| Objective: To investigate the correlation between neutrophils, high sensitivity C-reactive protein(hs-CRP), procalcitonin(PCT) and spontaneous recanalization(SR)of the infarct related artery in patients with ST-segment elevation myocardial infarction(STEMI), and explore the value of neutrophils, PCT, hs-CRP in predicting SR.Methods: A total of 105 patients with STEMI who received emergency coronary angiography from January 2013 to December 2014 in cardiovascular department of Gansu provincial hospital were prospectively included. All patients were divided into SR group and non-SR group according to the results of the emergency coronary angiography, then accordingly divided into four quartile group according to the level of neutrophils, hs-CRP, PCT. Multiple logistic regression analysis was used to select the independent predictor for SR. Receiver operating charactereristic(ROC) curve was plotted to assess the diagnostic value of neutrophils, hs-CRP, PCT for SR.Results: A total of 31(29.5%) patients met the criteria of SR. The blood level of neutrophils( 6.19 ± 3.5 vs. 7.53 ± 3.3, P=0.015), hs-CRP( 2.73 ± 4.84 vs. 5.37 ± 9.21, P=0.012), PCT( 0.058 ± 0.039 vs. 0.101 ± 0.052, P=0.001)and uric acid( 316.4 ± 85.4 vs. 359.3 ± 107.5, P=0.011) in SR group were significantly lower than in NSR group. Also, the use of statins in the SR group was higher than that in the NSR group(35.4% vs. 21.6%, P=0.048). Spontaneous coronary recanalization rate of neutrophils in Quartile 1, Quartile 2 was higher than that in Quartile 3, Quartile 4 group( 35.5% and 32.3% vs. 19.4% and 12.8%, P <0.05). Spontaneous coronary recanalization rate of hs-CRP in Quartile 1 was higher than that in Quartile 2, Quartile 3 and Quartile 4 group( 48.3% vs. 22.6%, 19.4% and 9.7%, P <0.05). Spontaneous coronary recanalization rate of PCT in Quartile 1 was higher than that in Quartile 2, Quartile 3 and Quartile 4 group(54.8% vs. 22.6%,16.1% and 6.5%, P <0.05). Multiple logistic regression analysis showed that neutrophils(OR=0.757,95%CI 0.538-1.064,P =0.032), hs-CRP(OR =0.642,95% CI 0.435-0.947,P =0.038), PCT(OR =0.397,95% CI 0.178-0.886,P =0.024)were independent predictors for SR. The area under the ROC curve(AUC) of PCT for predicting SR was greater than that of neutrophils, hs-CRP [ 0.788( 95% confidence interval 0.712-0.865) vs.0.635( 95% confidence interval 0.543-0.727) and 0.666( 95% confidence interval 0.579-0.753), P <0.05 ].Conclusions: Neutrophils, hs-CRP and PCT was independent predictor for SR. The lower the neutrophils, hs-CRP and PCT, the higher the SR rate was. The value of PCT for predicting SR was greater than that of neutrophils, hs-CRP. Hyperuricemia through inflammatory response may influence SR of infarct related artery. The use of statins in the SR group was higher than that in the NSR group, which may be related to its anti-inflammatory mechanism. |
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