Association of Monocyte-to-HDL Cholesterol Ratio with Cardiac Syndrome X is Linked to Systemic Inflammation

Abstract

Introduction: The aim of this study was to investigate an easily available inflammatory marker and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) in patients with cardiac syndrome X (CSX). Patients and Methods: The study population included 100 patients of which 50 had CSX (CSX group) and 50 had normal coronary angiograms (control group). Results: Total white blood cell (WBC) count, monocyte count, neutrophil count, NLR, high-sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP) and MHR were higher in the CSX group (p< 0.05), whereas high-density lipoprotein cholesterol (HDL-C) level was significantly lower in the CSX group as compared with that in the control group (p< 0.05). In the correlation analysis, MHR revealed a significantly positive correlation with hs-CRP (r= 0.375, p< 0.001) and CRP (r= 0.403, p< 0.001). In the multivariate logistic regression analysis, MHR was independently associated with the presence of CSX (odds ratio: 1.250, 95% confidence interval [CI]: 1.240-1.461, p< 0.001). Using a cut-off level of 90.6, pre-procedural MHR predicted the presence of slow coronary flow (SCF) with a sensitivity of 78% and specificity of 70%. Conclusion: In conclusion, our findings revealed that higher MHR levels were significantly and independently associated with the presence of CSX.