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Relationship between monocyte/lymphocyte ratio and non-culprit plaque vulnerability in patients with acute coronary

Ting-Yu Zhang1, Qi Zhao1, Ze-Sen Liu2

  • 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University.

Medicine
|October 8, 2020
PubMed

Insights

The monocyte/lymphocyte ratio (MLR) is linked to vulnerable coronary plaques in acute coronary syndrome patients. Higher MLR indicates increased plaque vulnerability, suggesting its potential as a non-invasive biomarker.

Area of Science:

  • Cardiology
  • Immunology
  • Medical Imaging

Background:

  • Monocyte/lymphocyte ratio (MLR) is implicated in coronary artery disease (CAD) development.
  • Limited research exists on the association between MLR and coronary plaque vulnerability.
  • Acute coronary syndrome (ACS) necessitates understanding plaque instability for risk stratification.

Purpose of the Study:

  • To investigate the relationship between MLR and non-culprit plaque vulnerability in ACS patients.
  • To assess plaque morphology and vulnerability features using optical coherence tomography (OCT).
  • To determine if MLR can predict vulnerable plaque characteristics like thin-cap fibro-atheroma (TCFA).

Main Methods:

  • Retrospective analysis of 72 ACS patients undergoing coronary angiography and OCT.
  • Assessment of plaque vulnerability and morphology via OCT imaging.
  • Statistical analysis including correlation, logistic regression, and diagnostic performance evaluation of MLR.

Main Results:

  • Higher MLR group showed more vulnerable plaques: thinner fibrous caps, larger lipid cores, and longer lipid plaque lengths.
  • Significant negative correlation between MLR and fibrous cap thickness (R=-0.225, P=.005).
  • Increased prevalence of TCFA (P=.014) and plaque rupture (P=.017) in high MLR group; MLR independently predicted TCFA (OR=3.316, P=.005).

Conclusions:

  • Circulating MLR is a potential non-invasive biomarker for identifying vulnerable coronary plaques in ACS patients.
  • Elevated MLR is associated with specific vulnerable plaque features and independently predicts TCFA.
  • MLR may serve as a valuable indicator of inflammation-related plaque vulnerability.

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