Predictive Value Of PDW、NLR Before PCI In Elderly STEMI Patients On Major Cardiovascular Adverse Events In The Hospital

Objective:To examine the levels of platelet distribution width(PDW)and neutrophil-lymphocyte ratio(NLR)in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)before emergency percutaneous coronary intervention(PCI),and explore PDW The value of NLR and NLR to predict the occurrence of major adverse cardiovascular events(MACE)during hospitalization of these patients is designed to enable early and accurate assessment of MACE high-risk patients and provide a basis for their selection of better clinical diagnosis and treatment options.Method:In this study,a retrospective analysis method was used to select 138 elderly patients who were diagnosed with acute STEMI and emergency PCI in Fenyang Hospital of Shanxi Province from July 2018 to June 2019.Collect information about all subjects’ gender,age,body mass index,whether they have high blood pressure,diabetes,smoking,and blood lipid levels.All subjects took blood samples through their elbow veins immediately after admission to check the levels of PDW,neutrophils,and lymphocytes,and calculated NLR values,and recorded the PDW,NLR values,and coronary angiography results of the subjects And the occurrence of MACE events in the hospital,according to the occurrence of MACE events in the hospital,it was divided into the MACE group(23 cases)and the MACE group(115 cases).Compare the general clinical data and the differences in PDW and NLR levels between the two groups.The multiple logistic regression model evaluates the relationship between PDW and NLR and the MACE events in the hospital,and draws the ROC curve based on PDW and NLR tocalculate the area under the curve(AUC)and analyzes the value of PDW and NLR to predict the occurrence of MACE.All the data obtained were statistically analyzed and processed using SPSS 20.0 software package,P <0.05 was considered statistically significant.Results:(1)The general clinical data of the two groups of study subjects showed that there was no statistical difference in gender,age,body mass index,history of hypertension,history of diabetes,smoking history,and number of coronary lesions in the patients with and without MACE.(Both P>0.05)(2)The results of hematological indicators showed that the levels of PDW and NLR in patients with MACE were significantly higher than those without MACE(both P<0.05).(3)Analysis of multiple logistic regression models showed that the incidence of PDW(OR = 4.307,95% CI was 1.564-11.864,P = 0.005),NLR(OR = 5.183,95% CI was1.841-14.591,P = 0.002)and MACE Obvious correlation.(4)ROC curve analysis showed that the areas under the curve(AUC)for predicting MACE occurrence by PDW and NLR were: 0.772 and 0.851,the sensitivities were:65.2% and 87%,and the specificities were: 80.9% and 79.1%.ConclusionThe increase of PDW and NLR levels before PCI is significantly related to the occurrence of MACE in elderly patients with STEMI.Preoperative detection of PDW and NLR has certain clinical value in predicting the occurrence of MACE after surgery.