| Objective:To analyze the correlation between CD4~+/CD8~+ratio in peripheral blood and subsequent Acute or chronic heart failure(HF)in patients with Acute coronary syndrome(ACS)with different GRACE scores.To investigate whether peripheral blood CD4~+/CD8~+ratio combined with GRACE score can be used as a biomarker for predicting and evaluating heart failure in patients with acute coronary syndrome.Methods:A total of 326 cases of acute coronary syndrome were included and retrospectively analyzed in the Department of Cardiovascular Medicine,Yanbian University Affiliated Hospital from January 2019 to January 2021,and 159 cases of chronic heart failure patients who were previously diagnosed with ACS were used as positive controls.group.ACS patients have clinical symptoms and signs of acute heart failure during hospitalization and use diuretics and B-type brain natriuretic peptide(BNP)≥400pg/ml,cardiac function Killip grade II and above,and whether ACS patients have acute heart failure,Divided into heart failure group and non-heart failure group.All ACS patients undergo GRACE scores upon admission and are divided into two groups according to the score results.Scores≤140 are considered as low-medium-risk groups,and those with scores>140 are divided into high-risk groups.30 healthy patients without coronary heart disease are selected as the negative control group.Venous blood was collected from the patient within 24 hours of admission,and the level of peripheral T lymphocyte subsets was determined by the immunoslide method.Using SPSS23.0 statistical software(IBM,USA)and Graph Pad Prism 8.0 statistical software,P<0.05 was considered statistically significant.Results:(1)There was no statistical significance in age and gender between the healthy group and STEMI,NSTEMI,UA,and HF groups(P>0.05),but the incidence of smoking,drinking,hypertension,and diabetes history were higher than that of the healthy group(P<0.01).(2)The CD3~+T lymphocyte count in peripheral blood of ACS patients was1344(672)cells/μL,1212(744)cells/μl,1320(666)cells/μl,respectively,which were higher than that of the healthy group(1196(620)cells/μl,heart failure group(1158)600cells/μl,respectively,and lower than that of the healthy group.The difference was statistically significant(P<0.05).The count of CD8~+T lymphocytes in peripheral blood of patients in each group was 484(324)cells/μl,480(340)cells/μl,499(320.5)cells/μl,and 412(284)cells/μl,respectively,which was lower than that in healthy group(500(226.3)cells/μl,with statistical significance(P<0.01).(3)CD4~+/CD8~+ratio in peripheral blood:The prevalence of>1.5 or<1.0 in patients with CD4~+/CD8~+ratio in each group was 69.37%,66.67%,61.0%,764.78%,respectively,higher than that in healthy group(40%),with statistical significance(P<0.05).(4)The CD4~+/CD8~+ratio of STEMI patients with different GRACE scores in>1.5 or<1.0 range was 26(78.79%),55(67.90%),respectively,higher than that of healthy group 12(40.00%),with statistical significance(P<0.01).There was no statistical significance in comparison of 103(64.78%)HF patients in each group(P>0.05).(5)The CD4~+/CD8~+ratio of NSTEMI patients with different GRACE scores in>1.5 or<1.0 range was 14(63.64%)and 28(63.64%),respectively,higher than that of healthy group 12(40.00%),with statistical significance(P<0.05).There was no significant difference between the groups and HF patients(103(64.78%),and there was no statistical significance(P>0.05).(6)There was no statistical significance in the low,medium and high-risk UA patients compared with the healthy group(P>0.05).There was statistical significance in the comparison of low-and medium-risk and high-risk UA patients with heart failure(P<0.05).(7)The independent variables entering the dichotomous logistic regression equation were heart failure,high-risk STEMI patients,CD4~+/CD8~+ratio in heart failure patients with>1.5 or<1.0 was 2.424 times as high as that in non-heart failure patients(OR=2.424,95%CI 1.807-3.253).It is suggested that a CD4~+/CD8~+ratio of>1.5 or<1.0 is strongly associated with high-risk acute ST-segment elevation myocardial infarction complicated with acute heart failure.In the NSTEMI group,the CD4~+/CD8~+ratio in heart failure patients with>1.5 or<1.0 was 1.692times that in the non-heart failure group(OR=1.692,95%CI 1.244-2.303).It is suggested that the CD4~+/CD8~+ratio in>1.5 or<1.0 range is strongly associated with high-risk acute ST-elevation myocardial infarction with acute heart failure.Conclusions:1.In the T lymphocyte subsets,CD3~+T lymphocytes are higher than the healthy group,and CD8~+T lymphocytes are lower than the healthy group,suggesting that T lymphocytes have a certain correlation with ACS and HF.2.Peripheral blood CD4~+/CD8~+ratio at the admission of ACS patients is correlated with GRACE score classification.The detection of the CD4~+/CD8~+ratio has a certain value in the risk stratification of ACS patients.The CD4~+/CD8~+ratio is greater than 1.5 or less than 1.0.The higher the GRACE score,the higher the risk stratification,which has an important reference value for early risk stratification,prognosis assessment,and early clinical treatment options for ACS patients.3.Peripheral blood CD4~+/CD8~+ratio combined with GRACE score is relevant to the occurrence of acute and chronic HF in ACS patients and has important reference value for clinical evaluation and early clinical treatment options. |
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