Monocyte-to-lymphocyte ratio as a predictor of left ventricular aneurysm in acute STEMI patients.

The prevalence of left ventricular aneurysm (LVA) was approximately 14% in both study cohorts of STEMI patients.

• LVA prevalence was 14.5% in the first cohort (n=551 patients)
• LVA prevalence was 13.6% in the validation cohort (n=471 patients)
• All patients had presented with acute ST segment elevation myocardial infarction (STEMI) and received primary PCI

Patients in the highest quartile of MLR (Q4) had significantly increased risk of LVA formation compared to those in the lowest quartile (Q1) in both cohorts.

• First cohort: OR = 3.07, 95% CI = 1.33–7.08, P = 0.009
• Validation cohort: OR = 3.55, 95% CI = 1.34–9.42, P = 0.011
• Association was determined via multivariable logistic regression analysis
• The association was described as independent, suggesting MLR remained significant after adjustment for other variables

Restricted cubic spline (RCS) analysis revealed a significant association between MLR and LVA risk in both cohorts, though the shape of the association differed between cohorts.

• A positively nonlinear association was identified in the first cohort (overall P < 0.05)
• A positively linear association was identified in the validation cohort (overall P < 0.05)
• RCS analysis was used to characterize the dose-response relationship between MLR and LVA risk

MLR demonstrated greater discriminative ability for LVA than either monocyte count or lymphocyte count alone.

• Area under the ROC curve (AUC) for MLR was 0.69 in the first cohort
• AUC for MLR was 0.71 in the validation cohort
• MLR exceeded the discriminative ability of both monocyte and lymphocyte individually in predicting LVA

Subgroup analyses supported the robustness of the association between elevated MLR and increased LVA risk.

• Subgroup analyses were conducted to test consistency of findings across patient subgroups
• Results were described as further substantiating the robustness of the findings
• The overall association between elevated MLR and LVA risk was maintained across subgroups

MLR has been identified as a novel inflammatory marker not previously evaluated for its utility in predicting LVA development in STEMI patients.

• MLR had emerged as a novel marker of inflammation prior to this study
• Its potential utility in predicting LVA had remained unexplored before this study
• The authors suggest MLR may offer supplementary prognostic information and could be considered for inclusion in future risk stratification models