Study On The Relationship Between PLR And PNI In Patients With ST-segment Elevation Myocardial Infarction And The Degree Of Coronary Artery Lesion And Prognosis

Objective:To investigate the relationship between platelet/lymphocyte ratio(PLR)and prognostic nutrition index(PNI)in patients with STEMI and the severity of coronary artery disease and prognosis.Methods:Patients diagnosed with acute st-segment elevation myocardial infarction(within 12 hours)and treated with emergency percutaneous coronary intervention(PCI)in the cardiovascular disease diagnosis and treatment center of The First Hospital of Jilin University from June 2016 to May 2017 were selected.According to the results of coronary angiography,the patients were divided into the single-vessel lesion group and the multi-vessel lesion group.The clinical history,coronary angiography,blood biochemistry and cardiac ultrasound of the two groups were analyzed retrospectively.Multivariate logistic regression model was used to analyze the factors affecting the degree of coronary artery lesions.Kaplan-meier survival analysis was used to compare the survival status of the two groups at 18 months follow-up.At the same time,PLR was divided into the high PLR group(PLR?211)and the low PLR group(PLR<211)according to the quarterwise method and the PNI group was divided into the PNI0 group(?45)and the PNI1 group(<45).Kaplan-meier survival analysis method was used to compare the survival status of the two groups after 18 months of follow-up.Results:1.General information:a total of 480 cases of acute STEMI patients were included according to the inclusion and exclusion criteria,including 165 cases in the single-vessel disease group with an average age of 54(48,63)years(78.2% for males)and 315 cases(65.6%)in the multi-vessel disease group with an average age of 60(52,66)years(72.4% for males);120 cases in the high PLR group and 360 cases in the low PLR group;297 cases in PNI0 group and 183 cases in PNI1 group.2.Compared with the single-vessel lesion group,the age,history of hypertension,history of diabetes and history of ischemic stroke,and fasting blood glucose level in the multi-vessel lesion group were higher than those in the single-vessel lesion group,and the differences were statistically significant;The levels of albumin and PNI in the multi-vessel lesion group were lower than those in the single-vessel lesion group,and the difference was statistically significant(P < 0.05).3.Multivariate Logistic regression analysis indicated that age,history of hypertension,fasting blood glucose and PNI were independent influencing factors for severe coronary artery disease in acute STEMI patients.4.Compared with the single-vessel lesion group,the multi-vessel lesion group had a higher Gensini score,and the difference was statistically significant.The all-cause mortality(6.6% vs0.6%,P < 0.001)was higher in the multi-vessel disease group than in the single-vessel disease group after 18 months of follow-up.5.Application of Kaplan-Meier survival analysis to compare the prognosis of each group patients who were followed up for 18 months,the survival probability without all-cause mortality in patients with multivessel disease group decline faster than single lesion group,the survival probability without all-cause mortality in patients with high PLR,PNI1 group decline quickly than low PLR,PNI0 group,survival outcome comparative differences between groups was statistically significant (Log-Rank,P?0.05),and survival outcome with multivessel disease group,the high PLR group and PNI1 group was lower than those of single lesion group,the PLR group and PNI0 group patients.Conclusion:1.Age,history of hypertension,PNI and fasting glucose were independent influencing factors for severe coronary artery disease.2.The prognosis of the multi-vessel disease group,the high PLR group and the PNI1 group in patients with STEMI was worse than that of the single-vessel disease group,the low PLR group and the PNI0 group(follow-up for 18 months).