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Abstract
Background
Neutrophil to high-density lipoprotein cholesterol ratio (NHR) has demonstrated predictive value for coronary artery disease (CAD). However, few research has been conducted on the predictive capacity of NHR for Major Adverse Cardiovascular Events (MACE) following Percutaneous Coronary Intervention (PCI) or the degree of coronary artery stenosis in hospitalized ST-segment elevation myocardial infarction (STEMI) patients.
Methods
The study involved 486 patients diagnosed with STEMI between the years 2020 and 2023. Univariate and multivariate logistic regression analyses were conducted to evaluate the risk factors for MACE after PCI and severe coronary artery stenosis during hospitalization. Receiver operating characteristic (ROC) curves were generated to determine predictive power of NHR and MHR. Spearman correlation analysis was performed to assess the correlation between NHR, MHR and the Gensini score (GS).
Results
Multivariate logistic regression analysis showed that the NHR and MHR were the independent risk factor for MACE during hospitalization in STEMI patients (MHR: the odds ratio (OR)=2.347, 95% confidence interval (CI)=1.082–5.089, P=0.031) (NHR: OR=1.092, 95% CI=1.025–1.165, P=0.004). In addition, NHR was also an independent risk factor for high GS (NHR: OR=1.103, 95% CI=1.047–1.162, P<0.001), and the MHR was not an independent risk factor. The ROC curve analysis was performed to evaluate the predictive ability of NHR and MHR for in-hospital MACE in STEMI patients after primary PCI. The area under the curve (AUC) for NHR was 0.681. The AUC for MHR was 0.672. Regarding the prediction of high GS, the AUC for NHR was 0.649. The AUC for MHR was 0.587. Spearman correlation analysis showed that NHR exhibited stronger correlation with GS, while MHR was lower (NHR: r=0.291, P<0.001) (MHR: r=0.156, P<0.001).
Conclusion
These findings highlight the potential clinical utility of NHR as a predictive indicator in STEMI patients after PCI during hospitalization, both for MACE events and the degree of coronary artery stenosis.
Abbreviations
NHR, neutrophil to high-density lipoprotein cholesterol ratio; MHR, monocyte to high-density lipoprotein cholesterol ratio; CAD, coronary artery disease; MACE, major adverse cardiovascular events; STEMI, ST-segment elevation acute myocardial infarction; PCI, percutaneous coronary intervention; CVD, cardiovascular diseases; US, the United States; AMI, acute myocardial infarction; HDL-C, high-density lipoprotein cholesterol; GS, Gensini score; CAG, coronary angiography; sCr, serum creatinine; BUN, blood urea nitrogen; UA, uric acid; ALB, albumin; LDL-C, low-density lipoprotein cholesterol; TG, triglyceride; FPG, fasting plasma glucose; LVEF, left ventricular ejection fraction; LVFS, left ventricular fractional shortening; CI, confidence interval; OX-LDL-C, oxidized low-density lipoprotein cholesterol; NETs, neutrophil extracellular traps; MPO, myeloperoxidase; ROS, reactive oxygen species; ACS, acute coronary syndrome; ROC curves, Receiver operating characteristic curves; OR, the odds ratio.
Ethics Approval and Consent to Participate
The study protocol and informed consent procedures were approved by the Ethics Committee of the Third Affiliated Hospital of Anhui Medical University. All methods were performed following the Declaration of Helsinki. Informed written consent for publication without direct personal identification details (such as name and address) was obtained from all the participants.
Data Sharing Statement
The datasets used and/or analysed during the current study are available from the corresponding authors, Minmin Fu and Bingfeng Zhou, upon a reasonable request. The data are not publicly available due to their containing information that could compromise the privacy of patients.
Acknowledgments
The authors would like to extend their sincere thanks to YT H, HY Z and YZ for their contribution to data collection. We also extend our gratitude to JC G, MC, YH, BF Z and MM F for their contributions.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare no conflicts of interest in this work.