Monocyte to High-Density Lipoprotein Ratio (MHR) as a predictor of mortality and Major Adverse Cardiovascular Events (MACE) among ST Elevation Myocardial Infarction (STEMI) patients undergoing primary percutaneous coronary intervention: a meta-analysis

Abstract

Background: Monocyte to High Density Lipoprotein Ratio (MHR) is a new marker that has been associated with major adverse cardiovascular outcomes among STEMI patients. We sought to strengthen the association between MHR and mortality and major adverse cardiovascular events (MACEs) among STEMI patients who underwent primary percutaneous coronary intervention. Methods: Studies were included if they satisfied the following criteria:1) Observational Studies; 2) Adult patients with ST-elevation Myocardial Infarction (STEMI) who underwent primary percutaneous intervention (PCI); and 3) Reported data on mortality and major adverse cardiovascular events. Using MEDLINE, Clinical Key, Science Direct, Scopus, and Cochrane Central Register of Controlled Trials databases, a search for eligible studies was conducted until September 2017. Our primary outcome of interest was all-cause cardiovascular (CV) mortality. We also investigated the association between MHR and major adverse cardiovascular events (MACEs). Results: We identified 3 studies involving 2793 STEMI patients, showing that in STEMI patients who underwent primary PCI, a high admission MHR is associated with a significantly higher in-hospital mortality [RR 4.71, (95% CI 2.36 to 9.39, p < 0.00001] and in-hospital MACE [RR 1.90, (95% CI 1.44 to 2.50), p < 0.00001]. This significant association was not observed in long term mortality or MACE. Conclusion: A high admission MHR among STEMI patients who underwent primary PCI is associated with a higher in-hospital mortality and MACE. This novel marker can be used as an inexpensive and readily available tool for risk stratification.

Evaluation of the laboratory parameters in hidradenitis suppurativa: Can we use new inflammatory biomarkers?

“…[36][37][38] The MHR is a new inflammatory marker that has been used for cardiovascular diseases, tumors and, chronic inflammatory diseases. [39][40][41] Aktas Karabay et al 42 found statistically significant difference in MHR between psoriasis patients and control group. Also they reported positive correlation between the psoriasis area and severity index and MHR.…”

“…It has been shown that high monocyte counts and low HDL cholesterol levels may be relevant to inflammation 36‐38 . The MHR is a new inflammatory marker that has been used for cardiovascular diseases, tumors and, chronic inflammatory diseases 39‐41 . Aktas Karabay et al 42 found statistically significant difference in MHR between psoriasis patients and control group.…”

Relationship Between Systemic Immune-Inflammation Index (SII) and the Severity of Stable Coronary Artery Disease

“…[9][10][11] High NLR values have been reported to be a marker of subclinical inflammation and were an independent predictor of cardiovascular events and mortality in ST-segment elevated MI (STEMI), 31 significantly correlate with SxS, 32 predict severe atherosclerosis in patients with CAD, 33 and predict mortality in hospitalized patients with the acute coronary syndrome. 34 Similarly, high MLR values could identify vulnerable plaques in stable angina 11 were associated with short-and long-term mortality in STEMI patients 35 as well as with inhospital and long-term major adverse cardiac and cerebrovascular events in STEMI patients 31 and were correlated with the SxS. 36 Likewise, it has been found that a high PLR could predict the severity of CAD 37 was associated with poor prognosis in CAD patients 38 was a predictor of long-term mortality in non-STEMI patients, 39 and could predict high-risk critical lower extremity ischemia.…”

Comparing the Prognostic Value of Hematological Indices in Patients With ST Segment Elevation Myocardial Infarction: “A Head to Head” Analysis

“…34 However, another big meta-analysis by Villanueva et al found that MHDLr was only associated with a significantly higher IHM, not LTM, a finding opposite to our results. 35 One possible explanation of the underlying mechanism is that the combination of monocyte and HDL-C may be closely linked to chronicle systemic inflammation, endothelial dysfunction, and oxidative stress. 36 Macrophages, transformed from circulating monocytes, are one of the key cell types for atherosclerotic plaque formation.…”