Effect Of PLR And MHR On Early Malignant Ventricular Arrhythmias In Patients With STEMI After PCI

Objective:This study analyzed the risk factors of on early malignant ventricular arrhythmia(MVA)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),and investigated the effects of preoperative platelet count to lymphocyte count ratio(PLR),monocyte count to HDL-C ratio(MHR)and the combination of the two on the occurrence of on earlyl MVA in patients with STEMI after PCI.Methods:We analyze STEMI of 240 patients who were diagnosed in the of Linfen People’s Hospital from January 2021 to December 2022.Patients were admitted to the hospital with ST-elevation MI(STEMI)for the first time ever and who underwent primary percutaneous coronary intervention within 12 hours after the onset of chest pain and who received postoperative ECG monitoring for 48 hours.after surgery.We divided these patients into MVA group(60 cases)and non-MVA group(180 cases)according to whether MVA occurred after PCI.Clinical data of the two groups of patients were collected,including age,gender,hypertension,diabetes,hyperlipidemia,family history of coronary heart disease,smoking,drinking,systolic blood pressure,diastolic blood pressure,heart rate,body mass index(BMI),Killip grading.Venous blood samples were taken at first admission and analyzed for white blood cells,hemoglobin,platelet count,lymphocyte count,mononuclear cell count,immediate admission blood glucose,serum creatinine,blood uric acid,potassium,albumin,triglyceride,total cholesterol,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),PLR,MHR,Myocardial troponin,NT-pro BNP.Echocardiography and ECG were performed before surgery in all patients,and left ventricular ejection fraction(LVEF)and ECG results was collected.Compare the demographic,clinical,angiographic,and procedural data from record of the two groups of patients,and analyze the independent risk factors for MVA in STEMI patients using multivariate logistic regression;The predictive value of PLR,MHR,and their combination for MVA after PCI in STEMI patients was analyzed using ROC curves.All patients in this study received oral aspirin300 mg,clopidogrel 300 mg,and subcutaneous injection of 70U/kg ordinary heparin in the emergency room.This study was in line with the Declaration of Helsinki and approved by the Clinical Research Ethics Committee of our hospital,Ethics number:E20230322017.Written informed consent was obtained from all patients.Results:1.The proportion of patients with age,lymphocyte,platelet count,PLR,mo nocyte count,MHR,albumin,serum creatinine,blood uric acid,immediate admissi on blood glucose,Killip grade Ⅲ-Ⅳ before PCI and TIMI grade 0-1 were compa red between the two groups,and the differences were statistically significant(P<0.05).Gender,heart rate,diastolic blood pressure,BMI,history of diabetes,hyperten sion,smoking,alcohol consumption,white blood cells,hemoglobin,HDL-C,total cholesterol,triglycerides,LDL-C,thyroid stimulating hormone,blood potassium,M yocardial troponin,NT-pro BNP,IRA,infarct site,number of diseased vessels,and nu mber of stents implanted were compared between the two groups.The difference was not statistically significant(P>0.05).2.Excluding possible multicollinearity or clinical relevance,binary Logistic analysis of the above different parameters showed that age,PLR,MHR,blood uric acid,and blood flow TIMI grading before PCI were considered as risk factors for early MVA after emergency PCI in STEMI patients.3.Preoperative PLR,MHR and their combination predicted that the AUC of early MVA after PCI in STEMI patients were 0.851,0.725 and 0.888,the optimal critical value was 180.864,0.631 and 0.203,and the sensitivity was 80%,75% and 66.1%,respectively.The specificity was 83.9%,66.1% and 83.9%,respectively.Conclusion:1.Elder,uric acid,PLR,MHR,and Post-PCI TIMI flow 0-1 were risk factors for STEMI patients early malignant ventricular arrhythmias after PCI.2.PLR and MHR have certain predictive ability for the occurrence of malignant ventricular arrhythmia in the early stage after PCI in STEMI patients,and the combined predictive ability was better.