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单核细胞与高密度脂蛋白比值在预测心血管结局方面是否优于单核细胞计数:来自大量接受冠状动脉造影的中国患者队列的证据。

Is monocyte to HDL ratio superior to monocyte count in predicting the cardiovascular outcomes: evidence from a large cohort of Chinese patients undergoing coronary angiography.

作者信息

Zhang Yan, Li Sha, Guo Yuan-Lin, Wu Na-Qiong, Zhu Cheng-Gang, Gao Ying, Xu Rui-Xia, Dong Qian, Liu Geng, Sun Jing, Li Jian-Jun

机构信息

a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease , FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , Beijing , China.

出版信息

Ann Med. 2016 Aug;48(5):305-12. doi: 10.3109/07853890.2016.1168935. Epub 2016 Apr 17.

Abstract

AIM

Recently, monocyte-to-high density lipoprotein ratio (MHR) has been proposed as a novel prognostic indicator of cardiovascular diseases. However, no study is currently available regarding the comparison between MHR and monocyte count (MC) in predicting the outcomes among patients undergoing coronary angiography.

METHODS

A total of 3798 patients scheduled for selective coronary angiography were enrolled and followed up to capture major adverse cardiovascular events (MACEs, death, acute myocardial infarction, unstable angina, stroke, heart failure, and unexpected coronary revascularization). Cox proportional hazards models were used to evaluate the risk of MHR or MC on MACEs.

RESULTS

During a median of 24.6 months follow-up, 347 (9.1%) MACEs occurred. The upper tertiles of MC and MHR have a significant lower event-free survival (p = 0.011; p = 0.014, respectively). Significantly, both MC and MHR were associated with increased MACEs risk after adjusting for potential confounders [adjusted HR (95% CI): 2.734 (1.547-4.832); 2.031 (1.268-3.254), respectively]. Additionally, the area under the receiver-operating characteristic curves of MC or MHR in predicting MACEs were 0.574 (0.542-0.606) and 0.562 (0.530-0.594) (p < 0.001, both), respectively.

CONCLUSIONS

Our data firstly indicated that MHR was an independent predictor of MACEs whereas the prognostic impact was not superior to MC in patients who underwent coronary angiography. Key Messages MHR has been suggested as a novel prognostic indicator of several cardiovascular diseases. No study is currently available regarding the comparison of MHR to MC in predicting the outcomes in a large cohort of patients undergoing coronary angiography. Our data firstly indicate that MHR is independently associated with MACEs in patients undergoing coronary angiography whereas the prognostic impact is similar to MC.

摘要

目的

最近,单核细胞与高密度脂蛋白比值(MHR)已被提出作为心血管疾病的一种新型预后指标。然而,目前尚无关于MHR与单核细胞计数(MC)在预测接受冠状动脉造影患者预后方面比较的研究。

方法

总共纳入3798例计划进行选择性冠状动脉造影的患者,并进行随访以获取主要不良心血管事件(MACE,包括死亡、急性心肌梗死、不稳定型心绞痛、中风、心力衰竭和意外冠状动脉血运重建)。采用Cox比例风险模型评估MHR或MC对MACE的风险。

结果

在中位24.6个月的随访期间,发生了347例(9.1%)MACE。MC和MHR的上三分位数的无事件生存率显著较低(分别为p = 0.011;p = 0.014)。值得注意的是,在调整潜在混杂因素后,MC和MHR均与MACE风险增加相关[调整后风险比(95%置信区间):分别为2.734(1.547 - 4.832);2.031(1.268 - 3.254)]。此外,MC或MHR预测MACE的受试者工作特征曲线下面积分别为0.574(0.542 - 0.606)和0.562(0.530 - 0.594)(两者p < 0.001)。

结论

我们的数据首先表明,MHR是MACE的独立预测因子,而在接受冠状动脉造影的患者中,其预后影响并不优于MC。关键信息 MHR已被建议作为几种心血管疾病的新型预后指标。目前尚无关于在大量接受冠状动脉造影的患者队列中比较MHR与MC预测预后的研究。我们的数据首先表明,在接受冠状动脉造影的患者中,MHR与MACE独立相关,而其预后影响与MC相似。

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