Combination Of D-D And MPV In Patients With Acute Myocardial Infraction Predictice Value Of MACE Occurrence During Hospitalization

Objective:This retrospective study was conducted to investigate the predictive value of D-dimer(D-D)and mean platelet volume(MPV)in the occurrence of major adverse cardiovascular events(MACE)during hospitalization in patients with acute myocardial infarction(AMI).Methods: A total of 162 patients with acute myocardial infarction who were admitted to the Department of Cardiovascular Medicine of our hospital from September 2018 to September 2020 were selected,collecting general data and hematological index results of the patients.Recording the results of electrocardiogram,medication in hospital,color ultrasound,coronary angiography and MACE in hospital.Calculating GRACE score and Gensini score.According the median of D-D and MPV of all patients,the patients were divided into four groups: Group 1: high DD and high MPV group,Group 2: high D-D and low MPV group,Group 3:low D-D and high MPV group,and Group 4: low D-D and low MPV group.Comparing General data,blood test results,heart color Doppler ultrasound LVEF value,MACE incidence,number of target vessels and disaffected vessels,GRACE score and Gensini score among the four groups.Comparing D-D and MPV of different GRACE groups.Analyzing GRACE score and D-D,MPV by Pearson correlation.Using Logistic regression analysis identify independent risk factors for MACE in patients with acute myocardial infarction during hospitalization.Using the ROC curve to investigate the predictive value of GRACE score and D-D combined with MPV in the evaluation of MACE in patients with acute myocardial infarction during hospitalization.All data were statistically analyzed by SPSS 25.0.Results:1.Comparing the general clinical data of different D-D and MPV groups,there were statistically significant differences in age,GRACE score,Killip(grade II-IV)rate,admission systolic and diastolic blood pressure,and LVEF in the four groups Comparison of general clinical data of the four groups(P<0.05).2.Comparing blood sampling indexes of different D-D and MPV groups,NT-pro BNP,CTn I,CRP,RBC,Hb,platelet,platelet distribution width,large platelet ratio,urea nitrogen,glutamic oxalacetic transaminase and creatine kinase shows significant differences in the four groups(P<0.05).3.Comparing the total incidence of MACE and the incidence of each event in different D-D and MPV groups,the results indicated that the total incidence of MACE and the rate of acute left heart failure in group 1 were higher than those in the other three groups,with statistical significance(P<0.05).4.Comparing the coronary vascular conditions of different D-D and MPV groups indicated that the Gensini score of group 1 was higher than that of the other three groups,and the difference was statistically significant(P<0.05).5.Dividing patients into three groups.D-D and MPV shows a gradually decreasing trend in the high risk group,medium risk group and low risk group of GRACE,with statistical significance in any two groups(P<0.05).6.Pearson correlation analysis was performed with GRACE score as dependent variable and D-D and MPV as independent variable,respectively.The results indicated that D-D(R=0.405,P <0.001)and MPV(R=0.319,P <0.001)were positively correlated with GRACE score.7.Comparing the MACE group and the Non-MACE group general clinical data and blood index comparison,the results of MACE group that patients age,GRACE score,Killip classification(grade II-IV)rate,NTPro BNP,D-D,MPV,CRP,PLCR,PDW,LDL,HB,UA and Gensini score higher than the Non-MACE group,but LVEF below the Non-MACE group,the difference was statistically significant(P< 0.05).8.With MACE occurrence as dependent variable and other indicators as independent variables,Multivariate Logistic regression analysis indicated that MPV>11.5fl and D-D>0.31mg/L were independent risk factors for MACE occurrence in patients with acute myocardial infarction during hospitalization.9.MACE in hospital for clinical observation the end,ROC curve was used to compare the predictive value of GRACE score D-D combined with MPV on MACE in patients with acute myocardial infarction during hospitalization.The results showed that the area of D-D joint MPV under the curve of MACE in patients with acute myocardial infarction was larger and with higher specificity and the positive predictive value than that of GRACE score.Conclusion:1.D-D and MPV are positively correlated with GRACE score,respectively.D-D and MPV can be used in risk stratification of AMI patients,and can be used as an important supplement to GRACE score.2.Comparing with GRACE score,D-D combined with MPV has a higher accuracy in predicting MACE occurrence in patients with AMI during hospitalization.