Relationship Between Neutrophil-lymphocyte Ratio,BNP,GRACE Score And Severity Of Coronary Artery Lesion And Short-term Prognosis In Patients With STEMI

Objective:To analyze the relationship between neutrophil-lymphocyte ratio(NLR),BNP,GRACE score and severity of coronary artery disease in patients with STEMI,and to explore the predictive value of NLR,BNP and GRACE score for short-term prognosis in patients with STEMI.Method:This was a retrospective analysis of 430 patients with acute STEMI who underwent primary percutaneous coronary intervention within 12 hours after the onset of symptoms in the department of cardiology of the First Hospital of Jilin University from September 2016 to April 2017.They were divided into mild disease group(8-43),moderate disease group(44-75),and severe disease group(76-178)according to the Gensini score intertrial tertile interval;and low-risk group(49-125),intermediate-risk group(126-154)and high-risk group(155-319)according to the GRACE score;and event group and non-event group according to the occurrence of cardiovascular adverse events during hospitalization.The general information,laboratory test results,imaging findings,coronary angiography results,treatment status,cardiovascular adverse events in the study subjects were collected and recorded.GRACE score was calculated according to the relevant indicators,and Gensini score was calculated according to the results of coronary angiography.The analysis was performed with SPSS 23.0 software,and the difference was statistically significant with P<0.05.Result:1.There were significant differences in NLR,BNP and GRACE score among different coronary artery lesion groups(P<0.05).2.NLR,BNP and GRACE score were positively correlated with Gensini score,with correlation coefficients of 0.365,0.350,and 0.397 respectively.NLR,BNP were positively correlated with GRACE score.The correlation coefficients were 0.334 and0.408 respectively.3.Age,serum creatinine,LVEF,NLR,BNP,GRACE score,and Gensini score were included in binary Logistic regression analysis.The results suggested that NLR,BNP,GRACE score were independent predictors of cardiovascular adverse events during hospitalization in patients with STEMI(P<0.05).4.The area under ROC curve of NLR,BNP,GRACE score and the combination for predicting cardiovascular adverse events during hospitalization in patients with STEMI were 0.697,0.752,0.742,and 0.830 respectively;the area under ROC curve of the combination for predicting cardiovascular adverse events was larger than NLR,BNP and GRACE score,and the differences were statistically significant(P<0.05).5.Gensini score was statistically significant among different risk stratification groups in GRACE score(P<0.05);The incidence of cardiovascular adverse events during hospitalization in patients with STEMI was statistically significant among different risk stratification groups in GRACE score(P<0.05).Conclusion:1.NLR,BNP,GRACE score are positively correlated with severity of coronary artery lesion in patients with STEMI.2.NLR,BNP,GRACE score are independent predictors of cardiovascular adverse events during hospitalization in patients with STEMI.3.The combination of NLR,BNP and GRACE score can increase the predictive value of short-term prognosis in patients with STEMI.