Monocyte/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients with non-ST-elevation myocardial infarction

Chen, Hui; Li, Min; Liu, Lei; Dang, Xiawei; Zhu, Danjun; Tian, Gang

doi:10.1097/md.0000000000016267

Cited by 81 publications

(94 citation statements)

References 37 publications

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“…In this meta-analysis, we enrolled 5 studies comprising 4343 patients to investigate the prognostic value of the LMR in patients with ACS [18,[21][22][23][24]. The present study showed that LMR might be a predictor for short-term mortality/MACE.…”

Section: Discussionmentioning

confidence: 70%

“…The result showed that LMR predicted short-term mortality/MACE (HR = 3.44, 95% CI: 1.46-8.14, P < 0.05, Figure 2A), with low levels of heterogeneity among studies (I 2 = 0%). The combined analysis of 5 studies covering 4343 patients described the relationship between LMR and longterm mortality/MACE [18,[21][22][23][24]. The pooled outcome for low LMR value compared with high LMR value group was found to be 1.70 (95% CI: 1.36-2.13, P < 0.05, Figure 2B), with moderate levels of heterogeneity among studies (I 2 = 46.8%).…”

Section: Lmr and Mortality/macementioning

confidence: 95%

“…Others were de ned as long-term. The combined analysis of 2 studies covering 1281 patients described the relationship between LMR and short-term mortality/MACE [21,23]. The result showed that LMR predicted short-term mortality/MACE (HR = 3.44, 95% CI: 1.46-8.14, P < 0.05, Figure 2A), with low levels of heterogeneity among studies (I 2 = 0%).…”

Section: Lmr and Mortality/macementioning

confidence: 99%

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The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

Quan¹,

Wang

Zhang

et al. 2020

Preprint

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Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis in the patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS.Methods: A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus, and Web of science. The association between LMR and mortality/MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted higher short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). In the subgroup analysis, there was still statistical significance of long-term mortality/MACE in all subgroups.Conclusions: This study suggested that lower LMR value might be associated with higher short-term and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

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Section: Discussionmentioning

confidence: 70%

Section: Lmr and Mortality/macementioning

confidence: 95%

Section: Lmr and Mortality/macementioning

confidence: 99%

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The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

Quan¹,

Wang

Zhang

et al. 2020

Preprint

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“…[ 4 , 5 ] Recently, Hanhua et al reported that monocyte-to-lymphocyte ratio (MLR) was an independent risk factor of the presence of CAD, and significantly associated with coronary lesion severity. [ 6 , 7 ] Furthermore, Chen et al reported that MLR was an independent predictor for major adverse cardiovascular event in patients with non-ST segment elevated myocardial infarction. [ 7 ] It was also demonstrated that increased MLR level was associated with higher morality in patients with acute heart failure.…”

Section: Introductionmentioning

confidence: 99%

Relationship between monocyte/lymphocyte ratio and non-culprit plaque vulnerability in patients with acute coronary syndrome

et al. 2020

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The importance of monocyte/lymphocyte ratio (MLR) has been indicated in the initiation and progression of coronary artery disease. However, few previous researches demonstrated the relationship between MLR and plaque vulnerability. We aimed to investigate coronary non-culprit plaque vulnerability in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). A total of 72 ACS patients who underwent coronary angiography and OCT test in Beijing Anzhen Hospital were included in this retrospective study. The plaque vulnerability and plaque morphology were assessed by OCT. The non-culprit plaque in high MLR group exhibited more vulnerable features, characterizing as thinner thickness of fibrous cap ( P = .013), greater maximum lipid core angle ( P = .010) and longer lipid plaque length ( P = .041). A prominently negative liner relation was found between MLR and thickness of fibrous cap (R = –0.225, P = .005). Meanwhile, the proportion of OCT-detected thin cap fibro-atheroma (TCFA) ( P = .014) and plaque rupture ( P = .017) were higher in high MLR group. Most importantly, multivariable logistic regression analysis showed MLR level was identified as an independent contributor to the presence of TCFA (OR:3.316, 95%: 1.448–7.593, P = .005). MLR could differentiate TCFA with a sensitivity of 60.0% and a specificity of 85.1%. Circulating MLR level has potential value in identifying the presence of vulnerable plaque in patients with ACS. MLR, as a non- invasive biomarker of inflammation, may be valuable in revealing plaque vulnerability.

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“…Recently, Hanhua Ji, et al reported that monocyte-to-lymphocyte ratio (MLR) was an independent risk factor of the presence of CAD, and significantly associated with coronary lesion severity [6,7] . Furthermore, Chen H, et al reported that MLR was an independent predictor for major adverse cardiovascular event (MACE) in patients with non-ST segment elevated myocardial infarction (NSTEMI) [7] .It was also demonstrated that increased MLR level was associated with higher morality in patients with acute heart failure [8] . However, the relationship between the MLR level and plaque vulnerability has not been sufficiently evaluated.…”

Section: Introductionmentioning

confidence: 99%

Relationship between monocyte-to-lymphocyte ratio and coronary plaque vulnerability in patients with acute coronary syndrome: an optical coherence tomography study

Zhang

Zhao

Liu

et al. 2019

Preprint

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Background The importance of monocyte-to-lymphocyte ratio (MLR) has been indicated in the initiation and progression of coronary artery disease (CAD). However, few previous researches demonstrated the relationship between MLR and plaque vulnerability. We aimed to investigate coronary plaque vulnerability in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Methods A total of 72 ACS patients who underwent coronary angiography and OCT test in Beijing Anzhen hospital were included in this retrospective study. The plaque vulnerability and plaque morphology were assessed by OCT. Results The coronary plaque in high MLR group exhibited more vulnerable features, characterizing as thinner thickness of fibrous cap (FCT)(112.37 ± 60.24 vs 153.49 ± 73.29 μm, P = 0.013), greater maximum lipid core angle (167.36 ± 62.33 vs 138.79 ± 56.37°, P = 0.010) and longer lipid plaque length (6.34 ± 3.12 vs 4.50 ± 2.21mm, P = 0.041). A prominently negative liner relation was found between MLR and FCT (R = 0.225, P < 0.005). Meanwhile, the incidence of OCT-detected thin cap fibro-atheroma (TCFA) (44.7% vs 18.4%, P = 0.014) and plaque rupture (36.8% vs 13.2%, P = 0.017) were higher in high MLR group. Most importantly, multivariable logistic regression analysis showed MLR level was related to the presence of TCFA (OR:3.316，95%：1.448-7.593，P = 0.005). MLR level could differentiate TCFA with a sensitivity of 72.0% and a specificity of 66.1%. Conclusion Circulating MLR level has potential value in identifying the presence of vulnerable plaque in patients with ACS. MLR, as a non- invasive biomarker of inflammation, may be valuable in revealing plaque vulnerability. Key words Monocyte-to-lymphocyte ratio, Optical coherence tomography, Plaque vulnerability

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Monocyte/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients with non-ST-elevation myocardial infarction

Abstract: Supplemental Digital Content is available in the text

Cited by 81 publications

References 37 publications

The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

Relationship between monocyte/lymphocyte ratio and non-culprit plaque vulnerability in patients with acute coronary syndrome

Relationship between monocyte-to-lymphocyte ratio and coronary plaque vulnerability in patients with acute coronary syndrome: an optical coherence tomography study

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