The Predictive Value Of PLR And NLR Combined With GRACE Score In The Prognosis Of Patients With Unstable Angina Pectoris

Objective:To explore the predictive value of platelet/lymphocyte ratio(PLR)and neutrophil/lymphocyte ratio(NLR)combined with global registry of acute coronary events(GRACE)score for the prognosis of patients with unstable angina.To provide a more simple and accurate prediction tool for clinical prognosis assessment.So as to guide clinicians to identify high-risk patients and develop individualized treatment and follow-up plans.Methods:364 patients with unstable angina diagnosed by coronary angiography in the Cardiology Department of Qingdao Fuwai Hospital from January 2019 to June 2020 were included in the study.The patients received routine treatment in Qingdao Fuwai Hospital and were followed up for 1 year.According to whether the major adverse cardiac events(MACEs)had happened,they were divided into two groups:good prognosis(n=298)and poor prognosis(n=66).Gender,age,height,weight,history of diabetes,history of hypertension and other general information of all patients were collected respectively.Total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),N-terminal pro-brain natriuretic peptide(NT-pro BNP),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),platelet(PLT),lymphocyte(L)count,neutrophil(N)count of patients in the two groups were detected.Platelet/lymphocyte ratio(PLR),neutrophil/lymphocyte ratio(NLR),global registry of acute coronary events(GRACE)score and body mass index(BMI)were calculated and compared.To assess the association of PLR,NLR,and GRACE scores with poor prognosis and to evaluate their combined use.SPSS 26.0 statistical software was used for data processing.Through ROC analysis,logistic regression analysis,etc.,the value of PLR,NLR,GRACE score and their combined prediction of poor prognosis in patients with unstable angina was clearly analyzed.Results:(1)Univariate analysis of unstable angina patients with poor prognosis(byc~2test,t test,univariate Logistic regression analysis)showed that there was no statistical significance in gender,age,BMI,history of diabetes,history of hypertension,TG,HDL-C,NT-pro BNP between the two groups(P>0.05);TC,LDL-C,LVEDD,PLR,NLR and GRACE score in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05);while LVEF was significantly lower than it in the good prognosis group(P<0.05).(2)According to ROC analysis,to predict poor prognosis of patients with unstable angina,Areas Under the Curve of PLR,NLR and GRACE score were 0.688,0.638 and0.717,the Youden indexes were 0.397,0.287 and 0.347(P<0.05).Areas Under the Curve of PLR combined with NLR,PLR combined with GRACE score,NLR combined with GRACE score,and the combination of the three were 0.655,0.757,0.777,0.779.Youden indexes were 0.354,0.409,0.486,0.491(P<0.05).(3)According to ROC and multivariate Logistic analysis,PLR≥117.3,NLR≥3.95and GRACE score≥125.5 were risk factors for poor prognosis in patients with unstable angina(P<0.05).Conclusions:(1)PLR,NLR and GRACE score were risk factors for poor prognosis in patients with unstable angina.(2)The combination of PLR and NLR in GRACE score has better prognostic value for patients with unstable angina.