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Admission Monocyte/HDL Ratio Predicts Adverse Cardiac Remodeling After St-Elevation Myocardial Infarction
Ferhat Eyyupkoca1, Onur Yildirim1, Serkan Sivri2
1Department of Cardiology at Dr. Nafiz Korez Sincan State Hospital, Ankara, Turkey
Insights
High monocyte to HDL-C ratio (MHR) predicts adverse cardiac remodeling and mortality after myocardial infarction (MI). This inflammatory marker can identify high-risk patients early, aiding in prognosis and management strategies.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation Research
Background:
- Inflammation is crucial in cardiac remodeling post-myocardial infarction (MI).
- The monocyte to HDL-C ratio (MHR) is a potential inflammation indicator.
Purpose of the Study:
- To assess the prognostic value of admission MHR for late cardiac remodeling and 1-year mortality after acute ST-elevation MI.
Main Methods:
- Prospective study of 231 acute ST-elevation MI patients.
- Cardiac MRI assessed LV function and volumes at 2 weeks and 6 months.
- Adverse remodeling defined as ≥12% increase in LV end-diastolic volume at 6 months.
- 1-year survival follow-up.
Main Results:
- 23.8% of patients showed adverse remodeling (AR) at 6 months.
- Median MHR was significantly higher in the AR group (2.2 vs. 1.5, p < 0.001).
- High MHR (>1.6) independently predicted AR (OR: 3.21) and was associated with 5.62-fold higher mortality risk (p < 0.001).
Conclusions:
- Admission MHR is a valuable predictor of adverse cardiac remodeling after MI.
- Elevated MHR identifies patients at risk for heart failure progression and mortality.
- MHR serves as a practical tool for early risk stratification in post-MI patients.
Background:
Inflammation plays a critical role in cardiac remodeling after myocardial infarction (MI). Monocyte to high-density lipoprotein-cholesterol (HDL-C) ratio (MHR) has emerged as a potential indicator of inflammation.
Objectives:
The study aimed to investigate the prognostic role of MHR at the time of hospital admission in late cardiac remodeling and subsequent 1-year mortality in an academic training and research hospital.
Methods:
This prospective multicenter study included 231 patients with acute ST-elevation MI. Left ventricular (LV) functions and volumes were assessed by cardiac magnetic resonance (CMR) imaging at 2 weeks and 6 months post-MI. The definition of adverse cardiac remodeling (AR) was based on the increase of LV end-diastolic volume by ≥ 12% at 6 months post-MI. All patients were followed for survival for 1 year after the second CMR imaging measurements.
Results:
At 6 months post-MI, 20 patients (23.8%) exhibited AR. The median MHR was higher in the AR group compared to the group without AR (2.2 vs. 1.5, p < 0.001). A positive correlation was found between MHR and infarct size in the groups with and without AR. High MHR was an independent predictor of AR (OR: 3.21, p = 0.002). The cut-off value of MHR in predicting AR was found to be >1.6 with 92.7% sensitivity and 70.1% specificity (AUC ± SE: 0.839 ± 0.03, p < 0.001). Mortality risk was 5.62-fold higher in the group with MHR of >1.6 (HR: 5.62, p < 0.001).
Conclusions:
These results indicate that admission MHR is a useful tool to predict patients with AR who are at risk of progression to heart failure and mortality after MI.
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