Correlation Analysis Of The Neutrophil To Platelet Ratio And Stress Hyperglycemia Ratio With In-hospital MACE In First Acute STEMI Patients

Objective: This study aimed to explore the correlation between the Neutrophil to platelet ratio(NLR),the Stress hyperglycemia ratio(SHR)and in-hospital major adverse cardiovascular events(MACE)in first acute ST-segment elevation myocardial infarction(STEMI)patients.Methods: This study was a single-center,retrospective study.A total of 291 patients with first acute STEMI who were hospitalized in the cardiology department of the First Hospital of Lanzhou University from August 2019 to February 2021 were selected.According to the presence or absence of MACE,patients were divided into MACE and non-MACE groups.The baseline data and clinical data of the two groups were compared.Using multiple linear regression analysis to analysis between NLR,SHR and Gensini score of first acute STEMI patients.The correlation between NLR,SHR and in-hospital MACE in patients with first-onset STEMI was explored by Univariate Logistic regression and binary multivariate logistic regression analysis,and the predictive value of NLR,SHR and their combination on in-hospital MACE was evaluated by the receiver operating characteristic curve.Results: 1.Among 291 first acute STEMI patients,67 had in-hospital major adverse cardiovascular events.There were 58 cases of heart failure,15 cases of cardiogenic shock,3 cases of recurrent myocardial infarction,5 cases of stroke,14 cases of cardiac arrest,and 3 cases of in-hospital death.2.The results of univariate analysis of baseline and clinical data between the MACE group and the non-MACE group showed significant differences in age,smoking,diabetes,BMI,NLR,TG,Cr,first random blood glucose,SHR,Fib,D-D,NT-pro BNP,EF,LVFS,LVEDd,LVESd,RWMA,Gensini score,culprit vessel,SBP,heart rate,Killip grade on admission,and in-hospital diuretics use(P<0.05).3.Results of multiple linear regression analysis of NLR,SHR and Gensini scores: The correlation between SHR and multi-vessel lesions and Gensini scores was statistically significant(P<0.05).4.Binary multivariate logistic regression analysis showed significant differences(P<0.05)in SHR(OR 2.591,95% CI 1.339-5.016),Fib(OR 1.675,95% CI1.187-2.363),HR(OR 1.038,95% CI 1.007-1.069),EF(OR 0.883,95% CI 0.815-0.955),ACEI/ARB(OR 2.353,95% CI 1.043-5.310),and diuretic use(OR 0.328,95%CI 0.132-0.813),which were independent predictors of in-hospital MACE in patients with first acute STEMI.5.Subgroup analysis showed that the NLR and SHR were relevant to the occurrence of in-hospital MACE in subsets of first acute STEMI patients including male,without hypertension,with dyslipidemia and severe coronary stenosis(P<0.05).NLR was associated with the occurrence of in subsets of first acute STEMI patients including older,diabetes and EF≥ 50%(P<0.05),while SHR was relevant in younger,non-diabetic.6.ROC curve analysis showed that the area under the curve(AUC)of NLR predicting in-hospital MACE in first acute STEMI patients was 0.591(95%CI:0.508-0.674,P<0.05),the cut-off value was 6.515,the sensitivity was 59.7%,and the specificity was 63.4%.SHR predicted that the AUC of in-hospital MACE in first acute STEMI patients was 0.618(95% CI: 0.535-0.701,P<0.05),cut-off value was 1.17,sensitivity was 56.7%,and specificity was 69.6%.The combined factor AUC was 0.655(95% CI: 0.576-0.733,P<0.05),the cut-off value was 0.289,the sensitivity was 59.7%,and the specificity was 69.2%.Conclusions: NLR and SHR were associated with the risk of in-hospital MACE in first acute STEMI patients.NLR and SHR had small prediction efficiency for the occurrence of in-hospital MACE in STEMI patients,and the prediction efficiency was moderate when the two were combined.Only SHR may be an independent risk factors for in-hospital MACE in first acute STEMI patients.