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

Abstract

late the secretion of inflammatory cytokines, 9 which play an important role in IE development. In addition, highdensity lipoprotein cholesterol (HDL-C) has been proven to exert anti-inflammatory, antioxidant, and antithrombotic effects. 11,12 Low levels of HDL-C also increase the risk of poor prognosis for IE patients. 13 Therefore, monocytes exert a proinflammatory and pro-oxidant effect, but HDL-C functions as a reversal factor. The monocyte to HDL-C ratio (MHR), which combines 2 opposite processes, pro-inflammatory and anti-inflammatory, would be helpful to identify IE patients at high risk of poor outcome. However, to the best of our knowledge, no study has evaluated D espite earlier diagnosis and more intensive therapeutic approaches, the mortality rate for infective endocarditis (IE) remains high and is approximately 10% at initial admission and reaches approximately 20% in the first year. 1-6 Early and quick identification of patients at high risk of poor outcome is necessary and urgent in order to make accurate clinical decisions for improving patient prognosis.