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The Predictive Value of Monocyte Count to High-Density Lipoprotein Cholesterol Ratio in Restenosis After Drug-Eluting
Jing Nan1, Shuai Meng1, Hongyu Hu1
1Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Insights
High monocyte count-to-HDL cholesterol ratio (MHR) predicts in-stent restenosis (ISR) in patients receiving drug-eluting stents (DES). This finding is crucial for managing coronary artery disease post-DES implantation.
Area of Science:
- Cardiology
- Biomarkers
- Interventional Cardiology
Background:
- In-stent restenosis (ISR) is a complication following coronary stent implantation.
- The monocyte count-to-high-density lipoprotein cholesterol ratio (MHR) has shown potential as a biomarker in cardiovascular disease.
- Previous studies explored MHR in bare metal stents, but its role in drug-eluting stent (DES) ISR remains unclear.
Purpose of the Study:
- To investigate the predictive value of pre-procedural MHR for ISR in patients undergoing DES implantation.
- To identify independent risk factors for ISR in patients with Non-ST segment elevation acute coronary syndrome (NSTE-ACS) after DES implantation.
Main Methods:
- Retrospective analysis of 214 NSTE-ACS patients who underwent DES implantation and follow-up coronary angiography.
- Patients were categorized into ISR and non-ISR groups based on angiography results.
- Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal MHR cutoff for ISR prediction.
Main Results:
- Elevated pre-procedural MHR was identified as an independent risk factor for ISR.
- Other independent risk factors included percutaneous coronary intervention for NSTE myocardial infarction, bifurcation lesions, and increased platelet count.
- The study identified specific predictors for ISR in the context of DES.
Conclusions:
- Elevated MHR is a significant and independent predictor of ISR in NSTE-ACS patients treated with DES.
- MHR serves as a valuable biomarker for assessing ISR risk after DES implantation.
- These findings can aid in risk stratification and personalized patient management.
Background:
The clinical value of monocyte count to high-density lipoprotein cholesterol ratio (MHR) in in-stent restenosis (ISR) of patients who have undergone bare metal stent implantation has been studied. However, the predictive value of MHR in ISR for patients who have undergone drug-eluting stent (DES) implantation has not been explored.
Methods:
Non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients who had undergone DES implantation and coronary angiography follow-up at the Beijing Shijitan Hospital, Capital Medical University, between January 1, 2008, and December 31, 2018, were retrospectively enrolled. Patients were divided into ISR and non-ISR groups depending on the follow-up coronary angiography results. Relative clinical information was recorded and analyzed. The receiver operating characteristic curve analysis was used to determine the optimum cut-off pre-procedural MHR to predict ISR.
Results:
A total of 214 patients were enrolled in our study. The mean period between two coronary angiography procedures was 25.4±9.8 months. Percutaneous coronary intervention due to NSTE myocardial infarction, a bifurcation lesion, increased platelet count, and a high MHR were the independent risk factors in multivariate logistic regression analyses.
Conclusion:
Our results indicated that elevated MHR is an independent and useful predictor of ISR in NSTE-ACS patients who have undergone DES implantation.
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