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. 2024 Jul 1;31(3):151-159.
doi: 10.4078/jrd.2024.0001. Epub 2024 Mar 12.

The monocyte-to-high-density lipoprotein-cholesterol ratio at diagnosis is associated with cerebrovascular accident during follow-up in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Jang Woo Ha  1 , Sung Soo Ahn  1 , Jason Jungsik Song  1   2 , Yong-Beom Park  1   2 , Sang-Won Lee  1   2
Affiliations

The monocyte-to-high-density lipoprotein-cholesterol ratio at diagnosis is associated with cerebrovascular accident during follow-up in patients with antineutrophil cytoplasmic antibody-associated vasculitis

Jang Woo Ha et al. J Rheum Dis. .

Abstract

Objective: In this study, the association between the monocyte-to-high-density lipoprotein cholesterol ratio (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 acute coronary syndrome (ACS) were evaluated as atherosclerosis-related poor outcomes of AAV. MHR was obtained by dividing monocyte counts (/mm3) by high-density lipoprotein 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 9 (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.

Keywords: Antineutrophil cytoplasmic antibody; High density lipoprotein cholesterol; Monocytes; Stroke; Vasculitis.

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Conflict of interest statement

CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
Correlation analysis. MHR at diagnosis is significantly correlated with the cross-sectional BVAS, ESR, and CRP levels. MHR: monocyte-to-high-density lipoprotein-cholesterol ratio, BVAS: Birmingham vasculitis activity score, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein.
Figure 2
Figure 2
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 ratio, CVA: cerebrovascular accident, CI: confidence interval.
Figure 3
Figure 3
Comparison of cumulative survival rates. Patients with MHR at diagnosis ≥3.0 exhibits a significantly lower cumulative CVA-free survival rate than those with MHR at diagnosis <3.0. MHR: monocyte-to-high-density lipoprotein-cholesterol ratio, CVA: cerebrovascular accident.
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References

    1. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65:1–11. doi: 10.1002/art.37715. - DOI - PubMed
    1. Watts R, Lane S, Hanslik T, Hauser T, Hellmich B, Koldingsnes W, et al. Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis. 2007;66:222–7. doi: 10.1136/ard.2006.054593. - DOI - PMC - PubMed
    1. Millet A, Pederzoli-Ribeil M, Guillevin L, Witko-Sarsat V, Mouthon L. Antineutrophil cytoplasmic antibody-associated vasculitides: is it time to split up the group? Ann Rheum Dis. 2013;72:1273–9. doi: 10.1136/annrheumdis-2013-203255. - DOI - PubMed
    1. Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S, et al. Modification and validation of the Birmingham Vasculitis Activity Score (version 3) Ann Rheum Dis. 2009;68:1827–32. doi: 10.1136/ard.2008.101279. - DOI - PubMed
    1. Jiang M, Yang J, Zou H, Li M, Sun W, Kong X. 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. 2022;21:30. doi: 10.1186/s12944-022-01638-6. - DOI - PMC - PubMed

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