Predictive Role of Monocyte to High-density Lipoprotein Ratio for Plaque Morphology in Asymptomatic Intermediate Carotid Stenosis

Objective:Carotid plaques are divided into calcified, mixed and fatty types according to the morphological ultrastructure. Increased risk of rupture, thromboembolism and stroke are more pronounced in mixed and fatty carotid plaques due to composition and instability. The present study aimed to assess the role of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) to predict mixed and fatty plaques in patients with intermediate carotid artery stenosis.Method:A total of 223 asymptomatic patients who had 50-70% stenosis in the carotid artery were included in this retrospective cohort study. Patients were assigned into three groups based on plaque morphology: 94 with calcified, 71 with mixed and 58 with fatty plaques. Groups were compared in terms of MHR. Predictive role of MHR for mixed and fatty plaque was investigated.Results:MHR was significantly higher in the mixed and fatty plaque groups (16.951±5.935 vs 20.181±9.405 vs 11.200±4.126, p<0.001). It, with a cut off of 13.61, had 71.8% sensitivity and 56.6% specificity for the prediction of mixed plaque [area under the curve (AUC): 0.645, 95% confidence interval (CI): 0.571-0.718, p=0.001]. Moreover, MHR, with a cut off of 14.40, had 77.6% sensitivity and 62.4% specificity for the prediction of fatty plaque (AUC: 0.746, 95% CI: 0.675-0.818, p<0.001). Multivariate regression analysis showed MHR was a significant independent predictor of mixed [odds ratio (OR): 1.230, p<0.001] and fatty (OR: 1.364, p<0.001) plaques in intermediate carotid artery stenosis, after adjusting for other risk factors.Conclusion:MHR plays a favorable role for the prediction of mixed and fatty plaques in asymptomatic intermediate carotid artery stenosis.