu çalışmadaki
amacımız, MHO ve NLO’nun perkütan koroner girişim (PKG) uygulanmış akut STME
hastalarında hastane içi ve 3 aylık mortaliteyi öngördürücü rolünü
değerlendirmektir.

Gereç ve Yöntemler: Çalışmaya PKG
uygulanmış toplam 184 STME hastası dahil edildi.  Hastalara ait NLO, MHO, klinik ve demografik
özellikler ile Syntax skorları kaydedilmiş olup hastalar medyan MHO
değerlerinde göre iki gruba ayrıldı (grup 1: 92 hasta; grup 2: 92 hasta). Hastane içi ve 3 aylık mortalite
oranları birincil sonlanım noktası olarak kaydedildi.

Bulgular:
Medyan MHO 19,31 olarak hesaplandı. Hastane içi
ve 3 aylık mortalite sırasıyla 14 (%15,2) ve 21 (%22,8) hastada gerçekleşti.
NLO ve kardiyojenik şok ile başvuru, grup 2’de anlamlı olarak daha yüksek
bulundu. Grup 1’de hiçbir hastada mortalite gelişmedi.  Çok değişkenli lojistik regresyon analizinde
yüksek düşük-yoğunluklu lipoprotein kolesterol düzeyinin, yüksek Syntax skorunun
ve yüksek MHO’nun, hastane içi ve 3 aylık mortalite ile bağımsız ilişkiye sahip
olduğu tespit edildi. Fakat aynı ilişki NLO ile gösterilemedi. ROC analizine
göre hastane içi ve 3 aylık mortaliteyi öngördüren MHO kestirim değerleri
sırasıyla >36,6 ve >46,81 bulundu.

Sonuç:
PKG uygulanmış
akut STME hastalarında MHO, hastane içi ve 3 aylık mortaliteyi öngördürmede
fayda sağlayabilmekte iken aynı fayda NLO ile sağlanamamaktadır.

Anahtar Kelimeler

monosit/HDL oranı, nötrofil/lenfosit oranı, mortalite

Kaynakça

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