Prognostic value of monocyte to high-density lipoprotein cholesterol ratio in assessing patients with heart failure with reduced ejection fraction
10.3760/cma.j.cn112150-20240912-00733
- VernacularTitle:单核细胞与高密度脂蛋白胆固醇比值评估射血分数降低型心力衰竭患者的预后价值
- Author:
Yajun WEI
1
;
Ze HOU
;
Yuting LIU
;
Mengwei WANG
;
Xinyi WANG
;
Yingnan YE
;
Kegang JIA
Author Information
1. 天津医科大学心血管病临床学院，天津 300457
- Publication Type:Journal Article
- Keywords:
Heart failure;
Heart failure with reduced ejection fraction;
Monocyte/High-density lipoprotein cholesterol ratio;
Prognosis;
Cohort stuties
- From:
Chinese Journal of Preventive Medicine
2025;59(3):309-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic value of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) in assessing patients with heart failure with reduced ejection fraction (HFrEF).Methods:Patients with HFrEF (LVEF<40%) admitted to the TEDA International Cardiovascular Disease Hospital between 2 January 2019 and 15 January 2023 were selected. The MHR levels were recorded at admission in patients with HFrEF who were followed up regularly for 12 months. The major adverse cardiovascular events (cardiac death and readmission for heart failure) were defined as poor prognosis. Multivariate Cox regression was used to analyze factors associated with poor prognosis. The receiver operator characteristic (ROC) curves were used to assess the diagnostic value of MHR for poor prognosis. The DeLong test was used to analyze whether there was a difference in the effectiveness of MHR and BNP for detecting poor prognosis. The critical value grouping for poor prognosis was evaluated by MHR, and survival analyses were performed using Kaplan-Meier.Results:A total of 286 subjects were enrolled in the study, including 206 males and 80 females, with a median age ( Q1, Q3) of 67 (58, 74) years. Multivariate Cox regression showed that MHR ( HR=1.482, 95% CI:1.015-2.164) and BNP ( HR=1.001, 95% CI:1.000-1.001) were associated with poor prognosis in patients with HFrEF. The area under the ROC curve for the adjunctive diagnostic value of MHR, BNP and the combination of both for poor prognosis in patients with HFrEF was 0.709, 0.738 and 0.769, respectively. The critical values were 0.486, 1 090 pg/ml and 0.41, respectively. The DeLong test showed no differences in the validity of MHR, BNP and their combination for detecting poor prognosis. Kaplan Meier survival analysis of 12-month follow-up showed that the time for poor prognosis in HFrEF patients with MHR>0.486 group (8.645 months) was significantly shorter than that in MHR≤0.486 group (10.296 months, P<0.001), and the risk of poor prognosis in MHR>0.486 group was 2.843 times higher than that in MHR≤0.486 group ( HR=2.843, 95% CI:1.867-4.327). Conclusion:MHR can be an indicator of poor prognosis in patients with HFrEF.
