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\begin{document}

\title{Prognostic Significance of Monocyte to High-density Lipoprotein Ratio in
Patients With Coronary Chronic Total Occlusion}



\author[1]{Muhammed Demir}%
\author[1]{Mehmet Ozbek}%
\author[2]{Tuncay Güzel}%
\author[3]{Adem Aktan}%
\author[2]{Burhan Aslan}%
\affil[1]{Dicle University Medical Faculty}%
\affil[2]{Diyarbakir Gazi Yasargil Training and Research Hospital}%
\affil[3]{Mardin State Hospital}%


\vspace{-1em}



  
  \date{May 27, 2024}


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\selectlanguage{english}
\begin{abstract}
Objective: Development of chronic total occlusion (CTO) consists of
multiple histological stages, with each stage containing different
histopathological features. The monocyte to high-density lipoprotein
ratio (MHR) is a useful marker of the degree of inflammatory response.
The aim of this study was to investigate the relationship between MHR
and long-term survival and mortality in CTO patients. Methods: The study
included 493 CTO patients that were followed over a period of 73 months
between January 2011 and December 2019. MHR was calculated from the
venous blood samples taken from each patient immediately before routine
coronary angiography. Results: The study included 493 patients
comprising 353 (71.6\%) men and 140 (28.4\%) women with a mean age of
63.03\selectlanguage{ngerman}±10.88 years. Median follow-up period was 48 (interquartile range
{[}IQR{]}: 26-73) months. Patients were divided into two groups: (I) MHR
\textless{}17.68 (n=278) and (II) MHR \selectlanguage{english}[?]17.68 (n=215). Long-term
mortality was significantly higher in group II than in group I (n=70,
32.6\% vs. n=43, 15.5\%; p\textless{}0,001). On multivariate logistic
regression analysis, MHR was found to be an independent predictor of
long-term mortality (Odds Ratio {[}OR{]}: 1.089, 95\% Confidence
Interval {[}CI{]}: 1.055-1.124, p\textless{}0,001). The Kaplan-Meier
analysis showed lower survival rates in group II (MHR \selectlanguage{english}[?]17.68) than in
group I (MHR \textless{}17.68) (75.223+-2.670 vs. 89.220+-2.102,
p\textless{}0,001). Conclusion: MHR could be used as a practical
universal biomarker of mortality and survival in CTO patients.%
\end{abstract}\selectlanguage{ngerman}%



\sloppy


\textbf{Prognostic Significance of Monocyte to High-density Lipoprotein
Ratio in Patients With Coronary Chronic Total Occlusion}

\textbf{Objective:} Monocyte to high-density lipoprotein ratio is a
marker of inflammatory response. We investigate the relationship between
MHR and mortality in CTO patients.

\textbf{Methods:} Study included 493 patients followed over a period of
73 months. Blood samples taken from patient before coronary angiography.

\textbf{Results:} Median follow-up was 48 months. Patients were divided
into two groups: (I) MHR \textless{}17.68 (n=278) and (II) MHR [?]17.68
(n=215). Mortality was significantly higher in group II than in group I
(n=70 vs. n=43; p\textless{}0,001). MHR was found to be an predictor of
mortality (OR: 1.089, 95\% {[}CI{]}: 1.055-1.124, p\textless{}0,001).
Kaplan-Meier showed lower survival rates in group II than in group I
(75.223\selectlanguage{ngerman}±2.670 vs. 89.220±2.102, p\textless{}0,001).

\textbf{Conclusion:} MHR could be used as a biomarker of mortality in
CTO patients

\textbf{Key words:} Chronic total occlusion, risk predictor, monocyte to
high-density lipoprotein ratio, long-term mortality, inflammation

\textbf{What's already known about this topic?}

The association of MHR as an inflammatory marker with atherosclerotic
diseases, various heart diseases, various inflammatory diseases and some
types of cancer has been demonstrated in clinical studies.

\textbf{What does this article add?}

We have shown that high MHR were significant and independent predictor
of long-term mortality in patients with CTO.MHR is a practical biomarker
that may be useful for long-term cardiac risk stratification in patients
with coronary chronic total occlusion.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-1/Figure-1}

\end{center}
\end{figure}\selectlanguage{english}
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\includegraphics[width=0.70\columnwidth]{figures/Figure-2/Figure-2}

\end{center}
\end{figure}\selectlanguage{english}
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\includegraphics[width=0.70\columnwidth]{figures/Figure-3/Figure-3}

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\end{figure}

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