Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Antunes MDO, Scudeler TL. Hypertrophic cardiomyopathy. IJC Heart & Vasculature. 2020;27:100503. doi: 10.1016/j.ijcha.2020.100503. - DOI - PMC - PubMed
    1. Becker RC, Owens AP, Sadayappan S. Tissue-level inflammation and ventricular remodeling in hypertrophic cardiomyopathy. The Journal of Thrombosis and Thrombolysis. 2020;49:177–183. doi: 10.1007/s11239-019-02026-1. - DOI - PMC - PubMed
    1. Bittencourt MI, Cader SA, Araújo DV, Salles ALF, De Albuquerque FN, Spineti PPDM, De Albuquerque DC, Mourilhe-Rocha R. Role of myocardial fibrosis in hypertrophic cardiomyopathy: a systematic review and updated meta-analysis of risk markers for sudden death. Arquivos Brasileiros de Cardiologia. 2019;112:281–289. doi: 10.5935/abc.20190045. - DOI - PMC - PubMed
    1. Ekizler FA, Cay S, Açar B, Tak BT, Kafes H, Ozeke O, Cetin EHO, Ozcan F, Topaloglu S, Tufekcioglu O, Aras D. Monocyte to high-density lipoprotein cholesterol ratio predicts adverse cardiac events in patients with hypertrophic cardiomyopathy. Biomarkers in Medicine. 2019;13:1175–1186. doi: 10.2217/bmm-2019-0089. - DOI - PubMed
    1. Epelman S, Liu PP, Mann DL. Role of innate and adaptive immune mechanisms in cardiac injury and repair. Nature Reviews Immunology. 2015;15:117–129. doi: 10.1038/nri3800. - DOI - PMC - PubMed

Publication types

LinkOut - more resources