The Predictive Value Of PLR In STEMI Patients With No Reflow And Short-term Prognosis After PPCI

Objective:To evaluate the role of a new predictor,platelet/lymphocyte ratio（PLR）,in St-segment Elevation Myocardial Infarction（STEMI）patients with no reflow and major adverse cardiovascular events（MACE）after primary percutaneous coronary intervention（PPCI）.Methods:This study enrolled 159 patients between April 1^st 2015 and December30^th 2017,from the First Affiliated Hospital of Xinjiang Medical University with the diagnosis of STEMI.According to their postoperative TIMI flow grades,there were 120patients in normal group and 39 patients in control（non-reflow）group,then the clinical characteristics of two groups were compared.Independent risk factor of non-reflow in STEMI patients after PPCI was determined by multivariate Logistic regression analysis,and the predictive value of PLR for non-reflow was evaluated by ROC curve.Furthermore,the occurrence of MACE between two groups was compared in order to investigate their correlation.Results:Invalid myocardial reperfusion was occurred in 39 patients with STEMI（24.5%）after PPCI.Compared with the normal group,Gensini score was significantly higher in control group,as well as the white blood cell,level of blood glucose,platelet count,thrombosis,thrombus aspiration,IABP,pathological Q waveguide numbers and PLR（all P<0.05）.Multivariate Logistic regression analysis revealed that white blood cell（OR=1.272,95%CI:1.048¹.543,P=0.015）,thrombosis（OR=5.828,95%CI:1.109³0.628,P=0.037）,PLR（OR=7.036,95%CI:2.647¹8.703,P<0.001）was an independent risk factor for the occurrence of non-reflow.ROC curve analysis showed that PLR level was greater than 158.58,and the area under the curve was 0.697（P<0.001,95%CI:0.599-0.796）,which indicates sensitivity and specificity for non-reflow after PPCI were 71.8%and 70.0%,respectively.The comparison of MACE among two groups after PPCI showed that the incidence of heart failure in PLR higher group was higher than that of lower group during their hospital stay.Conclusion:PLR can be used as an independent risk factor for STEMI patients with no reflow after PPCI.The higher PLR,the worse short term prognosis.