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Abstract：
BACKGROUND: The prevalence of ischaemic heart failure (HF) continues to increase. Diabetes mellitus (DM) concomitant with ischaemic HF increases the risk of major adverse cardiovascular events (MACEs). As a promising predictor for cardiovascular diseases, the predictive value of the monocyte to high-density lipoprotein cholesterol ratio (MHR) for MACE in the ischaemic HF with DM cohort has never been investigated before.
OBJECTIVE: We aimed to investigate the MHR as a predictor for MACE in ischaemic HF patients with DM who underwent percutaneous coronary intervention (PCI).
METHODS: This observational study enrolled 1049 patients with ischaemic HF and DM undergoing PCI from June 2017 to June 2019. The baseline data were collected. MACEs, including all-cause mortality, nonfatal myocardial infarction, and any revascularization, were recorded within the 36-month follow-up. The characteristics and incidence of MACE were analysed in four groups stratified by the quartiles of MHR. The hazard ratio for MACE was analysed with Cox regression models. The incidence of MACE in the four groups was evaluated by Kaplan‒Meier survival analysis. Restricted cubic spline analysis was performed to determine the nonlinear correlation between the MHR and MACE.
RESULTS: After the 36-month follow-up, 407 patients (38.8%) experienced MACEs. The incidence of MACE was significantly higher among patients in the upper MHR quartile than among those in the lower MHR quartiles (23.4% vs. 36.0% vs. 41.4% and 54.6%; P < 0.001, respectively), which was consistent with the Kaplan‒Meier survival analyses (P < 0.0001). A multivariate Cox regression model showed that the MHR was an independent risk factor for MACE after variables were adjusted (adjusted HR: 2.11; 95% CI 1.47-3.03; P < 0.001). Its predictive effects on MACE showed no interaction with hypercholesterolemia (P > 0.05).
CONCLUSIONS: The MHR was a significant and independent predictor of MACEs in ischaemic HF patients with DM undergoing PCI.
OBJECTIVE: We aimed to investigate the MHR as a predictor for MACE in ischaemic HF patients with DM who underwent percutaneous coronary intervention (PCI).
METHODS: This observational study enrolled 1049 patients with ischaemic HF and DM undergoing PCI from June 2017 to June 2019. The baseline data were collected. MACEs, including all-cause mortality, nonfatal myocardial infarction, and any revascularization, were recorded within the 36-month follow-up. The characteristics and incidence of MACE were analysed in four groups stratified by the quartiles of MHR. The hazard ratio for MACE was analysed with Cox regression models. The incidence of MACE in the four groups was evaluated by Kaplan‒Meier survival analysis. Restricted cubic spline analysis was performed to determine the nonlinear correlation between the MHR and MACE.
RESULTS: After the 36-month follow-up, 407 patients (38.8%) experienced MACEs. The incidence of MACE was significantly higher among patients in the upper MHR quartile than among those in the lower MHR quartiles (23.4% vs. 36.0% vs. 41.4% and 54.6%; P < 0.001, respectively), which was consistent with the Kaplan‒Meier survival analyses (P < 0.0001). A multivariate Cox regression model showed that the MHR was an independent risk factor for MACE after variables were adjusted (adjusted HR: 2.11; 95% CI 1.47-3.03; P < 0.001). Its predictive effects on MACE showed no interaction with hypercholesterolemia (P > 0.05).
CONCLUSIONS: The MHR was a significant and independent predictor of MACEs in ischaemic HF patients with DM undergoing PCI.
摘要：
背景：缺血性心力衰竭（HF）的患病率持续增加。糖尿病（DM）合并缺血性HF会增加主要不良心血管事件（MACE）的风险。作为心血管疾病的一个有希望的预测因子，以前从未研究过单核细胞与高密度脂蛋白胆固醇比值(MHR)对缺血性HF伴DM队列中MACE的预测价值.
目的：我们旨在研究MHR作为接受经皮冠状动脉介入治疗（PCI）的DM缺血性HF患者MACE的预测因子。
方法：这项观察性研究纳入了2017年6月至2019年6月接受PCI的1049例缺血性HF和DM患者。收集基线数据。MACEs,包括全因死亡率,非致死性心肌梗死,和任何血运重建，在36个月的随访中记录。按MHR的四分位数分层分析了四组MACE的特征和发生率。用Cox回归模型分析MACE的风险比。通过Kaplan-Meier生存分析评估四组的MACE发生率。进行限制性三次样条分析以确定MHR和MACE之间的非线性相关性。
结果：经过36个月的随访，407例患者（38.8%）出现MACEs。MHR四分位数较高的患者的MACE发生率明显高于MHR四分位数较低的患者（23.4％vs.36.0%与41.4%和54.6%；分别为P<0.001），这与Kaplan-Meier生存分析一致（P<0.0001）。多因素Cox回归模型显示，校正后MHR是MACE的独立危险因素（校正后HR：2.11；95%CI1.47～3.03；P<0.001）。其对MACE的预测作用与高胆固醇血症无交互作用(P>0.05)。
结论：MHR是接受PCI的缺血性HF合并DM患者MACE的重要且独立的预测因子。
目的：我们旨在研究MHR作为接受经皮冠状动脉介入治疗（PCI）的DM缺血性HF患者MACE的预测因子。
方法：这项观察性研究纳入了2017年6月至2019年6月接受PCI的1049例缺血性HF和DM患者。收集基线数据。MACEs,包括全因死亡率,非致死性心肌梗死,和任何血运重建，在36个月的随访中记录。按MHR的四分位数分层分析了四组MACE的特征和发生率。用Cox回归模型分析MACE的风险比。通过Kaplan-Meier生存分析评估四组的MACE发生率。进行限制性三次样条分析以确定MHR和MACE之间的非线性相关性。
结果：经过36个月的随访，407例患者（38.8%）出现MACEs。MHR四分位数较高的患者的MACE发生率明显高于MHR四分位数较低的患者（23.4％vs.36.0%与41.4%和54.6%；分别为P<0.001），这与Kaplan-Meier生存分析一致（P<0.0001）。多因素Cox回归模型显示，校正后MHR是MACE的独立危险因素（校正后HR：2.11；95%CI1.47～3.03；P<0.001）。其对MACE的预测作用与高胆固醇血症无交互作用(P>0.05)。
结论：MHR是接受PCI的缺血性HF合并DM患者MACE的重要且独立的预测因子。
