The Relationship Between NLR And Poincare Scatter Plot In Patients With Acute Coronary Syndrome

ObjectiveInflammation plays an important role in the occurrence and development of coronary heart disease.Early studies suggested that white blood cell count could be used as an inflammatory factor to predict the prognosis and severity of cardiovascular disease.NLR as a new inflammatory factor,is of important predictive value in the diagnosis and prognosis of cardiovascular diseases.Poincare plot(also known as Lorenz plot)is a nonlinear and chaotic analysis method to explain the phenomenon of cardiac electrophysiology.It is of great value in the diagnosis of arrhythmia and heart rate variability(HRV)analysis.Heart rate recovery(HRR)and heart rate variability(HRV)after exercise were the indicators of cardiac autonomic nervous function,and the reduction of HRR,HRV and the change of Poincare plot were related to the imbalance of autonomic nervous function.In recent years,it has been found that the indexes of cardiac autonomic nervous function are related to inflammatory index(white blood cell count,C reactive protein,etc.).However,the relationship between inflammatory factor NLR and Poincare scatter plot has not been reported.Therefore,this study was to investigate the correlation between NLR and Poincare plot in patients with acute coronary syndrome(ACS).MethodA total of 189 patients with coronary angiography(CAG)in Affiliated Hospital of Tai’an Medical College were enrolled,151 cases were diagnosed as coronary heart disease,and the other 38 patients were non coronary heart disease by CAG.In 151 patients with coronary heart disease,118 cases of acute coronary syndrome(ACS),33 cases of stable angina pectoris(SAP).The patient’s age,gender and blood pressure,whether to take betablockers,ACEI,statins after admission and other basic informa-tion and white blood cell count,neutrophil count,lymphocyte count,NLR,glucose,lipid,serum creatinine,left ventricular ejection fraction,Poincare plot index,Gensini score were statistically analyzed.ResultsACS group had higher NLR,shorter Poincare plot length than SAP group and non-CHD group.In ACS group,NLR was negatively correlation with L(r=-0.260,P=0.004),and was no significant correlation with W(r=0.023,P=0.802).In SAP and non-CHD group,NLR was no significant correlation with L and W.Multivariate Logistic regression analysis showed that NLR(OR=3.580,95%CI:2.044-6.270,P=0.000)was independent risk factors for ACS.The area under ROC curve predicted by NLR was0.8(95%CI:0.731-0.868).The cutoff value of NLR in diagnosing ACS was 2.01(sensitivity of 91.5% and specificity of 60.6%).Conclusion1.ACS patients with elevated NLR,shortened Poincare plot length L,and the loss of the normal comet shaped graphics,showing torpedo shape or other irregular shapes,showed that systemic activation of the inflammatory response and autonomic dysfunction.2.In ACS group,NLR was negatively correlation with L,indicating that NLR may be a novel indicator of autonomic nervous function in patients with ACS.