Correlation Between Neutrophil To Lymphocyte Ratio And Acute Myocardial Infarction

ObjectiveTo investigate the relationship between neutrophil to lymphocyte ratio(NLR)and acute myocardial infarction(AMI)and its value in early diagnosis MethodsA retrospective analysis of 183 patients who first diagnosed with AMI and underwent emergency percutaneous coronary intervention(PCI)from January 2017 to September 2017 in our hospital cardiology ward,including 136 males and 47 females,the average age was(59.59 ± 12.16)years old.The control group was enrolled in the same period with chest pain,chest tightness and other suspected acute coronary syndrome(ACS),but the possible of coronary heart disease can be excluded after coronary angiography in patients for 106 cases,included 57 males and 49 females,the average age was(53.86 ± 9.89)years old.During the hospital,all selected patients underwent coronary angiography and completed relevant blood biochemical tests,ECG and so on within 24 hours after admission.The general condition of the patients was enrolled,including age,gender,body mass index(BMI),past history(hypertension,diabetes)and smoking history.The results of laboratory tests such as blood routine and blood biochemistry were recorded.Compare the clinical data of the control group and the AMI group and analyze the relationship between NLR and AMI and the diagnostic value of NLR to AMI.Subsequently,AMI group was subdivided into acute ST-elevation myocardial infarction(STEMI)group and acute non-ST-segment myocardial infarction(NSTEMI)group according to myocardial injury markers and ST segment changes after admission.The clinical data of two groups were compared.Analysize the diagnostic value of NLR for STEMI and NSTEMI and its correlation with CK and CK-MB.Use SPSS24.0 for statistical analysis.Results1.Compared with the control group,patients in AMI had an older age,a higher proportion of gender(mainly male patients),and the prevalence of hypertension and diabetes,smoking rate were increased while PLT count was decreased,and the difference was statistically significant(P<0.05).In patients with AMI,WBC,N and NLR were significantly higher than those in the control group(P<0.05),and the difference was statistically significant(P<0.05);2.Multiple logistic regression analysis of risk factors for AMI revealed that not only age,sex(male),smoking and low-level HDL-C,but also NLR was the independent risk factor for AMI(OR=6.110,95%CI:3.691-10.116,P<0.05);3.The ROC curve analysis of patients with AMI found that it was the best diagnosed cutoff point when NLR was 2.205 during diagnosing AMI,the sensitivity was 0.918,the specificity was 0.840,the area under the curve was 0.941{ 95%CI(0.915,0.968,P<0.05};4.Compared with NSTEMI group,the levels of TnI,CK,CK-MB,WBC,N and N / L in STEMI group were significantly higher than those in NSTEMI group(P<0.05).5.The ROC curves of STEMI and NSTEMI patients were analyzed.The results showed that the best cut-off point of NLR for diagnosis of STEMI was 3.120,the sensitivity was 0.830,the specificity was 0.953.The area under the curve was 0.954{ 95%CI(0.927,0.980),P<0.05};NLR diagnosis of NSTEMI the best cutoff was 2.205,the sensitivity was 0.892,the specificity was 0.840,the area under the curve was 0.927 {95% CI(0.891,0.962),P<0.05};6.The correlation coefficient between NLR and CK in STEMI group was 0.285,P = 0.005,the correlation coefficient between NLR and CK-MB was 0.326,P = 0.001;the correlation coefficient between NLR and CK in NSTEMI group was 0.207,P = 0.047;the correlation coefficient between NLR and CK-MB was 0.272,P = 0.009;NLR and CK,CK-MB between the two groups were positively correlated,and the difference was statistically significant(P<0.05).Conclusion1.The NLR in patients with AMI was significantly higher than that in control group.NLR was an independent risk factor for AMI.When NLR was higher than 2.205,it had a higher diagnostic value for the occurrence of AMI.2.The degree of inflammation for STEMI patients admitted to hospital was more severe than that of NSTEMI patients.3.Whether STEMI or NSTEMI patients,NRL is positively correlated with CK and CK-MB.