Relationship between the neutrophil to high-density lipoprotein cholesterol ratio and severity of coronary artery disease in patients with stable coronary artery disease

Association of fibrinogen/albumin ratio and Castelli risk index 2 (CRI-2=LDL-C/HDL-C) with severity of coronary artery lesions in different glucose metabolism states

BACKGROUND

The fibrinogen to albumin ratio (FAR) is a novel inflammatory indicator correlating with the severity of coronary artery disease (CAD). An indicator of atherosclerosis is the Castelli Risk Index 2 (CRI-2=LDL-C/HDL-C). Yet, little research has focused on the link between both of indicators and CAD in different glucose metabolic states. Thus, this study aimed to investigate the association between FAR, CRI-2, and the severity of coronary artery lesions in patients with CAD in different glucose metabolic states.

METHOD

In this investigation, coronary angiography was performed about 2825 individuals suffering from symptomatic CAD at Tianjin Union Medical Center from 2016-2023.The number of stenotic arteries in the coronary arteries was counted. The Gensini scores were taken into account. Normal glucose regulation (NGR), pre-diabetes mellitus (Pre-DM), and diabetes mellitus (DM) were the three categories of glucose status according to the WHO diabetes guidelines. Patients were also divided into FAR index and CRI-2 quartiles to look into the link between FAR index and CRI-2 and coronary artery lesions in CAD patients with different glucose metabolic states. Receiver operating characteristic (ROC) curves were constructed to analyze the predictive value of the FAR index and CRI-2 for coronary artery lesions.

RESULT

According to logistic regression analysis, the FAR index and CRI-2 were statistically associated with coronary artery disease (P < 0.05). The FAR index was linked with severity of coronary artery lesions regardless of glucose metabolism states (P < 0.05). The CRI-2 was strongly linked with severity of coronary artery lesions in both NGR and DM status (P < 0.05). Yet, there was no statistical significance in Pre-DM states (P > 0.05). The FAR index and CRI-2 exhibited higher regions underneath the ROC curve in forecasting severity of coronary artery lesions.

CONCLUSION

The FAR index and CRI-2 were significantly associated with severity of coronary artery lesions in different glucose metabolic states. FAR index and CRI-2 have predictive value for coronary artery lesions.

Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in patients with acute ST-segment elevation myocardial infarction

Background

The neutrophil to high-density lipoprotein cholesterol ratio (NHR) has been proposed as a potential marker for predicting cardiovascular events. However, its prognostic role following percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to evaluate the predictive value of NHR for left ventricular remodeling (LVR) and long-term outcomes in STEMI patients post-PCI.

Methods

This retrospective study included 299 STEMI patients who underwent PCI and were followed for 24 months post-procedure. Echocardiography was performed upon admission and at 6 months post-myocardial infarction (MI). LVR was defined as an increase in left ventricular diastolic volume (LVEDV) of at least 20% from baseline. Based on their VR status, patients were divided into LVR (n = 81) and non-LVR (n = 218) groups and clinical data were compared. A weighted logistic regression model was used to study the correlation between NHR and LVR. Weighted Cox proportional risk models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for major adverse cardiovascular events (MACE). And the NHR was analyzed using receiver operating characteristic (ROC) curves to predict the occurrence of postoperative LVR and MACE in STEMI patients. Restricted cubic spline (RCS) analysis was used to explore the linear or non-linear relationship between NHR and LVR or MACE. Cox survival analysis was used to assess the relationship between NHR, LVR and survival time.

Results

Among the 299 STEMI patients enrolled in the study, LVR was observed in 81 patients after 24 months of follow-up. The LVR group had significantly higher NHR levels compared to the non-LVR group (8.19 ± 1.95 vs. 6.23 ± 1.91, P < 0.001). After adjusting for potential confounders, a significant positive correlation was found between NHR and LVR. Each standard deviation increase in NHR was associated with a 43% higher risk of MACE (HR: 1.43, 95% CI: 1.25-1.64, P < 0.001). ROC curve analysis demonstrated that NHR could predict both LVR (AUC: 0.762) and MACE (AUC: 0.722). An NHR cut-off value of >8.13 was significantly linked to an increased risk of MACE (HR: 4.30, 95% CI: 2.41-7.69).

