Relationship Between Neutrophils/Lymphocytes Ratio And Cardiac Dysfunction In Patients With Acute Myocardial Infarction

Objective: By observing the patients with acute ST segment elevation myocardial infarction cardiac function between normal group and cardiac insufficiency of neutrophils/lymphocyte ratio level difference,discuss the in patients with acute ST segment elevation myocardial infarction to predict the value of cardiac insufficiency,for clinicians provide simple and effective for treatment and evaluating prognosis.Methods:Were retrospectively analyzed in August 2018 to August 2020 in guilin medical college affiliated hospital cardiovascular internal medicine ward,diagnosed with acute ST segment elevation myocardial infarction,and receive emergency percutaneous coronary interventional treatment of 233 patients as the research object,among which 175 were male,female 58 cases,detailed record hpi and general hospital patients clinical data,Including gender,age,height,weight,body mass index,a past medical history included hypertension,and diabetes history,personal history including smoking history,all hospitalized patients underwent emergency PCI before surgery to improve blood routine,liver function,renal function,electrolyte,two check blood coagulation function,myocardial infarction,myocardial enzyme combinations,NT-pro BNP,electrocardiogram(ecg),such as routine examination,Cardiac ultrasonography was completed within 24 hours of admission.Patients with acute ST-segment elevation myocardial infarction were divided into two groups(Killip grade I,i.e.,normal cardiac function group and Killip >Class I group,i.e.,cardiac insufficiency group),the general clinical data between the normal group and the insufficiency group were compared,and the subgroup analysis of the insufficiency group was conducted to explore the value of neutrophils/lymphocytes ratio in predicting cardiac insufficiency in patients with acute ST-segment elevation myocardial infarction.Results:(1)Cardiac function in patients with normal group and the comparison between patients with cardiac insufficiency group,in body mass index,serum creatinine,glomerular filtration rate,myoglobin,troponin T,white blood cells,neutrophils and lymphocytes and neutrophils/lymphocyte ratio,GRACE risk score,the NT-pro BNP,left ventricular ejection fraction,left ventricular end-diastolic volume comparison difference is statistically significant.(2)There were statistically significant differences in neutrophil/lymphocyte ratio and GRACE risk score among patients in the Killip grade II,Killip grade III and Killip grade IV groups.(3)The results of logistic regression analysis showed that neutrophils/lymphocytes ratio and GRACE risk score were closely related to cardiac dysfunction in patients with AMI.(4)Pearson correlation analysis indicated that the neutrophils/lymphocytes ratio was positively correlated with GRACE risk score.(5)The results of ROC curve analysis showed that the area under the curve of neutrophil/lymphocyte ratio for predicting nosocomial cardiac dysfunction in patients with acute myocardial infarction was 0.761,the best cutoff value was 8.0,the sensitivity was 57.9%,and the specificity was42.1%.The area under the curve of GRACE risk score for predicting nosocomial cardiac dysfunction in patients with acute myocardial infarction was 0.713,the best cutoff value was 136.5,the sensitivity was 47.4%,and the specificity was94.2%.The combined NLR and GRACE risk score predicted the ROC curve of cardiac dysfunction in patients with AMI,with an area under the curve of 0.814.Conclusions:(1)NLR and GRACE risk scores were closely related to cardiac dysfunction in patients with acute ST-segment elevation myocardial infarction.The higher the NLR and GRACE risk scores were,the more severe the disease was and the higher the incidence of cardiac dysfunction in patients with acute ST-segment elevation myocardial infarction.8.0,GRACE risk score >At136.5,it has high diagnostic value for whether patients with acute ST-segment elevation myocardial infarction have cardiac dysfunction.(2)There was a positive correlation between NLR and GRACE risk scores,and the combined NLR and GRACE risk scores had a higher predictive value in detecting cardiac dysfunction in patients with acute ST-segment elevation myocardial infarction than the single index.