Association between monocyte to high-density lipoprotein cholesterol ratio and bicuspid aortic valve degeneration

Abstract

Background/aim: From a pathophysiological point of view, inflammation is thought to be more dominant in bicuspid aortic valve (BAV) stenosis than tricuspid aortic valve (TAV) stenosis. Our study aimed to determine the association between monocyte to highdensity lipoprotein cholesterol (HDL-C) ratio (MHR), a new inflammatory marker, and the speed of progression of stenosis and pathophysiology of BAV stenosis. Materials and methods: A total of 210 severe aortic stenosis patients (70 consecutive BAV patients, 140 matched TAV patients) were retrospectively enrolled in the study. Clinical and echocardiographic data and laboratory results related to our research were collected retrospectively from the patients' records. MHR was measured as the ratio of the absolute monocyte count to the HDL-C value. Results: Seventy BAV (mean age: 72.0 ± 9.1 years, 42.9% female) and 140 TAV patients (mean age: 77.9 ± 8.3 years, 51.4% female) with severe aortic stenosis were enrolled in this study. There was no difference between the two groups in terms of another baseline demographic or clinic findings except age (P < 0.001). Monocyte count, hemoglobin level, mean platelet volume was significantly higher, and HDL-C level was significantly lower in the BAV group, while other lipid and CBC parameters were found to be similar. In the multivariate analysis, MHR (P = 0.005, 95% CI: 0.90-0.98) and, as expected, age (P = 0.001, 95% CI: 1.02-1.11) were found to be significant as the independent predictor of BAV, after adjusting for other risk factors. Conclusion: Our study showed a significant correlation between increased MHR and BAV. MHR was determined as a significant independent predictor for the speed of progression and diagnosis of severe BAV stenosis in multivariate analysis.

Monocyte to high‐density lipoprotein ratio at hospital admission predicts intrahospital mortality in patients with Stanford type‐A dissection

“…Moreover, MHR is found to be an independent predictor of long term mortality among myocardial infarction patients 27 . Recently, an association between MHR and bicuspid aortic valve degeneration has also been reported 28 . To date, however, there has been no published clinical study including patients with AD patients.…”

“…27 Recently, an association between MHR and bicuspid aortic valve degeneration has also been reported. 28 To date, however, there has been no published clinical study including patients with AD patients. The present study, for the first time, reveals the clinical significance of MHR in predicting intrahospital mortality in patients with AD.…”

Monocyte to high‐density lipoprotein ratio as a predictive biomarker for in‐hospital mortality following surgery for type A aortic dissection: Reality or myth?

“…6 This study is the first in the literature to investigate the prognostic relationship between MHR and TAAD, yet, MHR has been linked with myocardial infarction as well as bicuspid aortic valve degeneration, proving to be a useful tool in tackling the cardiovascular disease. [6][7][8] Xie et al 9 studied and confirmed MHR as a biomarker for in-hospital and long-term mortality in patients undergoing endovascular repair for acute type b AD. Additionally, Du et al 10 looked at the diagnostic value of MHR in acute AD, providing further evidence in its favor.…”

Adjustment of the GRACE Risk Score by Monocyte to High-Density Lipoprotein Ratio Improves Prediction of Adverse Cardiovascular Outcomes in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“…Indeed, MHR reflects both immune and metabolic status and is associated with pathological processes in many diseases (30)(31)(32)(33)(34). In patients with atherosclerotic CV disease mainly characterized by inflammation and lipid deposition, MHR has a significant prognostic role.…”