Monosit/Yüksek-yoğunluklu lipoprotein kolesterol oranının, perkütan koroner girişim uygulanan akut st-elevasyonlu miyokard enfarktüsü hastalarında 3- aylık mortaliteyi öngördürmede nötrofil/lenfosit oranına üstünlüğü

Amaç: Akut ST-elevasyonlu miyokard enfarktüsünde (STME) 30-günlük mortalite oranlarında iyileştirme sağlanabilmiş olmasına rağmen, aynı durum daha uzun sureli mortalite oranlarında sağlanamamıştır. Monosit/yüksek yoğunluklu lipoprotein kolesterol (MHO) ve nötrofil/lenfosit (NLO) oranları, çeşitli hastalık durumlarında prognostik ve tanısal öneme sahip yeni belirteçler arasındadır. Bu çalışmadaki amacımız, MHO ve NLO’nun perkütan koroner girişim (PKG) uygulanmış akut STME hastalarında hastane içi ve 3 aylık mortaliteyi öngördürücü rolünü değerlendirmektir.Gereç ve Yöntemler: Çalışmaya PKG uygulanmış toplam 184 STME hastası dahil edildi. Hastalara ait NLO, MHO, klinik ve demografik özellikler ile Syntax skorları kaydedilmiş olup hastalar medyan MHO değerlerinde göre iki gruba ayrıldı (grup 1: 92 hasta; grup 2: 92 hasta). Hastane içi ve 3 aylık mortalite oranları birincil sonlanım noktası olarak kaydedildi.Bulgular: Medyan MHO 19,31 olarak hesaplandı. Hastane içi ve 3 aylık mortalite sırasıyla 14 (%15,2) ve 21 (%22,8) hastada gerçekleşti. NLO ve kardiyojenik şok ile başvuru, grup 2’de anlamlı olarak daha yüksek bulundu. Grup 1’de hiçbir hastada mortalite gelişmedi. Çok değişkenli lojistik regresyon analizinde yüksek düşük-yoğunluklu lipoprotein kolesterol düzeyinin, yüksek Syntax skorunun ve yüksek MHO’nun, hastane içi ve 3 aylık mortalite ile bağımsız ilişkiye sahip olduğu tespit edildi. Fakat aynı ilişki NLO ile gösterilemedi. ROC analizine göre hastane içi ve 3 aylık mortaliteyi öngördüren MHO kestirim değerleri sırasıyla >36,6 ve >46,81 bulundu. Sonuç: PKG uygulanmış akut STME hastalarında MHO, hastane içi ve 3 aylık mortaliteyi öngördürmede fayda sağlayabilmekte iken aynı fayda NLO ile sağlanamamaktadır.

Anahtar Kelimeler:

monosit/HDL oranı, nötrofil/lenfosit oranı, mortalite

Monocyte/high-density lipoprotein cholesterol ratio is superior to neutrophil/lymphocyte ratio in the prediction of 3-month overall death in patients with acute ST-elevation myocardial infarction treated with percutaneous coronary intervention

Aim: Although 30-day mortality rates were improved in the setting of acute ST-elevation myocardial infarction (STMI), the same does not hold true for longer-term mortality rates. The ratios of monocyte to high-density lipoprotein cholesterol (MHR) and neutrophil to lymphocyte (NLR) are novel markers with diagnostic and prognostic significance in various disease conditions. Our aim was to evaluate the predictive role of MHR and NLR in in-hospital and 3-month overall death in STMI patients treated with percutaneous coronary intervention (PCI). Material and Methods: A total of 184 consecutive STMI patients undergoing PCI were included. NLR, MHR, clinical and demographic characteristics, and syntax scores were recorded. The patients were divided into two groups according to the median MHR (group 1, n=92; group 2, n=92). In-hospital and 3-month overall death were noted as the primary outcome.Results: Median MHR was 19.31. In-hospital mortality and 3-month mortality occurred in 14 (15.2%) and 21 (22.8%) patients, respectively. NLR and number of the patients with cardiogenic shock on admission were greater in group 2. No mortality occurred in group 1. In multivariate logistic regression analysis, higher low-density lipoprotein cholesterol level, higher syntax score and MHR, but not NLR, were independently associated both with in-hospital and 3-month overall death. In ROC analysis, MHR >36.6 and MHR >46.81 emerged as cut-off values for in-hospital and 3-month mortality, respectively. Conclusion: MHR but not NLR may be utilized in the prediction of in-hospital and 3-month overall death in acute STMI patients treated with primary PCI.

Keywords:

monocyte to HDL ratio, neutropil to lymphocyte ratio, mortality,

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