Monocyte to high-density lipoprotein ratio as a predictive biomarker for in-hospital mortality following surgery for type A aortic dissection: Reality or myth?

Background: Type A aortic dissection (TAAD) is a life-threatening clinical emergency requiring timely surgical intervention. If untreated, 50% of TAAD die within the first 24 h, with mortality increasing by 1%-2% every passing hour within the first 48 h of presentation. Surgical repair of TAAD is a major procedure associated with relatively high mortality and morbidity postoperatively. Several inflammatory biomarker have been linked to aortic dissection (AD) as diagnostic and/or prognostic tools, one example is the monocyte count to high-density lipoprotein ratio (MHR).

Aims: This commentary aims to discuss the recent study by Savas et al. which investigated the use of MHR as a predictive biomarker for in-hospital mortality following surgery for TAAD.

Methods: We carried out a literature search on multiple electronic databases including PUBMED and Scopus to collate research evidence to assess the value of MHR as a prognostic biomarker in AD.

Results: Savas et al. proved that MHR is an effective predictive biomarker for in-hospital mortality following surgical repair of TAAD by demonstrating that MHR was independently associated with in-hospital mortality in this subset of patients.

Conclusion: Despite the advancement in surgical and perfusion techniques, surgical management of TAAD remains associated with relatively high risk of mortality and morbidity. Using prognostic biomarkers such as MHR can provide a means of reducing in-hospital mortality by identifying those at risk. Yet, further research into this area is encouraged.