| Objective To investigate the correlation between neutrophil to lymphocyte ratio(NLR),neutrophil monocyte product(NMP)in the peripheral blood and coronary heart disease(CHD)as well as the severity of coronary atherosclerosis and the incidence of major adverse cardiovascular events(MACEs)in CHD patients.Methods(1)544 patients undergoing coronary angiography(CAG)in Affiliated Hospital of Zunyi Medical University Department of Cardiology from April 2018 to August 2018were retrospectively analyzed.According to the CAG results,all patients were divided into CHD group(n=355)and non-CHD group(n=189).There was significant difference in general clinical data between the two groups.After propensity score matching(age,gender,smoking history),the CHD group(n=168)and the non-CHD group(n=168)were selected.The NLR and NMP levels of the two groups were compared,and the relationship between NLR,NMP and CHD was analyzed by logistics regression analysis.(2)The patients in the CHD group(355 cases)were further divided into the moderate to severe coronary artery disease(>22 points,n=59)group and the mild coronary artery disease(?22 points,n=296)group according to the SYNTAX score.The levels of NLR and NMP in the two groups were compared,and the relationship between NLR,NMP and the SYNTAX score was analyzed by Spearman rank correlation analysis.(3)According to the level of NLR,355patients of CHD were divided into three groups:the low NLR group(NLR?2.5,n=118),the medium NLR group(2.5<NLR<4.7,n=119)and the high NLR group(NLR?4.7,n=118)by trichotomy.CHD patients were divided into three groups according to NMP level in the same way:the low NMP group(NMP?1.7,n=118),the medium NMP group(1.7<NMP<3.4,n=119),and the high NMP group(NMP?3.4,n=118).The incidence of MACEs was compared among patients with different NLR and NMP subgroups.Results(1)Comparison of general clinical data between the CHD group and the non-CHD group showed no difference in admission heart rate and diastolic blood pressure between the two group,the differences were not statistically significant(P>0.05).There were much more patients with a history of smoking[215(60.6%)vs 80(42.3%)],hypertension[176(49.6%)vs 67(35.4%)]and diabetes mellitus[63(17.7%)vs 15(7.9%)]and higher age level[(59.79±11.62)vs(55.53±9.55)]and admission systolic blood pressure[(132.87±22.03)vs(127.43±17.13)]than in the non-CHD group significantly,the differences were statistically significant(P<0.05),but the proportion of women in the CHD group is smaller than in the non-CHD group significantly,the differences were statistically significant(P<0.05).(2)Matching age[(58.64±12.04)vs(56.72±9.30)],female[78(46.4%)vs 67(39.9%)],smoking history[65(38.7%)vs 79(47.0%)]were well matched between the two groups,the differences were not statistically significant(P>0.05).NLR[3.05(3.76)vs 2.45(1.57)]and NMP[1.98(2.70)vs 1.44(1.11)]in CHD group were significantly higher than those in the non-CHD group,the differences were statistically significant(P<0.05).According to the binary logistics regression analysis we found that for every 1 increase in NLR,the probability of CHD increased to 1.159times,and for every 1 increase in NMP,the probability of coronary heart disease increased to 1.458 times.(3)The analysis of the relationship between NLR,NMP and the severity of coronary atherosclerosis showed that there were no statistically significant differences between the two groups in age,gender,smoking history,history of hypertension,history of diabetes mellitus,admission heart rate,admission systolic blood pressure and admission diastolic blood pressure,the differences were not statistically significant(P>0.05).NLR[3.79(5.48)vs 3.11(3.55)]and NMP[2.83(3.68)vs 2.31(2.74)]in the moderate to severe coronary artery disease group were both higher than those in the mild coronary artery disease group,the differences were statistically significant(P<0.05),and both NLR and NMP in CHD patients were positively correlated with the SYNTAX score(r_s=0.463,P<0.05;r_s=0.249,P<0.05).(4)Analysis of the relationship between NLR,NMP and the incidence of nosocomial adverse events of CHD patients,It was found that the incidence of nosocomial adverse events in patients in the high NLR group was significantly higher than that in the medium NLR group[30(25.4%)vs 17(14.3%)]and the low NLR group[30(14.3%)vs 6(5.1%)],meanwhile,the medium NLR group was significantly higher than that in the low NLP group[17(14.3%)vs 6(5.1%)],the differences were statistically significant(P<0.05);The incidence of nosocomial adverse events in patients in the high NMP group was higher than that in the medium NMP group[29(24.6%)vs17(14.3%)]and the low NMP group[29(24.6%)vs 7(5.9%)],meanwhile,the medium NMP group was higher than that in the low NMP group[17(14.3%)vs 7(5.9%)],the differences were statistically significant(P<0.05).Conclusion NLR and NMP have the positive correlation to the serverity of coronary atherosclerosis lesion and have predictive value for CHD.Higher NLR or NMP indicates more MACEs in CHD patients. |
PDF Full Text Request