HIGH RATIO OF MONOSIT HIGH-DENSITY LIPOPROTEIN AS A RISK FACTOR OFCHRONIC TOTAL OCCLUSION IN PATIENTS CORONARY ARTERY DISEASE

ABSTRACT Objective: Chronic total occlusion (CTO) is frequently found in coronary heart disease (CHD) with multivessel lesions. Patients with CTO are associated with an increased mortality rate. Management CTO requires specialized techniques, more resource utilization, and high cost. The progression of atherosclerosis can be prevented by controlling for risk factors. Monocyte to high-density lipoprotein ratio (MHR) is one of the new biomarkers used to assess the incidence of a major adverse cardiovascular event, the severity of coronary lesions, and the incidence of in-stent restenosis. This study was aimed to determine the role of MHR levels as a risk factor for the occurrence of CTO in CAD patients. Methods: This research is a matched case–control located in Sanglah General Hospital from August 2017 until October 2017. This research consisted of 47 cases with CTO and 47 control without CTO. Case and control samples were adjusted by sex, age, and number of blood vessels involved in CAD. Results: The cutoff value of MHR was also determined by analyzing the receiver operating curve. The optimal cut off point was 14.33 with sensitivity 83% and specificity 80.9%. Bivariate analysis showed high MHR was found strongly associated with the risk of CTO in CHD patients with odds ratio (OR)=61; IK 95% (OR)=3.211–114.15; p?0.001. Multivariate analysis showed that high levels of MHR were significantly associated with risk of CTO after other traditional risk factors such as hypertension, diabetes mellitus, dyslipidemia, and smoking were controlled with OR=20,306; 95% IK (OR)=6.05–68.05; p?0.001. Conclusion: High levels of MHR were significantly associated with the risk factor of CTO in CAD patients. Keywords: Chronic total occlusion, Monocyte to HDL ratio, Coronary artery disease