Abstract
Several leukocyte to high-density lipoprotein cholesterol (HDL-C) ratios, including monocyte to HDL-C ratio (MHR), neutrophil to HDL-C ratio (NHR) and lymphocyte to HDL-C ratio (LHR), have been proposed as novel inflammatory indicators. We performed a cross-sectional study to investigate the relationships between these leukocyte to HDL-C ratios and coronary artery disease (CAD) in patients with chest pain with controlled low-density lipoprotein cholesterol (LDL-C). A total of 3482 patients with chest pain with LDL-C <1.8 mmol/L were enrolled. We evaluated the relationships between MHR, NHR, LHR and HDL-C and the occurrence of CAD as well as severe stenosis. We found that in patients with chest pain, higher MHR (adjusted OR=2.83, 95% CI 1.61 to 4.99, p<0.001) and NHR (adjusted OR=1.08, 95% CI 1.04 to 1.13, p<0.001), as well as lower HDL-C (adjusted OR=0.53, 95% CI 0.36 to 0.78, p=0.001), but not higher LHR (adjusted OR=1.06, 95% CI 0.94 to 1.20, p=0.341), had a stronger association with the occurrence of CAD. Moreover, unlike LHR (adjusted OR=1.02, 95% CI 0.93 to 1.13, p=0.654), higher MHR (adjusted OR=2.10, 95% CI 1.43 to 3.07, p<0.001) and NHR (adjusted OR=1.06, 95% CI 1.04 to 1.09, p<0.001) and lower HDL-C (adjusted OR=0.38, 95% CI 0.26 to 0.56, p<0.001) were risk factors for severe stenosis. A receiver operating characteristic curve analysis exhibited comparable abilities between MHR and NHR in predicting the presence and severity of CAD. In conclusion, even though patients with chest pain have achieved LDL-C <1.8 mmol/L, the inflammatory indicators MHR and NHR maintained their predictive abilities and remained associated with the occurrence and severity of CAD.
Footnotes
Contributors ZY and JZ conceived and designed the study. ML, ZW, RH, XH and YH collected the data. ML, XL and ZW analyzed the data. ML, XL and JZ interpreted and revised the results. ML and JZ wrote the paper. ML submitted the manuscript for publication. ML acts as a guarantor for the overall content. All authors reviewed and revised the manuscript.
Funding This work was supported by the National Key R&D Program of China (2018YFC1311505) and the Key Project of Research and Development Plan of Shaanxi Province of China (2017ZDCXL-SF-02-04-01).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.
Data availability statement
Data are available upon reasonable request. The data sets used and analyzed during the study are available from the corresponding author on reasonable request.
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