Correlation Between GLR And In-hospital Mace Events After Emergency PCI In Acute STEMI Patients

Objective: To investigate the association between γ-glutamate transferase to lymphocyte ratio(GLR)levels and in-hospital Major Cardiovascular Adverse Events(MACE)after emergency Percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI),and the predictive value of GLR for the occurrence of MACE after emergency PCI in acute STEMI patients.Methods: A total of 225 acute STEMI patients admitted to the cardiovascular Department of Hebei General Hospital for emergency PCI from January 2021 to December 2021 were retrospectively analyzed and divided into MACE group(n=54)and non-MACE group(n=171)according to the occurrence of MACE in the hospital.General clinical indicators,auxiliary examinations,and surgical data were compared between the two groups.Univariate and multivariate analyses were performed by binary Logistic regression to investigate the relationship between GLR level and inhospital MACE after emergency PCI in acute STEMI patients.Subgroup analysis was used to examine the heterogeneity among specific populations.Finally,ROC was used to analyze the predictive value of GLR for in-hospital MACE in acute STEMI patients after emergency PCI.Results: 1.Compared with the non-MACE group,the heart rate,the proportion of Killip grade II-IV,the proportion of c Tn T peak,ALT,AST,GGT,serum creatinine,uric acid,GLR and the proportion of IABP use were higher in the MACE group at admission,while the proportion of systolic blood pressure,lymphocytes,e GFR and Killip grade I was lower in the MACE group at admission(P<0.05).2.The results of multivariate Logistic regression analysis suggested that c Tn T peak and GLR were the factors affecting the occurrence of MACE in hospital after acute STEMI emergency PCI.In addition,c Tn T peak and GLR were the promoting factors for inhospital MACE after acute STEMI PCI(P<0.05).3.In subgroup analysis,after adjusting for covariates,no interaction was found between factors other than hypertension and the incidence of in-hospital MACE.The level of GLR in hypertensive patients(OR=1.11)increased the incidence of in-hospital MACE to a greater extent than that in non-hypertensive patients(OR=1.05).4.ROC analysis showed that: The AUCs of GGT,LY and GLR in predicting the occurrence of in-hospital MACE after emergency PCI in acute STEMI patients were 0.623(95%CI: 0.535-0.712,P=0.006)and 0.698(95%CI:0.620～0.775,P<0.001),0.765(95%CI: 0.690～0.840,P<0.001);The optimal cut-off values were 28.85,1.685 and 15.73,respectively.The sensitivity was53.7%,58.5% and 81.5%,respectively.The specificity was 70.8%,58.5%and 61.4%,respectively.Conclusions: Increased GLR levels significantly increased the incidence of in-hospital MACE after emergency PCI in acute STEMI patients.This relationship was more significant in hypertensive patients.In addition,GLR can be used as a predictor of in-hospital MACE after emergency PCI surgery in patients with acute STEMI.