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The monocyte to high-density lipoprotein cholesterol ratio (MHR) appears to be a newly emerging inflammatory marker. However, its prognostic value in patients with infective endocarditis (IE) and normal left ventricular ejection fraction (LVEF) has been unclear.Methods and Results:We enrolled consecutive patients with IE and normal LVEF and divided into 3 groups based on the tertiles of MHR. Of 698 included patients, 44 (6.3%) died while in hospital. The occurrence of in-hospital death (3.9%, 4.3%, and 10.8%, P=0.003) and of major adverse clinical events (MACEs) (15.6%, 20.9%, and 30.6%, P&lt;0.001) increased from the lowest to the highest MHR tertiles, respectively. Receiver-operating characteristic analysis demonstrated that MHR had good predictive value for in-hospital death (area under the curve [AUC] 0.670, 95% confidence interval [CI] 0.58-0.76, P&lt;0.001) and was similar to C-reactive protein (AUC 0.670 vs. 0.702, P=0.444). Furthermore, MHR &gt;21.3 had a sensitivity of 74.4% and specificity of 57.6% for predicting in-hospital death. Multiple analysis showed that MHR &gt;21.3 was an independent predictor of both in-hospital (odds ratio 3.98, 95% CI 1.91-8.30, P&lt;0.001) and long-term death (hazard ratio 2.29, 95% CI 1.44-3.64, P&lt;0.001) after adjusting for age, female, diabetes mellitus, estimated glomerular filtration rate &lt;90 mL/min/1.73 m 2 , and surgical treatment. Kaplan-Meier survival curves showed that patients with MHR &gt;21.3 had an increased rate of long-term death compared to those without (P=0.002).

circulation journal

Novel Risk Biomarker for Infective Endocarditis Patients With Normal Left Ventricular Ejection Fraction　― Monocyte to High-Density Lipoprotein Cholesterol Ratio ―

Novel Risk Biomarker for Infective Endocarditis Patients With Normal Left Ventricular Ejection Fraction ― Monocyte to High-Density Lipoprotein Cholesterol Ratio ―

Novel Risk Biomarker for Infective Endocarditis Patients With Normal Left Ventricular Ejection Fraction　― Monocyte to High-Density Lipoprotein Cholesterol Ratio ―