الفهرس 
Stable Coronary Artery DiseaseOnly 14 pages are availabe for public view
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Abstract
Coronary artery disease (CAD) is a leading cause of death worldwide. In addition to the other classic risk factors of CAD (smoking, male sex, hypercholesterolemia, and hypertension), atherosclerosis is recognized as an important risk factor for coronary artery disease (CAD). Mounting interest focusses on the identification of new prognostic markers better enabling the categorisation of patients who are at higher risk for future cardiovascular events. Considering the role of inflammation, oxidative stress, and endothelial dysfunction in the initiation and progression of atherosclerotic process, various inflammatory biomarkers including Creactive protein, and interleukin-6 have been reported to be associated with severity of coronary artery disease and prognosis. As a recently emerged inflammation-based marker, the monocyte count to HDL-C ratio (MHR) has been reported as a new predictor and prognostic indicator of cardiovascular diseases. MHR was calculated to 200 patient admitted to our department with stable coronary artery disease for doing elective angiography. The study population was stratified into the following syntax score tertiles: 1st ≥23 (n=60) and 2nd <23 (n=140). Significant coronary artery disease was defined as more than 50% diameter stenosis in any major vessel. Complexity of coronary lesion was assessed by SYNTAX score. We found significant correlation between MHR and severity of CAD measured by SYNTAX score. Moderate positive linear correlation was also found between HbA1c% level in non-diabetics and SYNTAX score. In the present study, we found MHR to be an independent predictor for more complex coronary artery lesions (SXscore ≥23) in patients with stable CAD. We also found MHR cutoff value for predicting a high SXscore was 19.2 with a sensitivity of 93.33% and a specificity of 80 % (area under the curve 0.924 , p<0.001).The positive predictive value was 66.7 and the negative predictive value was 96.6 . Our analyses suggest that MHR value is a marker for important pathological processes related to atherosclerosis and abnormal endothelial function that contribute to vascular disease risk in people with coronary artery disease. Although requiring further evaluation in randomised controlled trials, the medications targetting monocyte and HDL particles or this interaction may provide a new approach to preventing worse cardiovascular events. The evaluation of this parameter may be used to categorise patients who might benefit the most from HDL targetting therapy, intense statin medication, longer duration of antiplatelet therapy, drugs with antiinflammatory, pleiotropic properties. This parameter may also utilise monitoring the inflammatory response and the efficiency of therapies. Conclusion MHR was significantly higher in stable CAD patients with high SXscores. We believe that MHR may be used in daily clinical practice as a quickly accessible and inexpensive parameter to predict a high SXscore in stable CAD patients. Further prospective trials would better identify the clinical significance of MHR in patients with CAD.