Prediction Of MACE In Patients With Acute ST Segment Elevation Myocardial Infarction After PCI With PLR

Objective: To investigate the predictive value of platelet /lymphocyte count ratio(PLR)for major adverse cardiovascular events(MACE)in patients with acute ST segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods: In this study,253 patients with acute ST segment elevation myocardial infarction were admitted to the department of cardiovascular medicine of Yongzhou Central Hospital from October2017 to October 2019.1.The Receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of PLR for in-hospital MACE after emergency PCI in patients with acute ST segment elevation myocardial infarction.2.According to ROC curve,the optimal intercept value was selected and PLR was divided into the PLR high-value group and the PLR low-value group.Differences between the two groups in basic clinical data and laboratory examination results were compared.The single factor with statistical difference was analyzed by binary logistic regression to explore the predictors of mace in the hospital of patients with acute ST elevation myocardial infarction after PCI.3.The incidence of in-hospital MACE in patients with acute ST segment elevation myocardial infarction after emergency PCI was compared between the PLR high-value group and the PLR low-value group.4.Spearman rank correlation was used to analyze the correlation between PLR and the predictive factors of in-hospital MACE after emergency PCI in patients with acute ST segment elevation myocardial infarction.Results: 1.According to ROC curve analysis,the area under the curve under which PLR predicted MACE in patients with acute ST segment elevation myocardial infarction after emergency PCI was0.707(95%CI:0.638~ 0.775,P<0.05).When the cut-off value of PLR is195.81,the prediction efficiency is the highest,the sensitivity is 69.90%,and the specificity is 64.10%.2.According to PLR=195.81 in peripheral blood,all patients were divided into the PLR high-value group(PLR≥195.81,n=119)and the PLR low-value group(PLR<195.81,n=134).The comparison of basic clinical data between the PLR high-value group and the PLR low-value group showed that multi-vessel lesions of the PLR high-value group were significantly higher than those of the PLR low-value group(P<0.05),while the LVEF of the PLR high-value group was lower than that of the PLR low-value group(P<0.05).Comparison of laboratory results between the PLR high-value group and the PLR low-value group showed that NT-proBNP,CRP,CK-MB and hs-cTnI of patients in the PLR high-value group were higher than those in the PLR low-value group(P<0.05).Logistic multivariate regression analysis showed that PLR,CRP,NT-proBNP,LVEF,and multi-vessel lesions were independent predictors of in-hospital MACE in patients with acute ST segment elevation myocardial infarction after emergency PCI.3.The incidence of MACE in hospital in patients with acute ST segment elevation myocardial infarction in the high-value PLR group was higher than that in the low-value PLR group(P<0.05).4.Spearman level correlation showed that PLR was positively correlated with in-hospital MACE after emergency PCI in patients with acute ST segment elevation myocardial infarction,with a correlation coefficient of 0.336(P<0.05).PLR was positively correlated with CRP,NT-proBNP and multi-vessel lesions(P<0.05).The correlation coefficient between PLR and LVEF was-0.236(P<0.05).Conclusion: PLR is an independent predictor of major adverse cardiovascular events in patients with acute ST segment elevation myocardial infarction after PCI.When PLR is greater than or equal to195.81,it has a certain predictive value for the occurrence of major adverse cardiovascular events in patients with acute ST segment elevation myocardial infarction after emergency PCI.