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Relationships between monocyte count to high-density lipoprotein cholesterol ratio and cardiovascular outcomes in
Dongryul Kim1, Da Won Kim1, Yeon Hee Lee1
1Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea.
Insights
The monocyte to HDL cholesterol ratio (MHR) may predict cardiovascular events in dialysis patients. A high MHR indicates a higher risk of cardiovascular complications, even if overall mortality is similar.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- High monocyte to HDL cholesterol ratio (MHR) is a known cardiovascular risk factor.
- Patients commencing dialysis are at increased risk for cardiovascular complications.
Purpose of the Study:
- To investigate the association between MHR and cardiovascular outcomes in patients starting dialysis.
- To determine if MHR predicts cardiovascular events in this high-risk population.
Main Methods:
- Retrospective review of medical records for 597 patients initiating maintenance dialysis (2006-2017).
- Patients were categorized into low-MHR and high-MHR groups.
- Primary outcomes: all-cause mortality, CV mortality. Secondary outcomes: CV event-free survival, CV complication incidence.
Main Results:
- No significant difference in all-cause or CV mortality between low- and high-MHR groups.
- Significantly lower CV event-free survival in the high-MHR group (47.5% vs. 59.0%).
- High MHR independently predicted cardiovascular events (HR 1.886, 95% CI 1.015-3.505).
Conclusions:
- High MHR at dialysis initiation is associated with poorer cardiovascular event-free survival.
- MHR may serve as a valuable predictor of cardiovascular complications in dialysis patients.
Objective:
High monocyte to high-density lipoprotein cholesterol ratio (MHR) is known to be a risk factor for cardiovascular (CV) complications. We aimed to evaluate the relationship between MHR and CV outcomes in patients commencing dialysis.
Methods:
The medical records of patients who started maintenance dialysis between January 2006 and July 2017 were reviewed. The primary outcomes were all-cause mortality and overall CV mortality and the secondary outcomes were CV event-free survival and the incidence of CV complications.
Results:
Five hundred ninety-seven patients were enrolled and allocated to low- or high-MHR groups. All-cause mortality did not differ between the groups during a mean follow-up period of 3.9 years. In addition, overall CV mortality did not differ between the groups. However, CV event-free survival was significantly lower in the high-MHR group than in the low-MHR group (47.5% vs. 59.0%). Multivariate Cox regression analysis showed that high MHR was an independent predictor of CV events (HR 1.886, 95% CI 1.015-3.505).
Conclusion:
High MHR at the time of initiation of dialysis may represent a useful predictor of CV complications.
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