The relation between monocyte to HDL ratio and no-reflow phenomenon in the patients with acute ST-segment elevation myocardial infarction

Balta, Şevket; Çelik, Turgay; Öztürk, Cengiz; Kaya, Mehmet; Aparcı, Mustafa; Yıldırım, Ali Osman; Demır, Mustafa; Kılıç, Selim; Aydın, İbrahim; İyisoy, Atila

doi:10.1016/j.ajem.2016.05.031

Cited by 53 publications

(47 citation statements)

References 23 publications

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“…We also examined monocyte/HDL ratio (MHR) as another marker reflecting acute inflammation, which proved to be a strong predictive factor with an odd ratio of 0.321 (p value=0.002). This is similar to the data reported from Balta et al, 2016 [19].…”

Section: Discussionsupporting

confidence: 93%

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Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Othman¹

2019

CCR

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Background Primary Percutaneous coronary intervention (PPCI) is an established mainstay in treatment of patients presenting with acute ST elevation myocardial infarction (STEMI). However, successful revascularization of the culprit coronary vessel does not always mean ideal myocardial reperfusion in a portion of patients, mainly because of the noreflow phenomenon. Myocardial no-reflow is associated with worse contractile dysfunction and higher incidence of complications and is an independent predictor of death and myocardial infarction after PPCI. Objective: To study the relationship between admissions CRP, Albumin, CRP/Albumin ratio, Monocyte, HDL, and Monocyte/HDL ratio, in patients presenting with acute STEMI and angiographic no-reflow after PPCI. Material and Methods: From October 2018 to February 2019, of the 1500 patients who presented with STEMI for PPCI to any of the Ain Shams University Hospitals' cath labs, we enrolled 150 consecutive patients who had post revascularization angiographic no-reflow. They were allocated to group A. we allocated 150 age, gender, and baseline characteristics matched STEMI patients who had TIMI III flow post revascularization to group B. this was set as the control group. Results: The study population was divided into 2 groups: no-reflow "A" (n = 150) and reflow "B" (n = 150) groups. CRP and Monocytes were significantly higher in the no-reflow group; Albumin and HDL were significantly lower in the no-reflow group. The novel indices, CRP/Albumin ratio (CAR) and Monocytes/HDL ratio (MHR) were both significantly higher in the no-reflow group (p value = 0.000) for both. The tow indices were found to be independent predictors of no-reflow development. Conclusion: Our results suggested that CAR and MHR on admission before PPCI though cheap, and easily measurable laboratory tools, have a significant predictive value with an odds ratio of 0.182 with a p value = 0.000 and 0.321 with a p value = 0.002 respectively. They could help to risk stratify STEMI patients who might suffer from no-reflow phenomenon after PPCI.

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Section: Discussionsupporting

confidence: 93%

“…No-reflow has been clearly linked to increased mortality, poor outcome and increased 30 days readmission rates [15,16]. There is plethora of published work examining various predictors of no-reflow [17][18][19]. To the best of our knowledge, this is the first published data on Egyptian patients.…”

Section: Discussionmentioning

confidence: 99%

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Othman¹

2019

CCR

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“…T. Liang and coworkers observed that the development of no‐reflow was higher in advanced age patients . A higher incidence of diffuse atherosclerosis, severe calcification, distal microvessel embolization, and microvascular diseases in elderly patients are thought to cause the development of no‐reflow . Consistent with this, we showed that advanced age was an independent risk factor in the development of no‐reflow.…”

Section: Discussionmentioning

confidence: 97%

Prediction of no‐reflow and major adverse cardiovascular events with a new scoring system in STEMI patients

Bayramoğlu

Taşolar

Kaya

et al. 2017

J Interven Cardiology

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“…In these subjects, the association between high MHR values and in-hospital MACE showed an HR of 1.41 (95% CI, 1.14-1.73) and an HR of 1.44 with long-term MACE (95% CI, 1.23-1.68; M. S. Cetin et al, 2016). In addition, significantly higher MHR values were observed in STEMI patients with no reflow phenomenon compared with those of the reflow patients; in these patients, after pPCI, MHR levels were reported as independent predictors of no reflow (OR, 1.09; 95%CI, 1.07-1.12; Balta et al, 2016). Moreover, it was reported that the rates of in-hospital mortality and MACE were higher in patients with STEMI after pPCI who had higher MHR values compared with those with lower MHR values (Karataş et al, 2016), and elevated MHR levels independently predicted in-hospital mortality (OR, 1.03; 95% CI, 1.01-1.05) and MACE (OR, 1.02; 95% CI, 1.01-1.04) in these patients (Çiçek, Kundi, Bozbay, Yayla, & Uyarel, 2016;Karataş et al, 2016).…”

mentioning

confidence: 97%

Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases

Ganjali

Gotto

Ruscica

et al. 2018

Journal Cellular Physiology

207

201

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Inflammation and lipid accumulation are two basic hallmarks of atherosclerosis as a chronic disease. Inflammation not only is a local response but can also be considered as a systemic process followed by an elevation of inflammatory mediators. Monocytes are a major source of proinflammatory species during atherogenesis. In atherosclerosis, modified low-density lipoproteins (LDLs) are removed by macrophages; these are recruited in the vessel wall, inducing the release of inflammatory cytokines in inflamed tissue. Hence, inflammatory cholesterol ester-loaded plaque is generated. High-density lipoprotein-cholesterol (HDL-C) exhibits antiatherosclerotic effects by neutralizing the proinflammatory and pro-oxidant effects of monocytes via inhibiting the migration of macrophages and LDL oxidation in addition to the efflux of cholesterol from these cells. Furthermore, HDL plays a role in suppressing the activation of monocytes and proliferation-differentiation of monocyte progenitor cells. Thus, accumulation of monocytes and reduction of HDL-C may participate in atherosclerosis and cardiovascular diseases (CVD). Given that the relationship between the high number of monocytes and low HDL-C levels has been reported in inflammatory disorders, this review focused on understanding whether the monocyte-to-HDL ratio could be a convenient marker to predict atherosclerosis development and progression, hallmarks of CV events, instead of the individual monocyte count or HDL-C level.

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The relation between monocyte to HDL ratio and no-reflow phenomenon in the patients with acute ST-segment elevation myocardial infarction

Cited by 53 publications

References 23 publications

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Prediction of no‐reflow and major adverse cardiovascular events with a new scoring system in STEMI patients

Monocyte‐to‐HDL‐cholesterol ratio as a prognostic marker in cardiovascular diseases

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