| Objective:The aim of this study was to retrospectively investigate the predictive value of mean platelet volume to platelet count ratio(MPV/P)for nosocomial major adverse cardiovascular events(MACE)in patients with acute non-segment elevation myocardial infarction(NSTEMI)after emergency percutaneous coronary intervention(PCI).Methods:A total of 230 patents were included In this study who were with acute NSTEMI after emergency PCI in Fenyang Hospital of Shanxi Province from September 2019 to November 2020 by a retrospective analysis method.11 patients who did not meet the criteria were excluded.The data of the rest of 219 patients were analyzed.(1).Collect clinical information of all subjects including gender,age,history of hypertension,history of diabetes mellitus and smoking history,blood lipid level,left ventricular ejection fraction(LVEF),coronary angiography results and postoperative oral medication.Peripheral venous blood samples were taken from all subjects immediately after admission to be tested the laboratory indexes such as mean platelet volume(MPV)and platelet count(PC),and MPV/P values were calculated.(2).According to the occurrence of MACE in hospital,it was divided into the MACE group(+)and the non-MACE group(-).Differences between the two groups in general clinical data and the results of MPV,PC,MPV/P and other laboratory tests were compared.The single factors with statistical differences were analyzed by binary Logistic regression analysis to explore the relevant predictors of the occurrence of nosocomial MACE in acute NSTEMI patients after emergency PCI.(3).Receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of MPV/P,MPV and other related factors for nosocomial MACE,and the accuracy of MPV/P and MPV in predicting in-hospital MACE was compared.All the data were analyzed and processed by SPSS22.0 software except for ROC curve,and the drawing and comparison of ROC curves were performed by Med Calc.11.4.2.0 software package,with P < 0.05 showing statistical difference.Results:1.Analysis results of general clinical data and laboratory test indicators of MACE(+)and MACE(-)groups showed that the levels of MPV/P,MPV and NT-pro BNP in the MACE group(+)were significantly higher than those in the non-MACE group(-),and the LVEF value was significantly lower than that in the non-MACE group(-)(Both P<0.01).And there was no statistical significance in gender,age,history of hypertension,history of diabetes,smoking history,blood lipid level,number of coronary artery lesions,CK-MB,platelet count and postoperative medication between the two groups(Both P >0.05).2.Multivariate logistic regression analysis showed showed that MPV/P,MPV,NT-pro BNP and LVEF were independent influencing factors of nosocomial MACE in NSTEMI patients after emergency PCI(P < 0.05).MPV/P,MPV and NT-pro BNP were independent risk factors for hospital MACE in NSTEMI patients after emergency PCI(OR > 1.0).LVEF was an independent protective factor for noscomial MACE in NSTEMI patients after emergency PCI(OR < 1.0).3.According to ROC curve analysis,the area under the curve(AUC)of MPV/P to predict the occurrence of MACE in hospital was 0.873.When the cut-off value of MPV/P was 0.055,the prediction efficiency is the highest,the sensitivity was 71.4% and the specificity was 88.9%.The AUC of MPV for predicting the occurrence of MACE in hospital was 0.761.When the optimal cut-off value of MPV was 10.5fl,the sensitivity was 66.7% and specificity was and 73.7%.Both MPV/P and MPV had high predictive value for postoperative nosocomial MACE.Furthermore,the accuracy of MPV/P in predicting nosocomial MACE was better than that of MPV(MPV/P vs MPV: z=2.269,P<0.05).Conclusion:MPV/P,MPV were significantly correlated with the occurrence of nosocomial MACE in NSTEMI patients after emergency PCI,but PC was not.When MPV/P was greater than or equal to 0.055,it had a certain predictive value for the occurrence of nosocomial MACE,furthermore,the accuracy of the prediction was better than that of MPV for the MACE. |
PDF Full Text Request