Background: The monocyte-to-high-density lipoprotein-cholesterol (HDL-cholesterol) ratio (MHR) was introduced, and MHR at diagnosis or study entry was reported to be associated with all-cause mortality, acute coronary syndrome (ACS), and atherosclerosis.

Objectives: In this study, the association between the MHR at diagnosis and poor outcomes of atherosclerosis-related antineutrophil cytoplasmic antibody-associated vasculitis (AAV) during follow-up in patients with AAV was investigated.

Methods: This retrospective study included 138 patients diagnosed with AAV. Their comprehensive medical records were meticulously reviewed. All-cause mortality, cerebrovascular accident (CVA), and ACS were evaluated as atherosclerosis-related poor outcomes of AAV. MHR was obtained by dividing monocyte counts (/mm3) by HDL-cholesterol (mg/dL) levels.

Results: The median age of the 138 patients was 58.3 years with 44 being male (31.9%). Among the 138 patients, 11 (8.0%) died, and 11 (8.0%) and nine (6.5%) had CVA, and ACS, respectively. MHR at diagnosis was significantly correlated with the Birmingham Vasculitis Activity Score, erythrocyte sedimentation rate, and C-reactive protein at diagnosis. Among the three poor outcomes of AAV, only CVA during follow-up was significantly associated with MHR at diagnosis, and thus, only CVA was considered an atherosclerosis-related poor outcome of AAV. In the multivariable Cox hazards model analysis, MHR (hazard ratio [HR] 1.195) and serum albumin (HR 0.203) at diagnosis were independently associated with CVA during follow-up. Additionally, patients with MHR at diagnosis ≥3.0 exhibited a significantly higher risk for CVA and lower cumulative CVA-free survival rate than those with MHR at diagnosis <3.0.

Conclusion: This study is the first to demonstrate clinical implications of MHR suggesting that MHR at diagnosis is significantly and independently associated with CVA during follow-up in patients with AAV.

REFERENCES: [1] Jiang M, Yang J, Zou H, Li M, Sun W, Kong X (2022) Monocyte-to-high-density lipoprotein-cholesterol ratio (MHR) and the risk of all-cause and cardiovascular mortality: a nationwide cohort study in the United States. Lipids Health Dis 21(1):30. https://DOI:10.1186/s12944-022-01638-6 .

[2] Xi J, Men S, Nan J, Yang Q, Dong J (2022) The blood monocyte to high density lipoprotein cholesterol ratio (MHR) is a possible marker of carotid artery plaque. Lipids Health Dis 21(1):130. https://DOI:10.1186/s12944-022-01741-8 .

Figure 1.

Relative risk.

Patients with MHR at diagnosis ≥3.0 exhibits a significantly higher risk of CVA than those with MHR at diagnosis <3.0

MHR: monocyte-to-high-density lipoprotein-cholesterol; CVA: cerebrovascular accident.

Acknowledgements: NIL.

Disclosure of Interests: None declared.