Study On The Prognostic Value Of UA And NLR In Patients With Acute Myocardial Infarction After PCI

Objective:Neutrophil to lymphocyte ratio(NLR)has been found to be an effective systemic inflammatory marker associated with death and adverse cardiac events in various cardiovascular diseases,high uric acid(UA)level is associated with the accumulation of lipid plaque,the decrease of coronary flow reserve and the impairment of coronary microvascular function,these factors are related to the occurrence of cardiovascular adverse events in the future.Therefore,it is of clinical significance to explore the predictive value of NLR and UA levels for major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI).Methods:A total of 444 eligible AMI patients who received PCI Treatment in the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were selected as the research objects.After admission,the patients were treated with antiplatelet,anticoagulant,lipid regulating,coronal expansion,improvement of myocardial remodeling and other comprehensive medical treatment strictly according to the guidelines.The venous blood of the patients was collected on the first day after admission to determine the levels of UA,NT-pro BNP and blood routine,patients were divided into three groups according to the optimal threshold of NLR and UA:low NLR and low UA(group 1,n=126),low NLR and high UA or high NLR and low UA(group 2,n=264),high NLR and high UA(Group 3,n=54).The incidence of MACE within 12 months after PCI in the three groups was observed to explore the relationship between MACE and AMI patients within 12 months after PCI.Results:Pearson correlation analysis showed that there was a positive correlation between UA and NLR(r=0.096,P=0.043).The incidence of mace in group 3 was significantly higher than that in other groups(83.3% in group 3,0% in group 1 and 34.1% in group 2,P<0.001).In univariate analysis,hypertension history,low density lipoprotein cholesterol,total cholesterol,glycosylated albumin,neutrophil count,lymphocyte count,NLR,UA,LVEF,length of hospital stay,cardiac function grade,NT-pro BNP and combined NLR-UA were significant predictors of MACE within 12 months in AMI patients.Multivariate logistic regression analysis showed that the combination of high NLR and high UA was the best predictor.In the ROC curve,the area under the curve of combining high NLR and high UA with that of using high NLR or high UA alone was compared.The combined evaluation of these two parameters significantly improved the predictive ability of MACE risk in AMI patients within 12 months after PCI.Conclusion:In AMI patients receiving PCI treatment,the incidence of MACE within 12 months after operation was reviewed,the incidence of mace in high NLR/high UA group was significantly higher than that in low NLR group and/or low UA group.Therefore,the combined evaluation of high NLR and high UA can further improve the accuracy of predicting mace events.Multivariate logistic regression analysis showed that the combination of high NLR and high UA was independently associated with MACE(P<0.05).The combination of high NLR and high UA is an independent predictor of MACE in AMI patients after PCI.