The importance of the lipid-related biomarkers has been implicated in the pathological process and prognosis of acute myocardial infarction (AMI). Our work was conducted to discuss and compare the predictive ability of the neutrophil to high-density lipoprotein cholesterol (HDL-C) ratio (NHR) with other existing prognostic indices, for instance, the monocyte to HDL-C ratio (MHR) and the low-density lipoprotein cholesterol (LDL-C) to HDL-C ratio (LDL-C/HDL-C) in elderly patients with AMI. Our population was 528 consecutive elderly AMI patients (65–85 years) who were enrolled from Tongji Hospital and grouped according to the cutoff points which were depicted by the receiver operating characteristic (ROC). The Kaplan-Meier curves were plotted with the survival data from the follow-up to investigate the difference between cutoff point-determined groups. Moreover, we assessed the impact of NHR, MHR, LDL-C/HDL-C on the long-term mortality and recurrent myocardial infarction (RMI) with Cox proportional hazard models. Mean duration of follow-up was 673.85 ± 14.32 days (median 679.50 days). According to ROC curve analysis, NHR ≥ 5.74, MHR ≥ 0.67, LDL-C/HDL-C ≥ 3.57 were regarded as high-risk groups. Kaplan-Meier analysis resulted that the high-NHR, high-MHR and high-LDL-C/HDL-C groups presented higher mortality and RMI rate than the corresponding low-risk groups in predicting the long-term clinical outcomes (log-rank test: all P < 0.050). In multivariate analysis, compared with MHR and LDL-C/HDL-C, only NHR was still recognized as a latent predictor for long-term mortality (harzard ratio [HR]: 1.96, 95% confidence interval [CI]: 1.02 to 3.75, P = 0.044) and long-term RMI (HR: 2.23, 95% CI: 1.04 to 4.79, P = 0.040). Furthermore, the positive correlation between NHR and Gensini score (r = 0.15, P < 0.001) indicated that NHR was relevant to the severity of coronary artery to some extent. NHR, a novel laboratory marker, might be a predictor of the long-term clinical outcomes of elderly patients with AMI, which was superior to MHR and LDL-C/HDL-C.

中文翻译：

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老年急性心肌梗死患者中性粒细胞与高密度脂蛋白比值具有更好的预后价值

脂质相关生物标志物的重要性已与急性心肌梗死（AMI）的病理过程和预后相关。我们的工作旨在讨论和比较嗜中性粒细胞对高密度脂蛋白胆固醇（HDL-C）比（NHR）的预测能力以及其他现有的预后指标，例如单核细胞对HDL-C比（MHR）和老年AMI患者的低密度脂蛋白胆固醇（LDL-C）与HDL-C比率（LDL-C / HDL-C）。我们的人口是从同济医院招募的528例连续的AMI老年患者（65-85岁），并根据接受者操作特征（ROC）描绘的临界点进行分组。将Kaplan-Meier曲线与后续的生存数据作图，以研究临界点确定组之间的差异。此外，我们使用Cox比例风险模型评估了NHR，MHR，LDL-C / HDL-C对长期死亡率和复发性心肌梗塞（RMI）的影响。平均随访时间为673.85±14.32天（中位数679.50天）。根据ROC曲线分析，NHR≥5.74，MHR≥0.67，LDL-C /HDL-C≥3.57被视为高危人群。Kaplan-Meier分析结果表明，在预测长期临床结局时，高NHR，高MHR和高LDL-C / HDL-C组的死亡率和RMI率均高于相应的低风险组（对数秩测试：所有P <0.050）。在多变量分析中，与MHR和LDL-C / HDL-C相比，仅NHR仍被认为是长期死亡率的潜在预测因素（危险比[HR]：1.96，95％置信区间[CI]：1.02至3.75，P = 0.044）和长期RMI（HR：2.23，95） ％CI：1.04至4.79，P = 0.040）。此外，NHR与Gensini评分之间呈正相关（r = 0.15，P <0.001），表明NHR在一定程度上与冠状动脉的严重程度有关。NHR是一种新型的实验室指标，可能是老年AMI患者长期临床结果的预测指标，优于MHR和LDL-C / HDL-C。001）表明NHR在一定程度上与冠状动脉的严重程度有关。NHR是一种新型的实验室指标，可能是老年AMI患者长期临床结果的预测指标，优于MHR和LDL-C / HDL-C。001）表明NHR在一定程度上与冠状动脉的严重程度有关。NHR是一种新型的实验室指标，可能是老年AMI患者长期临床结果的预测指标，优于MHR和LDL-C / HDL-C。