Correlation Analysis Of Acute Total Coronary Occlusion In Patients With Non-ST-Segment Elevation Myocardial Infarction

BackgroundNon-st-segment elevation myocardial infarction is one of the most common types of myocardial infarction.NSTEMI has become a common type of myocardial infarction in clinical practice,and the number of patients with acute total occlusion of coronary artery in NSTEMI patients has also increased.These patients are more critical and may lead to poor prognosis if not treated in time.However,how to identify such patients early for active intervention is still controversial,and relevant clinical studies are limited.ObjectiveA retrospective study was conducted to investigate the correlation between acute total occlusion of coronary artery in patients with NSTEMI.MethodsPatients with non-ST-segment elevation myocardial infarction hospitalized in the Second Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed.According to coronary angiography,NSTEMI patients were divided into acute total occlusion group(ATO)and non-occlusion group(NATO).Lasso regression was used to screen out the related risk factors.According to the results of multivariate Logistic regression analysis,a Nomogram was constructed to predict the risk of acute complete occlusion of coronary artery in patients with NSTEMI.The ROC curve was used to evaluate the predictive efficiency of the prediction model.The calibration chart and DCA curve were used to evaluate the calibration and clinical practicability of the prediction model.ResultsA total of 366 patients with non-ST-segment elevation myocardial infarction were enrolled in this study and divided into ATO group and NATO group.Lasso regression analysis showed male,systolic blood pressure at admission,history of oral antidiabetic drugs,monocyte ratio,neutrophil ratio,NLR,SII,ALT,non-HDL-C,LMR,AC,LDL-C,CK-MB,LDH,moderately elevated troponin,severely elevated troponin,extremely severely elevated troponin,and ST-segment pressure Low,Killip grade 2,Killip grade 3,Killip grade 4 and Grace score were significantly associated with ATO.After adjusting the interference of confounding factors by multivariate Logistic regression,seven indicators were obtained: gender,neutrophil ratio,NLR,LDH,troponin,Killip cardiac function classification and Grace score.The Nomogram was established based on these seven indicators,and the ROC curve analysis showed that the model had a moderate predictive efficiency(AUC value was 0.753).To establish a predictive model for acute total coronary occlusion in patients with NSTEMI.The Hosmer-Lemeshow goodness-of-fit test showed a good fit,indicating that the model was basically consistent with the actual probability and had a certain degree of calibration.DCA analysis showed that when the threshold probability of the diagnostic model was greater than 18%,the Nomogram had higher value in predicting the risk of acute complete coronary occlusion in patients with NSTEMI in the current study.Conclusiona.Gender,neutrophil ratio,NLR,LDH,troponin,Killip grade and Grace score are related to the occurrence of acute total coronary occlusion in NSTEMI patients.b.The prediction model constructed by combining seven indicators such as gender,neutrophil ratio,NLR,LDH,troponin,Killip grade and Grace score can be used to predict the occurrence of acute total coronary occlusion in NSTEMI patients,but the predictive value is limited.