Conclusions

NHR is an independent predictor of LVR and MACE after PCI in STEMI patients. Monitoring NHR may aid in identifying high-risk patients early, facilitating individualized treatment.

Association of neutrophil to high density lipoprotein cholesterol ratio with aortic dissection and aneurysm risk: epidemiological insights from prospective cohort study based on UK biobank

BACKGROUND

Neutrophil to high-density lipoprotein cholesterol ratio (NHR) is a metabolic inflammatory biomarker reflecting the balance between pro- and anti-inflammatory responses. Extensive research has revealed that NHR is an effective predictor for cardiovascular risks, such as stroke and myocardial infarction. Nevertheless, the association between NHR and incidence risks of aortic dissection (AD) and aortic aneurysm (AA) remains unclear.

METHODS

This research, designed as a prospective cohort study, enrolled 409,357 participants based on the UK Biobank project. The cut-off value of NHR i.e., 0.205, was determined using a receiver operating characteristic curve for grouping. Participants were divided into two groups: NHR ≤ 0.205 (n = 293,294) and NHR > 0.205 (n = 116,063). The cumulative incidence of outcome, i.e., AD/AA including AD and AA, was calculated using Kaplan-Meier curves. The dose-response relationship between NHR and AD/AA was evaluated using restricted cubic spline (RCS). Multivariable-adjusted Cox proportional hazards regression models, followed by sensitivity analyses and subgroup analyses, were performed to evaluate the association between NHR and AD/AA onset.

RESULTS

A total of 3,408 participants developed AD/AA, including 233 AD cases and 3,259 AA cases, with a median follow-up period of 14.8 years. The incidences of AD/AA, AD and AA were 56.34, 3.85 and 53.87 cases per 100,000 person-years, respectively. A nonlinear relationship between NHR and the incidence risk of AD/AA was documented by RCS (P for nonlinear < 0.001). Participants in the NHR > 0.205 group had a higher risk of developing AD/AA compared to those in the NHR ≤ 0.205 group, with an adjusted HR of 1.47 (95%CI 1.37-1.58). This association was further validated by sensitivity analyses and subgroup analyses.

CONCLUSIONS

NHR is an independent risk factor for AD/AA. The disorder of metabolic inflammation may be a potential pathological mechanism for AD/AA. Tailored assessment and management of NHR may serve as effective strategies for the prevention and prediction of AD/AA.

Sex differences of neutrophil to high-density lipoprotein cholesterol ratio in predicting the severity of coronary lesions in acute coronary syndrome patients

BACKGROUND

The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is closely related to the occurrence and severeness of coronary stenosis in subjects with acute coronary syndrome (ACS). Men have higher NHR levels than women. The study was designed to examine the usefulness of NHR for predicting severe coronary stenosis in male and female ACS subjects.

METHODS

We enrolled 165 ACS patients (105 males and 60 females) who underwent coronary angiography. Clinical parameters; fasting glucose, creatinine, and uric acid levels; lipid profiles; and routine blood indices were measured. The NHR was computed by dividing the neutrophil numbers by the concentration of high-density lipoprotein cholesterol. Coronary stenosis severity was assessed using the Gensini score (GS). A GS˃41 points was regarded as a high GS.

RESULTS

The NHR was clearly greater in male ACS individuals than in their female counterparts (P = 0.001). The NHR was positively linked to the GS (r = 0.330, P = 0.001) in men, whereas there was no association between NHR and the GS in women (r=-0.0.032, P = 0.805). Univariate logistic regression analyses indicated that the NHR predicted a high GS in male ACS patients but not in their female counterparts. Multivariate logistic regression analyses indicated that a high NHR was an independent marker of severe coronary lesions in men (P = 0.001) but not in women (P = 0.274). The areas under the receiver operating characteristic curve of the NHR for the prediction of severe atherosclerosis were 0.681 (P = 0.001) and 0.560 (P = 0.431) in male and female subjects, respectively. An NHR value > 3.99 had a specificity and a sensitivity of 68% and 64%, respectively, for forecasting severe atherosclerosis in male subjects.

