Association Between SIIRI And In-hospital Major Adverse Cardiovascular And Cerebrovascular Events After PCI In STEMI Patients

Objective:The aim of this study was to investigate the elements influencing the occurrence of in-hospital MACCE after PCI in patients with STEMI.To further analyze the relationship between SIIRI and in-hospital MACCE events after PCI in STEMI patients to improve the prognosis and optimize the postoperative period after PCI in the STEMI patients.Method:In this study,a total of 300 patients diagnosed with STEMI by emergency PCI performed at the Affiliated Hospital of Yan’an University from January 1,2019 to December 31,2019 were collected,and the clinical data(general data,laboratory and cardiac ultrasound data,intraoperative observation indexes of PCI and postoperative medication)were analyzed using SPSS26.0 statistical software.1.All enrolled patients were grouped into MACCE and non-MACCE groups on the basis of MACCE during hospitalization,and the clinical symptoms of the MACCE and non-MACCE groups were compared and analyzed.2.Binary logistic regression was used to analyze the elements influencing the arising of in-hospital MACCE after PCI in patients with STEMI.3.ROC curves were drawed in the light of whether SII,SIRI,SIIRI and in-hospital MACCE occurred,respectively,and the AUCs of these three inflammatory indexes were compared to evaluate their predictive efficacy for in-hospital MACCE.4.The optimal cut-off value of SIIRI was used as the boundary to divide into low SIIRI and high SIIRI groups,and the clinical features of the low SIIRI and high SIIRI groups were compared and analyzed.5.Analysis of the relationship between SIIRI and NT-pro BNP and other selected clinical indicators.Results:Patients in the MACCE group had higher SII,SIRI,SIIRI,age,CTNI,CKMB,NT-pro BNP,longer time from symptoms to balloon dilation,more stents,multiple lesions and lower LVEF values and lower albumin at admission than those in the non-MACCE group(P < 0.05).1.In multivariate regression analysis,SIIRI(OR=1.212,95%CI=1.13-1.31,P<0.001),NT-pro BNP/100(OR=1.069,95%CI=1.04-1.10,P<0.001),multiple lesions(OR=9.38,95%CI=3.33-26.40,P<0.001),albumin(OR=0.922,95%CI=0.85-0.99,P=0.058),and LVEF(OR=0.899,95%CI=0.85-0.95,P<0.001)were independent correlates of in-hospital MACCE.2.The AUC of SII,SIRI and SIIRI were 0.729,0.726 and 0.798 respectively,indicating that SIIRI had better prediction efficiency than SII and SIRI.The ROC curve was drawn according to the occurrence of SIIRI and MACCE in hospital.The optimal cut-off value of Yoden index was found to be 960.42,and its sensitivity and specificity were 74.1% and 84.1%,respectively.3.The median SIIRI of all subjects was 600.39,the minimum was 51.15,and the maximum was 2978.57.The optimal cut-off value of SIIRI was 960.42,which was divided into low SIIRI group(< 960.42)and high SIIRI group(≥960.42).Compared with low SIIRI group,patients in high SIIRI group had high CKMB and high NT-pro BNP at admission,long time from symptom to balloon dilation,low LVEF value,more stents and multi-vessel lesions(P < 0.05).4.Spearman rank correlation analysis showed that SIIRI was positively correlated with Killip grade at admission,NT-pro BNP,symptom to balloon dilation time in STEMI patients(P < 0.05).SIIRI and LVEF were negatively correlated(P < 0.05).Conclusion:1.SIIRI,NT-pro BNP,multivessel disease,albumin and LVEF were independent correlated factors for the occurrence of MACCE in hospital after PCI in STEMI patients.2.SIIRI has certain clinical value in predicting the prognosis of patients with STMEI in hospital after PCI,and is an independent predictor of MACCE in hospital.