Relationship Between Neutrophil Lymphocyte Ratio And Coronary Collateral Circulation In Patients With Acute Myocardial Infarction

Purpose : This study mainly discusses the relationship between the neutrophils lymphocytes ratio and coronary collateral circulationin in patients with acute myocardial infarction.object and methods: A total of 210 patients with AMI admitted to Subei hospital from August 2017 to September 2018 who underwent coronary angiography(CAG)during hospitalization were selected as the study subjects.These patients were grouped into Rentrop grades based on angiographic results.Rentrop is graded 0 for a non-collateral circulation group,while Rentrop is graded 1-3 for a collateral circulation group.Relevant medical history was collected in detail after admission:Age,sex,height,weight,smoking history,hypertension,diabetes,hyperlipidemia,hyperuricemia,and the use of medications(angiotensin converting enzyme inhibitors(ACEI)or angiotensin receptor blockers(ARB),calcium channel blockers(CCB),and statins).Body mass index(BMI)was calculated based on height and weight.Blood samples were collected preoperatively and in the morning of the following day:Fasting plasma glucose,creatinine,uric acid,D-D dimer,triglyceride,total cholesterol,low-density lipoprotein cholesterol,(LDL-C),high density lipoprotein cholesterol(HDL-C),white blood cells,neutrophils,lymphocytes,hemoglobin,red blood cell distribution width,platelets,platelet distribution width,calculated the NLR according to neutrophils and lymphocytes.The number of diseased blood vessels was determined according to the angiography results,and the culprit vessels were determined according to the coronary angiography combined with electrocardiogram examination.Statistical software SPSS22.0 was used to analyze the above data.Independent sample t test and chi-square test were used for comparison between the two groups.Logistic regression was used for multivariate analysis,andReceiver-operating curve(ROC)of NLR predicting collateral circulation formation was drawn,P<0.05 was considered statistically significant.Results: A total of 210 patients with acute myocardial infarction in our hospital from August 2017 to September 2018 were included in the comparison.According to the situation of collateral circulation,they were divided into a total of 74 patients in the non-collateral circulation group and 136 patients in the collateral circulation group.Analysis of the general data and medical history of the two groups indicated that there was no statistical significance in age,gender(male),BMI,smoking history,hypertension,hyperlipidemia,hyperuricemia,taking ACEI or ARB,CCB,and statins medications,and there was statistical significance in diabetes(36.5%vs23.5%)(P<0.05).Analysis of clinical serological test results between the two groups,There was no significant difference in fasting blood glucose,uric acid,D-D polymer,triglyceride,total cholesterol,LDL-C,HDL-C,hemoglobin,erythrocyte distribution width,platelet and platelet distribution width between the two groups(P >0.05)),creatinine(77.78 ±21.64vs71.27 ± 14.97),leukocyte(10.85 ± 3.59vs9.32 ± 3.12),neutrophil(8.66 ±6.05vs4.81±2.94),lymphocyte(1.31±0.58vs1.83±1.03)and NLR(8.55±6.16vs4.84±2.97)were statistically significant(P <0.05).The number of diseased blood vessels and culprit vessels between the two groups count analysis.There was no significant difference in the number of diseased vessels and the culprit vessel is left circumflex(LCX)between the two groups(P >0.05),while there was significant difference between the two groups when the culprit vessel is left anterior descending(LAD)(59.5%vs39.0%)or Right coronary(RCA)(25.7%vs41.9%)(P < 0.05).Multivariate Logistic regression analysis of the factors related to coronary collateral circulation showed that the independent factor influencing the formation of coronary collateral circulation was NLR(OR =1.210,95% CI:1.103~1.328;P<0.05).The ROC curve analysis results of NLR predicting the no collateral circulation showed that the optimal node of NLR predicting the no collateral circulation was 7.311,with a sensitivity of 0.527,a specificity of 0.794,and area under the curve is0.713(95CI:0.642~0.784,P<0.05).Conclusion:1.NLR level is related to CCC,and high NLR level is an independent risk factor for CCC in patients with AMI.2.Differences in diabetes,leukocytes,neutrophils,lymphocytes,creatinine and culprit vessel were associated with CCC formation in patients with AMI.3.Age,gender,BMI,smoking history,hypertension,hyperlipidemia,high uric acid hematic disease,taking ACEI or ARB,CCB,statins medications,fasting glucose,uric acid,D-D dimer,triglyceride,total cholesterol,LDL,HDL,hemoglobin,red blood cell distribution width,number of platelet and platelet distribution width and lesion blood vessel has no obvious relation with CCC in patients with AMI.