Predicting the mortality in patients with carotid artery stenosis by monocyte to high density lipoprotein ratio
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Tarih
2023
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Introduction: Background: Monocytes, which produce a variety of cytokines and molecules,
interact with platelets and endothelial cells, causing inflammatory and thrombotic pathways to
become worse. Macrophage migration and oxidation of low-density lipoprotein cholesterol
molecules are both inhibited by high-density lipoprotein cholesterol (HDL-C). HDL-C
neutralizes monocytes' pro-inflammatory and pro-oxidant effects through several mechanisms.
As a result, characteristics like the monocyte to HDL-C ratio (MHR) may reveal a patient's
inflammatory status. Objective: The development of carotid artery stenosis (CAS) is influenced
by inflammation, oxidative stress, and endothelial dysfunction. Recent research suggests that
inflammatory biomarkers are important for assessing mortality in carotid artery stenosis. This
study aims to determine the association between MHR and mortality after carotid artery stenting.
Tools and Method: We enrolled 260 patients with CAS who underwent carotid artery stenting
between 2019 and 2021. MHR was calculated using the formula: the monocyte value dividing by
the high-density lipoprotein cholesterol value. According to 30-day mortality, the patients were
divided into two groups; surviving and non-surviving. Monocyte counts, HDL-C, and MHR
values were compared between the groups.
Results: The patient group had significantly higher monocyte counts and lower HDL levels than
the control group, resulting in higher MHR values. In addition, non-surviving patients had a
higher monocyte count and MHR value, as well as a lower HDL-C level (p<0.001). In patients
with CAS, the MHR value was also found to be a significant independent determinant of 30-day
mortality (p<0.001). MHR had the optimum cut-off value of 17.52 with 78.3% sensitivity and
83.4% specificity (AUC:0.724, p<0.001) for predicting 30-day mortality in patients with CAS.
Comparison of the monocyte count, HDL level, and MHR value according to the mortality
within the 30 days.
Non-surviving
group
n=48
Surviving group
n=212
P-values
Monocyte (x109
µL) 915.42±53.21 524.03±9.98 <0.001
HDL-C (mg/dL) 37.03±1.16 46.22±0.9 <0.001
MHR 18.86±5.25 12.21±2.21 <0.001
Values are presented as mean ± SD and median [interquartile range]. HDL-C; high-density
lipoprotein cholesterol, MHR; monocyte to high-density lipoprotein ratio.
Discussion: Conclusion: In patients with CAS, a high MHR value was found to be an
independent predictor of 30-day mortality.
Açıklama
Anahtar Kelimeler
Carotid artery stenosis, monocyte, high-density lipoprotein.
Kaynak
Advanced Stroke and Peripheral Intervention Course (ASPIC 2023)
