Prognostic Value Of Monocyte-to-Lymphocyte Ratio In Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention

Objective: Acute Myocardial Infarction is the most severe coronary atherosclerotic heart disease.According to the researches,inflammation and immune cells play an important role in processes of the occurrence and development of coronary heart disease.Therefore,the discovery of new inflammatory markers is significantly valuable for the accurate diagnosis,prognosis and treatment of AMI.Recently,MLR has become a new biomarker of inflammation.The purpose of this study was to explore the predictive value of monocyte-to-lymphocyte(MLR)in the prognosis of patients with AMI after emergency percutaneous coronary intervention(PCI).Methods:We enrolled 1,290 patients with AMI who received emergency PCI from July 2013 to June 2018 at Zhongda Hospital Southeast University consecutively,and record the medical history of the subjects,laboratory data,characteristics of coronary angiography,etc.We split subjects into three groups based on the MLR average(T1: MLR <0.2658,T2: 0.2658 <MLR<0.4458,T3: MLR> 0.4458).We followed up and recorded the occurrence of major adverse cardiovascular events(MACE)within 1 year.The baseline data and the occurrence of MACE in the three groups were compared.Cox regression were used to analyze the risk factors of MACE,and ROC curve method was used to analyze the value of MLR in predicting the occurrence of MACE in patients with AMI after emergency PCI,P <0.05 was considered statistically significant.Results: Patients had no significant statistical differences in smoking history,drinking history,diabetes history,and old myocardial infarction history.The age,heart rate,history of hypertension,and history of old cerebral infarction in the T3 group were significantly higher than those in the other 2 groups(P <0.05).During follow-up,477 patients(37%)occurred MACE,49 patients(11.4%)in T1 group,107 patients(24.9%)in T2 group,and 321 patients(74.7%)in T3 group(P <0.001).Cox regression showed that MLR,NLR and total number of diseased vessels were independent risk factors for the prognosis of patients with AMI,(95%CI(2.559–3.462)P=0.007 、 95%CI(1.023-1.257)P=0.017 、95%CI(1.067-1.770)P=0.014,respectively).The receiver operating characteristic(ROC)curve of MLR for predicting MACE showed the sensitivity of 77.1% and specificity of 79.2% and the optimal cut-off value was determined as 0.3387.Conclusion: The higher the MLR,the higher the occurrence rate of MACE in AMI patients,which verifies that MLR can be used as an independent predictor of prognosis in AMI patients undergoing emergency PCI.