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. 2022 Mar 29:10:e13212.
doi: 10.7717/peerj.13212. eCollection 2022.

Relation between lymphocyte to monocyte ratio and survival in patients with hypertrophic cardiomyopathy: a retrospective cohort study

Zhonglan Chen #  1 , Ziqiong Wang #  2 , Youping Li  3 , Xiaoping Chen  2 , Sen He  2
Affiliations

Relation between lymphocyte to monocyte ratio and survival in patients with hypertrophic cardiomyopathy: a retrospective cohort study

Zhonglan Chen et al. PeerJ. .

Abstract

Background: The lymphocyte-to-monocyte ratio (LMR) has been proposed as a novel prognostic factor in malignancies and cardiovascular diseases. Our study aimed to ascertain whether LMR is a useful biomarker in discriminating the hypertrophic cardiomyopathy (HCM) patients at higher risk of all-cause mortality.

Methods: This retrospective study consisted of 354 adult HCM patients. Cox's proportional hazards regression models were used to analyze the association between LMR and all-cause mortality. Smooth curve fitting was conducted to explore the linear relationship between LMR and all-cause mortality.

Results: During the follow-up, 44 patients reached the study endpoint. The all-cause mortality rate was 7.3 per 100 person-years in the first tertile and decreased across the three tertiles of LMR. With the first tertile as reference, adjusted hazard ratios (HR) for all-cause mortality were 0.43 for the second tertile (95% CI [0.20-0.91], p = 0.027) and 0.39 for the third tertile (95% CI [0.17-0.90], p = 0.028), respectively. Smooth curve fitting exhibited a nonlinear relationship between LMR values and all-cause mortality. For LMR < 6.5, per SD increase resulted in a significantly decreased risk of all-cause mortality by 62% (HR: 0.38, 95% CI [0.21-0.68]). For LMR ≥ 6.5, the all-cause mortality risk did not progressively increase. Stratified and subgroup analyses revealed similar results to the main analyses,andE-value analysis suggested robustness to unmeasured confounding.

Conclusions: The study demonstrated that LMR was an independent predictor of all-cause mortality in HCM patients, and LMR may be useful for identifying HCM patients at high mortality risk.

Keywords: All-cause mortality; Cardiac inflammation; Hypertrophic cardiomyopathy; Lymphocyte to monocyte ratio.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Kaplan–Meier analysis showing cumulative all-cause mortality by baseline lymphocyte to monocyte ratio tertiles.
ACM, all-cause mortality.
Figure 2
Figure 2. Association between LMR and all-cause mortality by smooth curve fitting (A–B).
HR was adjusted for the covariates, which were the same as those in the model 2, and the red lines and blue ribbons depict the adjusted HRs and 95%CI. Abbreviations as in Tables 1 and 2.
Figure 3
Figure 3. Time-dependent AUCs (A–B).
The red lines and grey ribbons depict the AUCs and 95%CI. Abbreviations as in Tables 1 and 2.
See this image and copyright information in PMC

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