| BackgroundThe first symptoms of acute myocardial infarction(AMI)are various.As a common critical illness in the cardiovascular department,AMI have a high mortality rate.AMI patients are prone to various adverse complications during hospitalization,and the characteristics and prognosis of the disease exist.Gender differences,inflammation,and brain natriuretic peptides play an important role in the pathogenesis,progression,and prognosis of AMI.There may be differences in the expression of inflammatory markers and brain natriuretic peptides in patients with different genders of AMI.ObjectiveIn this study,we compared the differences of white blood cells,neutrophils,lymphocytes,neutrophil lymphocyte ratios,high-sensitivity C-reactive protein and N-terminal pro-brain natriuretic peptide in patients with different genders of AMI,and we assessed the impact on coronary lesions and assessment of prognosis to provide a personalized treatment for patients with different genders of AMI.MethodsA total of 138 AMI patients successfully underwent emergency PCI were enrolled in this study,then divided them into male group(99 cases)and female group(38 cases).Collect the baseline characteristics,and results of coronary angiography results,measure the WBC,NE,LY,NLR,hs-CRP and NT-proBNP levels of pre-operation,post-operation 1st day?5h day.Using t-test,chi-square test,multiple linear regression analysis,Logistic analysis and other methods to compare the difference of inflammatory markers and NT-proBNP in different gender AMI patients,and analyze the impact of different gender AMI patients with coronary lesions and prognosis.Results(1)WBC levels in AMI Female patients were higher than those in males at admission,but the difference was not statistically significant(P>0.05),the WBC levels were higher in females than in males on postoperative first day and fifth day(P< 0.05),the male group WBC gradually decreased after surgery(P <0.05),while the female group did not significantly decreased in 1st day after surgery(P> 0.05),but decreased in 5th day after surgery(P <0.05).There was no significant difference in NE on preoperative and postoperative between the two groups(P>0.05).The NE in the male group decreased gradually after surgery(P<0.05),but there was no significant decrease in the female group at 1st day after surgery(P>0.05),but it decreased in 5th days(P<0.05);there was no difference in LY levels between the two groups(P>0.05),and no significant decrease after surgery(P>0.05).There was no significant difference in preoperative and postoperative NLR levels between the two groups(P>0.05),and there was no significant decrease in males on the 1st postoperative day(P>0.05),but it was decreased on the 5th day(P<0.05).The female group had the highest preoperative NLR and gradually decreased after surgery,but the difference was not statistically significant(P>0.05).(2)The hs-CRP in the female group was higher than that in the male group before and after the operation(P<0.05).The hs-CRP was highest at the 1st postoperative day in both groups(P<0.05),and decreased at 5th days after operation.(P<0.05)(3)The NT-proBNP levels in female patients were higher than those in males before and after surgery(P<0.05),and the NT-proBNP levels in the two groups were highest before operation and gradually decreased after operation(P<0.05).(4)Correlation analysis showed that in males,NE(r=0.27),LY(r=-0.26),NLR(r=0.32),hs-CRP(r=0.23)were associated with coronary Gesini score,in female group,NE(r=0.31),LY(r=-0.23),NLR(r=0.44),hs-CRP(r=0.55),NT-proBNP(r=0.34)were associated with coronary Gesini score.(5)Multiple linear regression analysis showed that: in male group,NLR,LY were associated with coronary Gesini score,in female group,NLR,LY,hs-CRP were associated with coronary Gesini score.(6)Multivariate Logsitic analysis showed that: hypertension(OR=2.113,CI:1.027-7.575),diabetes mellitus(OR=2.135,CI:1.172-6.264),low density lipoprotein(OR=2.342,CI:1.251-7.439),NLR(OR=2.987,CI:1.461-8.463)are adverse cardiovascular events predictors in male group;hypertension(OR=2.361,CI:1.027-8.153),diabetes mellitus(OR=2.745,CI:1.125-8.264),low density lipoprotein protein(OR=1.642,CI:1.051-6.364),NLR(OR=2.572,CI:1.263-9.164),hs-CRP(OR=3.154,CI:2.257-10.258)are adverse cardiovascular events predictors in female group.For different gender of the patients with AMI,NLR are more valuable in the prediction of postoperative PCI adverse cardiovascular events.Conclusions1.Compared with the male group,the WBC,hs-CRP,and NT-proBNP expression levels are higher in the female group,the inflammation load in female is also higher,and the heart function was worse in female.2.The coronary artery lesions in patients with AMI are positively correlated with NLR expression levels,but negatively correlated with LY expression levels.hs-CRP also have important value in predicting the severity of coronary artery disease in female.3.Patients with acute myocardial infarction in female have a higher incidence of adverse cardiovascular events than that in male;NLR is more valuable in predicting adverse cardiovascular events after PCI. |
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