The Correlation Analysis Of Clinical Characteristics And Inflammation Indexes Of Acute Myocardial Infarction Induced By Acute Infection

Objective: To investigate the clinical characteristics of acute myocardial infarction induced by acute infection and the differences in inflammation-related indexes among serological indexes,and to explore the inflammatory process and related inflammatory markers in the pathophysiology of the course of AMI induced by acute infection,the acute infection and acute myocardial infarction development In connection,learning more may encourage people to research ways to protect high-risk patients who develop AMI after infection.Methods:(1)From January 2019 to December 2020,132 patients with acute myocardial infarction who have a clear history or evidence of infection in Jiang Su Su Bei hospital,and set them as the infected AMI group;Set 141 patients with acute myocardial infarction with no evidence of infection as non-infected AMI group;132 patients admitted to hospital due to infection without acute myocardial infarction were set as the infection without AMI group;145 patients who were hospitalized for other reasons and excluded coronary heart disease,infection and other related diseases were set as the control group.Included in the standard the infected AMI group: meets the following two items:(1)Acute myocardial infarction meets the relevant diagnostic criteria in the Fourth Universal Definition of Myocardial Infarction(2018);(2)Patients with obvious symptoms of infection or evidence of examination,including lung infections(Community-acquired pneumonia),urinary tract infections,skin infections,abdominal cavity infections,systemic inflammatory reactions,etc.Non-infected AMI group:Exclude evidence of infection and meet the diagnostic criteria for acute myocardial infarction.Infection without AMI group: Patients with obvious infection symptoms or examination evidence,but exclude acute myocardial infarction or myocardial injury(Troponin I negative).Exclusion criteria:(1)combined with other diseases that affect the index level;(2)patients with immunosuppressive diseases or malignant tumors;(3)recent anticoagulation therapy;(4)patients with severe liver dysfunction or multiple organ failure.Collect all research subjects of the general information(age,gender,body mass index(BMI)),past medical history(history of hypertension,diabetes,coronary heart disease,cerebral infarction,hyperlipidemia,COPD,chronic kidney disease),smoking history,and main hospital Cardiac adverse events(MACE,including malignant arrhythmia,heart failure,cardiogenic shock,heart rupture,etc.),admission heart rate,blood routine at admission,CRP,myocardial injury markers,BNP,D-dimer,coagulation routine,Liver and kidney function,C-reactive protein(CRP),blood lipid analysis,Cys-C detection.Gensini scores were used to assess the severity of coronary artery in patients who had undergone coronary angiography.The pneumonia severity index(PSI)was used to assess risk stratification for patients with community-acquired pneumonia.Results: 1.The inflammatory indexes NLR,MPV,Cys-C,and D/F ratio of patients in the infected AMI group were higher than those in the non-infected AMI group.In the infected AMI group,there was no correlation between NLR,MPV,Cys-C,D/F ratio and Gensini score(P>0.05).In the non-infected AMI group,NLR,Cys-C,D/F ratio were positively correlated with Gensini score.2.The MPV and Cys-C of patients in the infected AMI group were higher than those in the infection without AMI group,and the predictive value of AMI after acute infection(area under the curve of MPV(AUC=0.624,95%CI: 0.557-0.691,P< 0.001),the area under the curve of Cys-C(AUC=0.645,95%CI: 0.579-0.712,P<0.001));among the CAP middle and high risk PSI subgroups,MPV and Cys-C in the infected AMI group were higher than those in the infection without AMI group(P<0.05),it had predictive significance for AMI after infection(area under the curve of MPV(AUC=0.752,95%CI: 0.587-0.851,P=0.002),Cys-C curve Lower area(AUC=0.719,95%CI: 0.636-0.869,P<0.001)),COPD and MPV are independent risk factors for AMI in high-risk patients with CAP.3.the infected AMI group,the incidence of major adverse reactions in the hospital was 57.9%,and heart failure was the most common(84.4%);it was related to MPV,Cys-C,and D/F ratio(correlation coefficients were 0.157,0.321,0.181,P<0.05),and the predictive value of the main hospital adverse events of AMI induced by acute infection(area under the curve of MPV(AUC=0.611,95%CI: 0.511-0.711,P=0.030),area under the curve of Cys-C(AUC=0.728,95%CI: 0.642-0.814,P<0.001),the area under the curve of D/F ratio comparison(AUC=0.629,95%CI: 0.540-0.737,P=0.011));Number of days in hospital,history of coronary heart disease,heart rate,LVEF,and Cys-C are independent risk factors for major adverse reactions of AMI induced by acute infection.Conclusion: The inflammatory indexes NLR,MPV,Cys-C,and D/F ratio of patients in the infected AMI group were higher than those in the non-infected AMI group.In the infected AMI group,there was no correlation between NLR,MPV,Cys-C,D/F ratio and Gensini score(P>0.05).In the non-infected AMI group,NLR,Cys-C,D/F ratio were positively correlated with Gensini score,indicating that infection caused an increase in inflammation indicators,and none of the four inflammation-related indicators could reflect the severity of coronary artery.COPD and MPV are independent risk factors for AMI in middle and high risk of PSI patients with CAP.The incidence of major inhospital adverse events in the infected AMI group was 57.9%,and central failure was the most common(84.4%);it was related to MPV,Cys-C,and the D/F ratio,and it was a prediction of major hospital-induced adverse events in AMI induced by acute infection value;The length of hospitalization,coronary heart disease history,heart rate,LVEF,Cys-C are independent risk factors for the main adverse reactions of induced by acute infection.This study summarized the clinical diagnosis and treatment,prognosis and other factors affecting the occurrence of AMI induced by acute infection,and assessed the differences in commonly used economic serological indicators.It has certain clinical application value and provides new ideas for clinical diagnosis and treatment.