Predictive Value Of WBC And HBP Within 24 Hours In Early Heart Failure After Myocardial Infarction In Patients With Acute Myocardial Infarction

Background and Objectives:Heart failure（heart failure,HF,referred to as "heart failure"）after acute myocardial infarction（AMI）is one of the main reasons for the poor prognosis of patients.The inflammatory response runs through the whole process of the occurrence and development of AMI,and the inflammatory response also plays an important role in the occurrence of early heart failure after AMI.White blood cells（WBC）and heparin binding protein（HBP）,as inflammatory markers,have obvious changes in the inflammatory response of AMI.So whether WBC and HBP within 24 hours of acute myocardial infarction are related to heart failure after myocardial infarction,and whether the occurrence of heart failure after AMI can be predicted early,so as to provide a basis for early intervention and improve the prognosis of patients with AMI.Research methods:Patients who were diagnosed with AMI for the first time in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Dali University from December 2020 to December 2021 and underwent percutaneous coronary intervention（PCI）within 24 hours were collected as research subjects.agree.The general information of the patients,routine serological indexes within 24 hours were recorded,and blood samples were collected to detect the plasma HBP level.A total of 120 patients were included,38 patients who did not meet the inclusion criteria were excluded,and 82 patients were included in the study.According to whether the investigators had heart failure during hospitalization,they were divided into heart failure group（28 cases）and non-heart failure group（54 cases）.Chi-square test was used to analyze general count data such as gender and smoking history,and two independent samples t test was used to analyze Statistical analysis of measurement data,WBC,HBP,etc.was carried out to compare whether the data were statistically different,and the related factors of early heart failure after AMI were obtained.Spearman correlation analysis was used to analyze the related factors of WBC,HBP and early heart failure after AMI,as well as left ventricular ejection fractions（LVEF）,left ventricular end diastolic diameter（LVEDD）,left ventricular Correlation of left ventricular end systolic diameter（LVESD）.The independent risk factors of heart failure after AMI were further analyzed by binary Logistic regression using the related factors of early heart failure.Finally,the receiver operating characteristic（ROC）curve was drawn with WBC and HBP levels as test variables and post-AMI heart failure as state variables,and the cutoff values of WBC,HBP and WBC+HBP were selected according to the best Youden index,and calculate the sensitivity,specificity,etc.corresponding to each cut-off value,evaluate the predictive performance,and compare whether the difference in the area under the ROC curve of the three is statistically significant.Predictive value of exhaustion.The data were statistically analyzed using SPSS 26.0 analysis software.Results:1 There was no statistical difference in general enumeration data such as gender,smoking history,drinking history,thrombolysis,diabetes history,and hypertension history between the heart failure group and the non-heart failure group（all P>0.05）.WBC,HBP,Gensini score,cardiac troponin I（c Tnl）,b-type natriuretic peptide（BNP）,D Dimer（d-dimer,D-D）,procalcitonin（procalcitonin,PCT）,interleukin-1（IL-6）,LVEF were statistically different（P<0.05）,Age,myoglobin（MYO）,creatine kinase-MB（CK-MB）,tumor necrosis factor-α（TNF-a）,C-reactive protein（Creactive protein,CRP）,LVESD,LVEDD,and stroke volume were not statistically different（P>0.05）.2 Spearman correlation analysis showed that WBC within 24 hours after AMI was positively correlated with c Tnl,Gensini score and BNP on admission.3 Spearman correlation analysis showed that HBP within 24 hours of AMI was positively correlated with c Tnl,Gensini score and BNP on admission.4 Binary Logistic regression analysis found that WBC and HBP were independent risk factors for early heart failure after AMI.5 The ROC curve analysis showed that the areas under the ROC curve（AUC）of WBC,HBP,and HBP+WBC were 0.776,0.881,and 0.885,respectively,and the 95%CIs were 0.674-0.877,0.801-0.961,and 0.806-0.964,indicating that WBC,HBP,and HBP+WBC all have value in predicting early heart failure after AMI.According to the best Youden index,after analyzing the cutoff values of WBC,HBP,HBP+WBC and the corresponding sensitivity and specificity,it is concluded that when the WBC is greater than 13.34*109/L,the probability of predicting early heart failure after AMI is higher than that of AMI.When the HBP is greater than 6.390pg/ml,it is more likely to predict early heart failure after AMI.Analysis of HBP+WBC has the greatest predictive value,followed by HBP,and finally WBC.After the analysis of the area under the ROC curve of the three,it was suggested that WBC,HBP,and HBP+WBC had predictive value on early heart failure after AMI,and the difference was statistically significant（P<0.001）.Conclusion:1 WBC,HBP and c Tnl,BNP and Gensini scores were positively correlated within24 hours of acute myocardial infarction.2 WBC and HBP within 24 hours of acute myocardial infarction are independent risk factors for early heart failure after myocardial infarction.3 WBC,HBP and HBP+WBC within 24 hours of acute myocardial infarction have predictive value for early heart failure after AMI.When WBC>13.34*109/L,HBP>6.390pg/ml,patients are more likely to develop heart failure.The predictive value of HBP+WBC was higher than the predictive value of HBP,and the predictive value of HBP was significantly higher than that of WBC.