Correlation Between Corrected QT Interval Combined With NLR And MACE Events Within One Year In Patients With Chronic Heart Failure

Objective: The purpose of this study was to evaluate the relationship between ECG parameter correction QT(QTc)interval and neutrophil to lymphocyte ratio(NLR)on major adverse cardiovascular events(MACE)in patients with chronic heart failure(CHF),and to analyze the potential influencing factors for poor prognosis in patients with CHF.To investigate the predictive value of QTc interphase,NLR and their combination on MACE occurrence in CHF patients within 1 year.Methods: In this study,760 CHF patients admitted to the cardiovascular Department of Hebei general Hospital from January 2018 to September 2021 were retrospectively included.According to whether the patients developed MACE within 1 year,they were divided into the MACE group(430 cases)and the non-MACE group(330 cases),among them,in the MACE group,265 cases were re-hospitalized with heart failure,38 cases of cardiac death,56 cases of recurrent angina pectoris,42 cases of acute myocardial infarction,16 cases of malignant arrhythmia,and 13 cases of non-fatal stroke.General clinical data,ECG indicators,other auxiliary examinations and medication were collected.All enrolled patients were followed up by telephone,outpatient review or electronic medical record,and the occurrence of MACE within 1 year after discharge was followed up.Univariate Logistic regression was used to analyze the independent factors influencing the occurrence of MACE in CHF patients within 1 year,and ROC curve was used to analyze the predictive value of QTc interval,NLR and their combination on the occurrence of MACE in CHF patients within 1 year.All data were analyzed by SPSS25.0 statistical software.Results: 1.Compared with the non-MACE group,the MACE group had higher age,NYHA Ⅳ proportion,proportion of old myocardial infarction,proportion of cerebral infarction,QRS duration,QT interval,QTc interval,white blood cell count,neutrophil count,NLR,creatinine,triglyceride,and lower BMI,NYHA Ⅲ proportion,drinking history proportion,ventricular rate,lymphocyte count,hemoglobin content,albumin,prealbumin content,treatments with beta-blockers(P < 0.05).2.Multivariate Logistic regression analysis showed that QRS duration,QTc interval and NLR are the influencing factors of MACE in CHF patients within 1 year,Among them,QRS duration,QTc interval and NLR were the promoting factors for MACE in CHF patients within 1 year(P<0.05).3.ROC analysis estimating the performance in predicting the occurrence of MACE within 1 year in patients with showed that the area under curve(AUC)of QTc interval,score was 0.654(95%CI:0.615～0.694,P<0.001)with 0.599 sensitivity and 0.692 specificity when the optimal cut-off value was determined as 443.5,the AUC of NLR was 0.619(95%CI:0.579～0.658,P<0.001)with 0.583 sensitivity and 0.649 specificity when the optimal cut-off value was determined as 4.115,and the AUC of QTc interval and NLR was 0.706(95%CI:0.669～0.743,P<0.001)with 0.617 sensitivity and 0.718 specificity when the optimal cut-off value was determined as 0.584.Conclusion: Prolonged QTc interval and increased NLR may be independent risk factors for MACE in CHF patients within 1 year,and their combination can be used as predictors of MACE in CHF patients within 1year.