Relationship Between NLR And The Degree Of Coronary Artery Diseaseand Cardiovascular End Point After PCI

Objective: To investigate the relationship between neutrophil-tolymphocyte ratio and coronary artery lesion and cardiovascular end point event after percutaneous coronary intervention in patients with coronary heart disease(PCI).Subjects and methods: A total of 302 patients with coronary artery disease underwent coronary angiography and PCI for the first time from March 2,2015 to November 30,2015 at the First Affiliated Hospital of Nanhua University were enrolled in this study.Follow-up whether or not cardiovascular end points were evaluated to assess the prognosis.The observation date was December 31,2016.According to gensini score quartile method 302 patients with coronary heart disease were divided into lowgroup(4-46.5points)and high groups(46.5-176 points).Comparison of the differences between the two groups of clinical data.Binary stepwise logistic regression analysis was used to investigate the correlation between NLR and coronary artery disease.2.According to the follow-up results of the occurrence of cardiovascular end points,coronary heart disease patients were divided into event group,non-incident group.To compare the clinical data of the two groups.The ROC curve was used to analyze the predictive value of NLR in cardiovascular endpoints after PCI in Patients with Coronary Heart Disease.Kaplan-Meier survival curve analysis and multivariate COX regression analysis were used to investigate the correlation between NLR and cardiovascular end point event after coronary stent implantation.3.According to the optimal threshold of NLR,302 patients with coronary heart disease is divided into NLR low value group(<3.985)and high value group(> 3.985).Comparison of clinical data between the two groups.Spearman analysis was used to investigate the association between NLR and other risk factors.Result: 1.In patients with coronary heart disease,there were significant differences in blood lipid abnormality,prevalence of hypertension and NLR between the two groups(P <0.05).Binary stepwise logistic regression analysis showed that NLR and blood lipid abnormality were independent predictors of severity of coronary artery disease.The risk of severe coronary artery disease in patients with coronary heart disease who had dyslipidemia was 1.905 times higher than that in patients with normal coronary heart disease(Ratio ratio OR: 1.905,95% CI: 1.174-3.090,P <0.05).The risk of coronary artery disease was increased by 20.7% for every 1increase in NLR(OR: 1.207,95% CI: 1.115-1.306,P <0.05).2.The patients were followed up for 1-21 months,the average follow-up of 15.7 months,a total of 49 cases of cardiovascular end event,the heart-derived death in 6 cases,1 case of non-cardiac death,16 cases of unstable angina hospitalization,11 cases of PCI,and then hospitalized coronary artery bypass surgery(CABG)1 case,11 cases of heart failure hospitalization,stroke in 3 cases.Compared with the non-incident group,the ratio of elderly patients(?60 years),the prevalence of hypertension,the prevalence of diabetes mellitus,the abnormality rate of dyslipidemia and the level of NLR in the event group were significantly higher than those in the non-event group Differences(P <0.05).ROC curve analysis showed that the area under the curve of AUC was 0.710(95% confidence interval: 0.632-0.788,P <0.05)when NLR predicted coronary angiogenesis in patients with coronary artery disease after PCI,and when NLR cut The critical value was 3.985,the diagnostic efficiency was the highest,the sensitivity was 67.3% and the specificity was 70.4%.(P <0.05).Kaplan-Meier curve analysis showed that the incidence of cardiovascular end point in the high-value group(> 3.985)was significantly higher than that in the NLR group(<3.985).Multivariate COX regression analysis showed that NLR,age,hypertension and diabetes were independent predictors of cardiovascular end point after PCI.The risk ratio(RR)of the cardiovascular end point in elderly patients with coronary heart disease was 1.953(95% CI: 1.031-3.699,P <0.05).RR was 3.218(95% CI: 1.144-3.804,P <0.05)in HR patients with coronary heart disease(CHD)of 3.218(95% CI: 1.559-6.644,P <0.05).The NLR high value group(> 3.985)HR was 5.260(95% CI: 2.864-9.657,P <0.05)with NLR low value group(<3.985)as reference.3.In patients with coronary heart disease,the incidence of cardiovascular events and the Gensini score in the NLR group(>3.985)were significantly higher than those in the NLR group(<3.985),and the difference was significant(P <0.05).Spearman correlation analysis showed that NLR was positively correlated with Gensini score and cardiovascular end point(R = 0.262,R = 0.268,P <0.05).Conclusion: NLR is associated with the severity of coronary artery disease and the incidence of cardiovascular end points after PCI.The high NLR value(> 3.985)may be an independent predictor of coronary artery disease and postoperative cardiovascular outcome.