Predictive value of monocyte-to-HDL and neutrophil-to-HDL cholesterol ratio for obstructive coronary artery disease in Patients undergoing coronary angiography.
6 affiliations
- 1Faculty of Nursing, Middle East University, Amman, Jordan.
- 2University of Jordan, Amman, Jordan.
- 3Nursing Education Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
- 4Faculty of Nursing, Isra University, Amman, Jordan.
- 5Royal College of Surgeon in Ireland, in Bahrain, Bahrain.
- 6University of Rochester, Rochester, NY, USA.
Abstract
Background
The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) are emerging composite biomarkers that reflect systemic inflammatory status and lipid metabolism. Although both indices have individually been associated with coronary artery disease (CAD), evidence directly comparing their diagnostic performance for obstructive CAD remains scarce.Objective
This study aims to compare the diagnostic performance of MHR and NHR in identifying obstructive CAD among patients undergoing elective coronary angiography.Methods
A prospective cohort study was conducted involving patients who underwent diagnostic coronary angiography in Jordan. Obstructive CAD was defined as stenosis of 50% or more in a major epicardial vessel on invasive coronary angiography.Results
A total of 215 patients were included, of whom 129 (60%) were male, with a mean age of 58.4 ± 11.4 years; 43.7% had obstructive CAD. After adjusting for age, sex, and prior CAD history in multivariate regression analysis, MHR remained an independent predictor of obstructive CAD (OR = 1.99, 95% CI: 1.34-2.97, p < 0.001), whereas NHR was not independently associated (OR = 1.66, 95%CI: 0.74-3.69, p = 0.21). The clinical model integrating MHR demonstrated an AUC of 0.801 (95% CI: 0.74-0.86); however, this numerical increase was not statistically significant (DeLong test, p = 0.216).Conclusion
MHR may have potential value for risk stratification in obstructive CAD. Although adding MHR to the clinical model resulted in a numerically higher AUC, the incremental improvement in discrimination was not statistically significant. Further studies involving larger, multicenter cohorts are needed to establish the incremental predictive and clinical utility of MHR.
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BibTeX
@article{hani2026predictive,
title = {{Predictive value of monocyte-to-HDL and neutrophil-to-HDL cholesterol ratio for obstructive coronary artery disease in Patients undergoing coronary angiography.}},
author = {Dania A Bani Hani and Jafar A Alshraideh and Afaf S Yousef and Abeer A Alwahadneh and Meshal Matar Alenazi and Ja'far M Alkhawaldeh and Hamza Alduraidi and Shaker Al-Nabulsi and Salah S Al-Zaiti},
journal = {American heart journal plus : cardiology research and practice},
year = {2026},
month = oct,
doi = {10.1016/j.ahjo.2026.100943},
url = {https://europepmc.org/article/MED/42898219},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Predictive value of monocyte-to-HDL and neutrophil-to-HDL cholesterol ratio for obstructive coronary artery disease in Patients undergoing coronary angiography.
AU - Dania A Bani Hani
AU - Jafar A Alshraideh
AU - Afaf S Yousef
AU - Abeer A Alwahadneh
AU - Meshal Matar Alenazi
AU - Ja'far M Alkhawaldeh
AU - Hamza Alduraidi
AU - Shaker Al-Nabulsi
AU - Salah S Al-Zaiti
PY - 2026
DA - 2026/10/07
JO - American heart journal plus : cardiology research and practice
DO - 10.1016/j.ahjo.2026.100943
UR - https://europepmc.org/article/MED/42898219
AB - Background The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) and neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) are emerging composite biomarkers that reflect systemic inflammatory status and lipid metabolism. Although both indices have individually been associated with coronary artery disease (CAD), evidence directly comparing their diagnostic performance for obstructive CAD remains scarce.Objective This study aims to compare the diagnostic performance of MHR and NHR in identifying obstructive CAD among patients undergoing elective coronary angiography.Methods A prospective cohort study was conducted involving patients who underwent diagnostic coronary angiography in Jordan. Obstructive CAD was defined as stenosis of 50% or more in a major epicardial vessel on invasive coronary angiography.Results A total of 215 patients were included, of whom 129 (60%) were male, with a mean age of 58.4 ± 11.4 years; 43.7% had obstructive CAD. After adjusting for age, sex, and prior CAD history in multivariate regression analysis, MHR remained an independent predictor of obstructive CAD (OR = 1.99, 95% CI: 1.34-2.97, p < 0.001), whereas NHR was not independently associated (OR = 1.66, 95%CI: 0.74-3.69, p = 0.21). The clinical model integrating MHR demonstrated an AUC of 0.801 (95% CI: 0.74-0.86); however, this numerical increase was not statistically significant (DeLong test, p = 0.216).Conclusion MHR may have potential value for risk stratification in obstructive CAD. Although adding MHR to the clinical model resulted in a numerically higher AUC, the incremental improvement in discrimination was not statistically significant. Further studies involving larger, multicenter cohorts are needed to establish the incremental predictive and clinical utility of MHR.
SN - 2666-6022
ER -