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Relation between lymphocyte to monocyte ratio and survival in patients with hypertrophic cardiomyopathy: a
Zhonglan Chen1, Ziqiong Wang2, Youping Li3
1West China Hospital Cardiology department/West China School of Nursing, Chinese Evidence-Based Medicine Centre, Cochrane China Center, Chengdu, China.
Insights
The lymphocyte-to-monocyte ratio (LMR) can predict mortality risk in hypertrophic cardiomyopathy (HCM) patients. Higher LMR levels are associated with a significantly lower risk of all-cause mortality in HCM individuals.
Area of Science:
- Cardiology
- Hematology
- Biomarker Research
Background:
- The lymphocyte-to-monocyte ratio (LMR) is an emerging prognostic indicator in various diseases.
- Its potential role in predicting outcomes for hypertrophic cardiomyopathy (HCM) requires further investigation.
Purpose of the Study:
- To evaluate the lymphocyte-to-monocyte ratio (LMR) as a biomarker for identifying hypertrophic cardiomyopathy (HCM) patients at elevated risk of all-cause mortality.
Main Methods:
- Retrospective analysis of 354 adult HCM patients.
- Cox proportional hazards regression and smooth curve fitting to assess LMR's association with all-cause mortality.
Main Results:
- A decreased risk of all-cause mortality was observed with increasing LMR tertiles.
- Higher LMR values (especially < 6.5) were independently associated with significantly reduced mortality risk.
- Nonlinear relationship identified between LMR and mortality, with risk plateauing at higher LMR values.
Conclusions:
- The lymphocyte-to-monocyte ratio (LMR) is an independent predictor of all-cause mortality in HCM patients.
- LMR can serve as a valuable tool for risk stratification in hypertrophic cardiomyopathy management.
Background:
The lymphocyte-to-monocyte ratio (LMR) has been proposed as a novel prognostic factor in malignancies and cardiovascular diseases. Our study aimed to ascertain whether LMR is a useful biomarker in discriminating the hypertrophic cardiomyopathy (HCM) patients at higher risk of all-cause mortality.
Methods:
This retrospective study consisted of 354 adult HCM patients. Cox's proportional hazards regression models were used to analyze the association between LMR and all-cause mortality. Smooth curve fitting was conducted to explore the linear relationship between LMR and all-cause mortality.
Results:
During the follow-up, 44 patients reached the study endpoint. The all-cause mortality rate was 7.3 per 100 person-years in the first tertile and decreased across the three tertiles of LMR. With the first tertile as reference, adjusted hazard ratios (HR) for all-cause mortality were 0.43 for the second tertile (95% CI [0.20-0.91], p = 0.027) and 0.39 for the third tertile (95% CI [0.17-0.90], p = 0.028), respectively. Smooth curve fitting exhibited a nonlinear relationship between LMR values and all-cause mortality. For LMR < 6.5, per SD increase resulted in a significantly decreased risk of all-cause mortality by 62% (HR: 0.38, 95% CI [0.21-0.68]). For LMR ≥ 6.5, the all-cause mortality risk did not progressively increase. Stratified and subgroup analyses revealed similar results to the main analyses,andE-value analysis suggested robustness to unmeasured confounding.
Conclusions:
The study demonstrated that LMR was an independent predictor of all-cause mortality in HCM patients, and LMR may be useful for identifying HCM patients at high mortality risk.
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