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. [ABSTRACT FROM AUTHOR]