| Objective:Studies at home and abroad have shown that the ratio of neutrophil to lymphocyte(NLR)has a significant correlation with the prognosis of patients with acute ST segment elevation myocardial infarction,Serum sialic acid(SA),as an acetylated derivative of neuraminic acid,is rarely studied in the prognosis of patients with myocardial infarction at home and abroad.The purpose of this study was to investigate the predictive value of NLR and SA on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction,TIMI score is a commonly used index to predict the prognosis of myocardial infarction.By calculating TIMI score of patients,the correlation between NLR and SA and TIMI score was studied,and the predictive value of NLR,SA,TIMI score and their combination for mace events in a short period(March)after STEMI was further compared.Methods:A total of 210 STEMI patients were selected from the Department of Cardiology in our hospital from October 2018 to October 2019 for emergency PCI.Venous blood samples were taken from all patients and sent for examination immediately.Through case inquiry and telephone contact,the relevant clinical data of patients were collected: age,gender,BMI,previous medical history,coronary angiography results and the occurrence of mace events within 3 months after operation;The first blood routine index and the first blood biochemical index were collected,and the NLR was calculated according to the blood routine results.According to the ROC curve,the best cutoff point(NLR=6.96,SA=576.5 mg / L)of NLR and SA in predicting mace events in hospital was calculated.According to the best intercept values of NLR and SA,patients were divided into four groups: group 1(NLR > 6.96 and SA > 576.5 mg / L,also high NLR and SA group),group 2(NLR > 6.96 and SA ? 576.5 mg / L,also high NLR and low SA group),group 3(NLR ? 6.96 and SA > 576.5 mg / L,also low NLR and high SA group),group 4(NLR ? 6.96 and SA ? 576.5 mg / L,also low NLR and low SA group),to compare the differences of general clinical data and the incidence of mace events among the groups,Logistic regression analysis was used to find the risk factors and independent risk factors of mace events in a short period(March)after STEMI,TIMI scores were calculated,The correlation between NLR,SA and TIMI was studied by Spearman correlation analysis,Furthermore,the score of NLR,SA,TIMI and their predictive value for mace events in STEMI patients were obtained by ROC curve analysis.All data were analyzed by SPSS 20.0,P < 0.05 was statistically significant.Result:1.Comparison of general information among groups,the main results showed that the TIMI score of group 1 was higher than that of the other three groups,and the difference was statistically significant(P < 0.05).2.The results showed that there was no statistical difference between the four groups.3.Comparison of blood routine and biochemical Routine Indexes among groups,the main results showed that the central granulocyte count and NLR value of group 1 were higher than that of group 3 and group 4,the lymphocyte count of group 1 was lower than that of group 3 and group 4,the Sa of group 1 was higher than that of group 2 and group 4,the Sa of group 3 was higher than that of group 2 and group 4,the difference was statistically significant(P < 0.05).4.Comparison of the location of culprit's blood vessels and the number of diseased blood vessels in each group,the results showed that there was a statistical difference in the number of diseased vessels,compared with group 1,the probability of single vessel disease was higher in group 2,3 and 4,the difference was statistically significant(P < 0.05),but there was no statistical difference in the location of culprit vessels among the four groups.5.The incidence of mace events and the total number of mace events among groups were compared,the main results showed that the total number of mace events and the total incidence of mace in group 1 were higher than those in the other three groups(P < 0.05).6.According to the logistic regression analysis,the risk factors and independent risk factors of mace events were found,the results showed that age,BMI,LVEF,the number of diseased vessels(two vessel disease,three vessel disease or left main vessel disease),the location of diseased vessels(left main vessel disease),NLR > 6.96 and SA > 576.5 were all risk factors for mace.Further multivariate analysis showed that age,LVEF,the number of diseased vessels(two vessel disease,three vessel disease or left main vessel disease),NLR > 6.96 and s A> 576.5 is an independent risk factor for mace.7.According to logistic Regression analysis showed that NLR > 6.96 was 2.681 times higher than that of NLR ? 6.96,similarly,SA > 576.5 was 2.798 times higher than that of SA ? 576.5.Based on group 4,the risk of mace in the other three groups was further compared with that in group 4.The results showed that Compared with group 4,the risk of group 1 was 11.546 times of group 4,group 2 was 2.954 times of group 4,and group 3 was 2.992 times of group 4,the difference was statistically significant(P < 0.05).8.The correlation between NLR and SA and TIMI score was studied by Spearman correlation analysis.The results showed that NLR and SA were positively correlated with TIMI score,and the correlation coefficients were 0.335 and 0.307.9.According to ROC curve,NLR,SA,TIMI scores and the combined value of the three for mace events were obtained.The main results showed that NLR combined with SA had the greatest predictive value for mace events in a short period of time.Conclusion1.NLR and SA can be used as predictors of mace events in a short period of time(3 months)after PCI in STEMI patients,and NLR combined with SA has a higher predictive value for mace events in a short period of time(3 months)after PCI in STEMI patients. |
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