CONCLUSIONS

The NHR could be utilised to independently predict the severeness of coronary lesions in male ACS subjects but not in their female counterparts. Therefore, the NHR should be used with caution when screening female ACS patients for severe coronary restrictions.

The change of inflammatory markers may predict long-term major adverse cardiovascular events in elderly patients with coronary heart disease: a retrospective cohort study

Background

At present, the relationship among inflammatory markers [monocytes/HDL-c (MHR), neutrophils/HDL-c (NHR) and lymphocytes/HDL-c (LHR)] and long-term prognosis of coronary heart disease (CHD) is still unclear. Therefore, this study explores the relationship between inflammatory indicators and the risk of long-term major adverse cardiovascular events (MACE) in elderly patients with CHD.

Methods

A retrospective analysis was conducted on 208 elderly patients who underwent coronary angiography at Wuhan Fourth Hospital from August 2022 to August 2023. They were divided into the CHD group (N = 116) and control group (N = 92). Patients in the CHD group were followed up for 1 year and divided into the MACE group (N = 36) and the non-MACE group (N = 80) according to whether MACE occurred.

Results

In elderly patients, logistic regression analysis shows that MHR is an independent risk factor for CHD (OR = 3.050, 95% CI 1.318-1.772). ROC curve analysis found that MHR (AUC = 0.865, 95% CI 0.811-0.919, p < 0.001) is higher than NHR and LHR. In patients with CHD, the spearman analysis show that MHR is positively correlated with Gensini score (R = 0.266, p = 0.004). The logistic regression analysis found that MHR is independent risk factors for MACE (OR = 6.048, 95% CI 1.224-1.941, p = 0.002). ROC analysis showed that the critical value of MHR to predict MACE was 0.651, the sensitivity of 58.3% and specificity of 90.0% could predict MACE, and the AUC was 0.793 (95% CI 0.702-0.884, p < 0.001) is higher than LHR.

Conclusion

In elderly patients, MHR is an independent predictor of CHD and long-term MACE and is positively correlated with the severity of coronary artery lesions.

Prognostic Value of Neutrophil, Monocyte, Lymphocyte, and Platelet/High-Density Lipoprotein Ratios in Ischemic Heart Disease: An NHANES Analysis

The prognostic value of easily accessible hematologic biomarkers, such as the neutrophil-to-HDL ratio, as well as the monocyte-to-HDL, lymphocyte-to-HDL, and platelet-to-HDL ratios, remains underexplored in patients with established ischemic heart disease (IHD). Community-dwelling adults aged ≥ 20 with established IHD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were eligible. Mortality was tracked through linkage to the National Death Index (NDI) until the end of 2019. Cox regressions examined the associations between these hematologic ratios and all-cause mortality. Receiver operating characteristic (ROC) curve analysis assessed the predictive accuracy of these ratios for mortality. A total of 2265 patients were analyzed, with a median follow-up period of 80 months. After adjusting for demographic factors, lifestyle variables, and comorbidities, patients in the highest quartile of the neutrophil/HDL had a significantly increased all-cause mortality risk (aHR = 1.41, 95% CI: 1.13-1.77) compared to those in the lowest quartile. No significant associations were found between the other ratios and mortality. In conclusion, this study found that among the hematologic ratios analyzed, an elevated neutrophil-to-HDL ratio has the strongest potential for mortality risk stratification in community-dwelling patients with ischemic heart disease in the US, offering important guidance for both patients and clinicians.

