Predictive Value Of Neutrophil / Albumin Ratio And Prognostic Nutritional Index In Cardiogenic Shock After Acute ST Segment Elevation Myocardial Infarction

Objective: To explore the risk factors of cardiogenic shock after acute ST segment elevation myocardial infarction and the risk factors of hospital death in stemi-cs patients.To investigate the predictive value of neutrophil / albumin ratio and prognostic nutritional index in cardiogenic shock after acute ST segment elevation myocardial infarction.Methods: All patients with acute ST segment elevation myocardial infarction diagnosed in the Department of Cardiology,the Department of critical medicine and the emergency department of the Affiliated Hospital of Guilin Medical College from August 2019 to August 2021 were retrospectively studied.According to whether the patients had cardiogenic shock during hospitalization,they were divided into cardiogenic shock group and non cardiogenic shock group.According to whether the patients died,the patients in the cardiogenic shock group were further divided into death group and non death group.Collect the detailed hospitalization data of all patients,including demographic variables,past history,personal history,laboratory results,ECG results,imaging results,etc.,and use statistical methods to compare and analyze the differences in clinical data between cardiogenic shock group and non cardiogenic shock group,death group and non death group.Results: A total of 287 patients were included and divided into cardiogenic shock group(52 cases,18.1%)and non cardiogenic shock group(235 cases,81.9%).Patients in cardiogenic shock group were divided into death group(30 cases,57.7%)and non death group(22 cases,42.3%).1.univariate analysis showed that the pulmonary infection rate,age,shock index,admission random blood glucose,leukocyte count,absolute value of neutrophils,percentage of neutrophils,neutrophil /albumin ratio,alt,AST,globulin,blood creatinine,urea nitrogen,uric acid and D-dimer in cardiogenic shock group were higher than those in non cardiogenic shock group,and the revascularization rate,absolute value of lymphocytes and The prognostic nutritional index,hemoglobin concentration,albumin,albumin / globulin ratio,prealbumin and glomerular filtration rate were significantly lower than those in non cardiogenic shock group(P < 0.05);Binary logistic regression analysis showed that shock index,admission random blood glucose,neutrophil /albumin ratio,prognostic nutrition index and pulmonary infection were closely related to cardiogenic shock after acute ST segment elevation myocardial infarction(P < 0.05).2.univariate analysis showed that the proportion of people aged ≥ 65 in the death group was higher than that in the non death group,and the revascularization rate in the death group was lower than that in the non death group,and the difference was statistically significant(P < 0.05);Binary logistic regression analysis showed that age≥ 65 years old and no revascularization were closely related to the in-hospital death of stemi-cs patients(P < 0.05).3.The results of ROC curve analysis showed that:(1)the critical value of neutrophil / albumin ratio for predicting stmei-cs was 0.2574,with a sensitivity of 80.8% and a specificity of 73.2%.(2)The critical value of prognostic nutritional index for predicting stmei-cs was 44.02,with sensitivity of 77.4% and specificity of 69.2%.Conclusion:(1)pulmonary infection,shock index,admission random blood glucose,neutrophil / albumin ratio are the risk factors of cardiogenic shock after acute ST segment elevation myocardial infarction,and prognostic nutritional index is the protective factor of cardiogenic shock after acute ST segment elevation myocardial infarction.(2)Neutrophil / albumin ratio and prognostic nutritional index have predictive value for cardiogenic shock after acute ST segment elevation myocardial infarction.(3)Non revascularization and age ≥ 65 years old were the risk factors for in-hospital death in patients with stmei-cs.