Monocyte-to-high-density lipoprotein ratio as a predictor for patients with Takayasu arteritis and coronary involvement: a double-center, observational study

Weiping Ci; Jin Wan; Jing Han; Kaiyuan Zou; Changjiang Ge; Lili Pan; Zening Jin

doi:10.3389/fimmu.2023.1120245

Monocyte-to-high-density lipoprotein ratio as a predictor for patients with Takayasu arteritis and coronary involvement: a double-center, observational study

Front Immunol. 2023 Jun 22:14:1120245. doi: 10.3389/fimmu.2023.1120245. eCollection 2023.

Authors

Weiping Ci^{1

2}, Jin Wan³, Jing Han¹, Kaiyuan Zou¹, Changjiang Ge⁴, Lili Pan², Zening Jin¹

Affiliations

¹ Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
³ Department of Rheumatology and Immunology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.

Abstract

Background: The implication of the monocyte-to-high-density lipoprotein ratio (MHR) in Takayasu arteritis (TAK) remains unclear.

Objective: We aimed to assess the predictive value of the MHR to identify coronary involvement with TAK and determine the patient prognosis.

Methods: In this retrospective study, 1,184 consecutive patients with TAK were collected and assessed, and those who were initially treated and with coronary angiography were enrolled and classified according to coronary involvement or no involvement. Binary logistic analysis was performed to assess coronary involvement risk factors. Receiver-operating characteristic analysis was used to determine the MHR value to predict coronary involvement in TAK. Major adverse cardiovascular events (MACEs) were recorded in patients with TAK and coronary involvement within a 1-year follow-up, and Kaplan-Meier survival curve analysis was conducted to compare MACEs between them stratified by the MHR.

Results: A total of 115 patients with TAK were included in this study, and 41 of them had coronary involvement. A higher MHR was found for TAK with coronary involvement than for TAK without coronary involvement (P = 0.014). Multivariate analysis showed that the MHR is an independent risk factor for coronary involvement in TAK (odds ratio: 92.718, 95% confidence interval (CI): 2.813-3056.291, P = 0.011). With the best cut-off value of 0.35, the MHR identified coronary involvement with 53.7% sensitivity and 68.9% specificity [area under the curve (AUC): 0.639, 95% CI: 0.544-0.726, P=0.010] and identified left main disease and/or three-vessel disease (LMD/3VD) with 70.6% sensitivity and 66.3% specificity (AUC: 0.704, 95% CI: 0.612-0.786, P = 0.003) in TAK. Combined with other variables, the MHR identified coronary involvement with 63.4% sensitivity and 90.5% specificity (AUC: 0.852, 95% CI: 0.773-0.911, P < 0.001), and identified LMD/3VD with 82.4% sensitivity and 78.6% specificity (AUC: 0.827, 95% CI: 0.720-0.934, P < 0.001) in TAK. A total of 39 patients with TAK and coronary involvement were followed up for 1 year, and 5 patients suffered a MACE. Those with an MHR >0.35 had a higher MACE incidence than their counterparts with an MHR ≤0.35 (χ²=4.757, P = 0.029).

Conclusions: The MHR could be a simple, practical biomarker for identifying coronary involvement and LMD/3VD in TAK and predicting a long-term prognosis.

Keywords: Takayasu arteritis; coronary involvement; left main; monocyte-to-high-density lipoprotein ratio; prognosis; three-vessel disease.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Coronary Artery Disease*
Humans
Lipoproteins, HDL
Monocytes
Retrospective Studies
Takayasu Arteritis*

Substances

Lipoproteins, HDL

Grants and funding

This research was supported by the National Natural Science Foundation of China (grant number 52275517), and Beijing Municipal Hospital Cultivate Program (grant number PX2020025). The sponsors had no role in the study design, data collection, analysis and interpretation, writing of this manuscript, or decision to publish.