Neutrophil-to-High-Density Lipoprotein Ratio (NHR) and Neutrophil-to-Lymphocyte Ratio (NLR) as prognostic biomarkers for incident cardiovascular disease and all-cause mortality: A comparison study

Cardiovascular diseases (CVD) remain a leading cause of global mortality, with atherosclerosis and inflammation playing pivotal roles in their development. The neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-HDL cholesterol ratio (NHR) have emerged as potential biomarkers for assessing CVD risk. In this community-based cohort study conducted in Taiwan, involving 3278 participants, we investigated the associations between NHR, NLR, and the risks of CVD and all-cause mortality. Our findings revealed that both NHR and NLR were effective in identifying individuals at high risk for CVD. However, when assessing their joint effect, NHR alone demonstrated a stronger predictive value for CVD prognosis than NLR or the combination of both markers. Furthermore, NLR alone showed potential as a predictor of all-cause mortality when compared with NHR alone or in combination with NLR and NHR. These findings underscore the complex interplay between inflammation and lipid metabolism in the pathogenesis of CVD. While NHR shows promise as a cost-effective tool for CVD risk assessment, NLR emerges potential as a prognostic marker for mortality. Further research is warranted to explore the dynamic changes in these markers and their implications for clinical practice.

Association between high-density lipoprotein-related inflammation index and periodontitis: insights from NHANES 2009-2014

BACKGROUND

Periodontitis, a persistent inflammatory condition, significantly impairs individuals' overall quality of life. Lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR), monocyte-to-high-density lipoprotein cholesterol ratio (MHR), neutrophil-to-high-density lipoprotein cholesterol ratio (NHR), and platelet-to-high-density lipoprotein cholesterol ratio (PHR) are new convenient and economical biomarkers. However, whether the above high-density lipoprotein-related inflammatory biomarkers are associated with periodontitis has rarely been investigated. Therefore, the research endeavor focused on uncovering potential relationships.

METHODS

The research encompassed a diverse and extensive sample, comprising 9,470 participants, selected from the National Health and Nutrition Examination Survey spanning the years 2009 to 2014. The association between high-density lipoprotein-related inflammatory biomarkers and periodontitis was explored utilizing a multivariable logistic regression model with weighted analysis. Additionally, the study employed smoothed curve fitting to explore potential nonlinear relationships. Further stratified analyses and interaction tests were performed.

RESULTS

This study indicated no apparent association between MHR and PHR with periodontitis, whereas LHR and NHR demonstrated a statistically significant positive relationship with the prevalence of periodontitis. In the fully adjusted model, participants belonging to the highest tertile of both LHR and NHR showed a notably higher likelihood of having periodontitis compared to those in the lowest tertile (LHR: OR = 1.22, 95% CI: 1.06, 1.39; NHR: OR = 1.27, 95% CI: 1.09, 1.49). Furthermore, smooth curve fitting was employed to investigate the potential nonlinear relationship between LHR, NHR, and periodontitis. The results indicated that there was a significant increase in the occurrence of periodontitis when Log2 (LHR) exceeded 1.01 and Log2(NHR) surpassed 2.16 (Log2(LHR): OR = 1.42; 95% CI: 1.19, 1.69; Log2(NHR): OR = 1.40; 95% CI: 1.15, 1.71). The subgroup analysis revealed that the associations between periodontitis and either LHR or NHR, separately, were more pronounced among individuals under the age of 50 and those without hypertension.

CONCLUSIONS

This cross-sectional study revealed a positive relationship between LHR、NHR and periodontitis, particularly when these indicators exceeded their thresholds. LHR and NHR may serve as potential inflammatory markers for identifying periodontitis, thereby facilitating early warning for both patients and dentists, and enabling early intervention in the oral environment. Besides, extensive prospective cohort investigations are essential to confirm and solidify this observation.

