Association of Novel Hematological Indices with Severity of Coronary Artery Disease using SYNTAX Score in Patients with Acute Coronary Syndrome.

Vivek Mohanty, Shubham Sharma, Sourabh Goswami, Atul Kaushik, Rahul Choudhary, Dharamveer Yadav, Surender Deora, Kuldeep Singh
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Abstract

Introduction: Recent evidence suggests that systemic inflammation not only plays an important role in the pathogenesis of Acute Coronary Syndrome but also correlates with disease severity. Monocyte-to-high-density lipoprotein cholesterol ratio (MHR), Neutrophil-Lymphocyte Ratio (NLR), and Monocyte-Lymphocyte Ratio (MLR) are novel systemic inflammation markers used for predicting the burden of coronary artery disease (CAD) based on SYNTAX Score. This single-center, cross-sectional, observational study compared the association of these novel hematological indices with CAD severity using the SYNTAX Score in ACS patients and aimed to determine the best predictor of the severity of CAD.

Methods: A total of 403 consecutive patients with ACS who underwent coronary angiography were enrolled. On the basis of the SYNTAX Score, patients were divided into three groups: Low: <22, Moderate 22 - 32 and High ≥ 32. MHR, MLR, and NLR were calculated and correlated with SYNTAX Score.

Results: All three indices: MHR (r=0.511; p <0.001), MLR (r=0.373; p <0.001), and NLR (r=0.292; p =0.001) showed significant correlation with SYNTAX Score. The MHR ROC was significantly higher than that of MLR (difference between area: 0.158; 95% CI: 0.079-0.259) and NLR (difference between area: 0.279; 95% CI: 0.172-0.419) for the SYNTAX Score. Analysis showed a strong correlation between these indices with SYNTAX Score >22 compared to low scores <22 and that these also related to the LAD as an infarct artery. Multiple regression analysis showed that diabetes mellitus, eGFR, Infarct-related artery left anterior descending (IRALAD), MHR, MLR, and NLR were predictors of the severity of CAD in ACS patients based on SYNTAX Score.

Conclusion: In ACS patients MHR, MLR, and NLR showed significant correlation with SYNTAX score >22 which may be indicative of severity of disease. MHR is a better predictor of the severity of CAD than MLR and NLR in ACS patients.

急性冠脉综合征患者新血液学指标与冠状动脉疾病严重程度的关联
最近的证据表明,全身性炎症不仅在急性冠状动脉综合征的发病机制中起重要作用,而且与疾病的严重程度有关。单核细胞-高密度脂蛋白胆固醇比值(MHR)、中性粒细胞-淋巴细胞比值(NLR)和单核细胞-淋巴细胞比值(MLR)是基于SYNTAX评分预测冠状动脉疾病(CAD)负担的新型全身炎症标志物。这项单中心、横断面、观察性研究使用ACS患者SYNTAX评分比较了这些新的血液学指标与CAD严重程度的关系,旨在确定CAD严重程度的最佳预测指标。方法:共纳入403例连续行冠脉造影的ACS患者。根据SYNTAX评分将患者分为三组:Low: Results:三个指标均为:MHR (r=0.511);结论:ACS患者MHR、MLR、NLR与Syntax评分bbbb22有显著相关性,可作为病情严重程度的指标。在ACS患者中,MHR比MLR和NLR更能预测CAD的严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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