Evaluation of the prognostic value of monocyte to HDL ratio (MHR) in primary PCI STEMI patients

Background: The purpose of this study was to assess the prognostic value of the monocyte-to-high-density lipoprotein ratio (MHR) as a marker of inflammation in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Materials and Methods: This retrospective cross-sectional study was conducted on patients with a diagnosis of STEMI who underwent PCI between March 2021 and March 2022 at Madani Training and Research Hospital in Tabriz, Iran. Data regarding clinical and demographic properties, and laboratory parameters were obtained from medical records. Patients were categorized into two groups according to the median of admission MHR. Results: The study population consisted of 652 patients, 378 males (58%), and 275 females (42%), with a median age of 68 years (interquartile range: 57-77). Results showed that groups with higher MHR (>15.59) had higher rates of in-hospital mortality and higher major adverse cardiovascular events (MACEs) in comparison with the group featuring lower MHR (<15.59). Receiver operating characteristic (ROC) curves demonstrated that MHR could predict in-hospital mortality with a 75.7% sensitivity and 53.5% specificity, as well as predict MACE with 60.2% sensitivity and 59.7% specificity. Multivariate analyses indicated that MHR is an independent predictor of both in-hospital mortality (OR 1.05, 95% CI 1.02-1.08, P=0.002) and MACE (OR 1.05, 95% CI 1.02-1.08, P<0.001). Conclusion: This research indicated that the rise in MHR was independently associated with a higher risk of MACE and in-hospital mortality in STEMI patients undergoing primary PCI.