Association between neutrophil-to-high-density lipoprotein cholesterol ratio and metabolic dysfunction-associated steatotic liver disease and liver fibrosis in the US population: a nationally representative cross-sectional study using NHANES data from 2017 to 2020

BACKGROUND

The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) has emerged as a promising biomarker for assessing inflammation and lipid dysregulation. Increasing evidence indicates that these metabolic disturbances play a crucial role in the development of metabolic dysfunction-associated steatotic liver disease(MASLD). This study aims to investigate the association between NHR, MASLD, and liver fibrosis.

METHODS

This cross-sectional study analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). Weighted multivariate logistic regression models were used to investigate the association between NHR and both MASLD and liver fibrosis. Smoothed curve fitting and threshold effect analysis were performed to detect potential nonlinear relationships. Subgroup analyses were conducted to assess the consistency of these associations across different groups.

RESULTS

The study involved 4,761 participants. We observed a significant positive association between NHR and MASLD (OR = 1.20, 95% CI: 1.09-1.31). However, there was no significant association between NHR and liver fibrosis (OR = 1.01; 95% CI: 0.94-1.09). The analysis of smoothed curve fitting and threshold effect revealed an inverted U-shaped relationship between NHR and MASLD, with a turning point at 5.63.

CONCLUSION

Our findings indicate a positive correlation between elevated NHR levels and MASLD prevalence. However, we did not observe a significant association between NHR and liver fibrosis prevalence. Further prospective research is needed to validate these findings in a longitudinal setting.

The relationship between NLR, LDL-C/HDL-C, NHR and coronary artery disease

OBJECTIVE

Chronic inflammation and dyslipidemia are key risk factors for atherosclerotic cardiovascular diseases. We retrospectively explored the association between the neutrophil to lymphocyte ratio (NLR), the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), and the neutrophil to HDL-C ratio (NHR), and the severity of coronary lesions in patients with acute coronary syndrome (ACS).

METHOD

In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69).

RESULT

1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P<0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P<0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P<0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708).

CONCLUSION

Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.

Predictive Value of CFIm25 Expression in Peripheral Blood Monocytes for Coronary Atherosclerosis

Background: Cleavage factor Im25 (CFIm25) regulates cell function by affecting mRNA editing processes and plays diverse roles in various diseases. Studies have found that peripheral blood monocytes are valuable in diagnosing and prognosing coronary atherosclerosis. However, no studies have examined the predictive value of CFIm25 expression in peripheral blood monocytes for coronary atherosclerosis. Methods and Results: We collected the coronary angiography results of 267 patients and calculated the Gensini score to evaluate their degree of coronary atherosclerosis. We isolated peripheral blood monocytes and detected CFIm25 RNA expression. Based on their Gensini score, we divided the patients into negative (0, n = 46), mild lesion (≤ 8, n = 71), moderate lesion (8-23, n = 76), and severe lesion (≥ 23, n = 74) groups. Results showed that CFIm25 expression correlated negatively with the Gensini score and the number of involved coronary vessels. Univariate and multivariate binary logistic regression analyses showed that CFIm25 expression in peripheral blood monocytes was a protective factor for severe lesions, ≥ 50% stenosis, and three-vessel lesions. The areas under the receiver operating characteristic curve of CFIm25 expression for predicting lesions, severe lesions, ≥50% stenosis, and three-vessel lesions were 0.743, 0.735, 0.791, and 0.736, respectively. Conclusions: CFIm25 expression in peripheral blood monocytes correlates negatively with the degree of coronary atherosclerosis and helps predict the severity and number of coronary artery lesions.

Association of Monocyte-to-HDL Cholesterol Ratio with Endothelial Dysfunction in Patients with Type 2 Diabetes

Aims

To explore the relationship between monocyte-to-HDL cholesterol ratio (MHR) and endothelial function in patients with type 2 diabetes (T2DM).

Methods

243 patients diagnosed with T2DM were enrolled in this cross-sectional study. Patients were divided into two groups by flow-mediated dilation (FMD) quintile as nonendothelial dysfunction (FMD ≥ 6.4%) and endothelial dysfunction (FMD < 6.4%). The relationship between MHR and FMD was analyzed using Spearman's correlation, partial correlation, and multiple logistic regression analysis. ROC curve was fitted to evaluate the ability of MHR to predict endothelial dysfunction.

Results

Endothelial dysfunction was present in 193 (79%) patients. Patients with endothelial dysfunction had higher MHR (p < 0.05) than those without endothelial dysfunction. Furthermore, MHR had a significantly positive correlation with endothelial dysfunction (r = 0.17, p < 0.05), and the positive association persisted even after controlling for confounding factors (r = 0.14, p < 0.05). Logistic regression showed that MHR was an independent contributor for endothelial dysfunction (OR: 1.35 (1.08, 1.70), p < 0.05) and the risk of endothelial dysfunction increases by 61% with each standard deviation increase in MHR (OR: 1.61 (1.12, 2.30), p < 0.05) (model 1). After adjusting for sex, age, BMI, disease course, hypertension, smoking, and drinking (model 2) as well as HbA1c, HOMA-IR, C-reactive protein, and TG (model 3), similar results were obtained. In ROC analysis, the area of under the ROC curve (AUC) for MHR was 0.60 (95% CI 0.52-0.69, p < 0.05).

Conclusion

MHR was independently associated with endothelial dysfunction in T2DM patients. It could be a new biomarker for vascular endothelial function assessment.

High-density lipoprotein-related inflammatory indices predict repeat revascularization in coronary drug-eluting stenting

Background: HDL-C-related inflammatory indices are potential predictors of repeat revascularization (RR) after coronary drug-eluting stenting. Methods: Multivariable Cox regression with restricted cubic splines and receiver operating curve was used. Results: The median follow-up was 50 months. A total of 521 (35.42%) patients experienced RR. The incidence of RR was positively associated with the monocyte-to-HDL-C ratio, neutrophil-to-HDL-C ratio and lymphocyte-to-HDL-C ratio (log-rank p < 0.05). After being fully adjusted, the largest tertile of monocyte-to-HDL-C ratio, neutrophil-to-HDL-C ratio, white blood cell-to-HDL-C ratio and lymphocyte-to-HDL-C ratio increased the risk by 38, 30, 28 and 37%, respectively. Monocyte-to-HDL-C ratio was dose-responsive and linearly correlated with RR. HDL-C-related inflammatory indices had over 60% predictive ability. Conclusion: HDL-C-related inflammatory indices independently predicted RR after coronary drug-eluting stenting.

Correlation between Serum 25-Hydroxyvitamin D Concentration, Monocyte-to-HDL Ratio and Acute Coronary Syndrome in Men with Chronic Coronary Syndrome-An Observational Study

Cardiovascular disease (CVD) continues to be the leading cause of death in European men. Atherosclerosis and its clinical consequence, chronic coronary syndrome (CCS), comprise two main elements: dysfunction of lipoprotein metabolism and an important inflammatory component that contributes to the development of complications, including acute coronary syndrome (ACS). Measures of both components are combined in a composite marker called monocyte-to-HDL ratio (MHR). Vitamin D was previously described to influence inflammation processes, and its deficiency influences CVD risk factors. This research describes the differences in MHR and total serum 25-hydroxyvitamin D (25(OH)D) concentration between male patients with different diagnoses of CCS and the correlation between 25(OH)D and MHR in this group. Significant differences were observed between ACS and CCS patients in 25(OH)D and MHR-the highest HDL and serum 25(OH)D concentrations were observed in patients with CCS, whereas the highest value of MHR was observed in patients with STEMI. A significant correlation was observed between 25(OH)D, HDL, and MHR. Due to the significant but small nominal difference in MHR values between groups of patients diagnosed with ACS and CCS, and the possible influence of age and hyperlipidemia status on the differences in vitamin D levels in these groups, this subject requires further well-designed research. The suggested bidirectional relationship between MHR and 25(OH)D and the role of MHR as a predictor of vitamin D status in the body also needs to be verified.