Predictive Value Of NLR And PLR For Major Adverse Cardiovascular Events In Patients With Acute STEMI After Emergency PCI

Objective:To explore the predictive value of the ratio of neutrophil to lymphocyte(NLR)and platelet to lymphocyte(PLR)for major adverse cardiovascular events(MACE)in patients with acute STEMI after emergency PCI,and to provide reference for predicting the occurrence of major adverse cardiovascular events(MACE)in patients with acute STEMI.Methods:232 patients with acute STEMI and emergency PCI admitted to the Department of Cardiology of Kunshan First People’s Hospital from June 2016 to March 2018 were selected according to certain criteria and analyzed retrospectively.The general clinical data,blood parameters,Killip classification,cardiac ultrasonography and coronary angiography results of all patients were recorded,including gender,age,smoking history,history of hypertension,diabetes mellitus,Leu count,neutrophil count,lymphocyte count,platelet count,low density lipoprotein(LDL),high density lipoprotein(HDL).The ratio of neutrophils to lymphocytes(NLR),platelets to lymphocytes(PLR),low density lipoprotein(LDL)and high density lipoprotein(HDL)were calculated.According to the occurrence of major adverse cardiovascular events(MACE)during hospitalization,the patients were divided into MACE group and non-MACE group,and the differences of recorded data between the two groups were compared.The patients were divided into high NLR group,low NLR group,high PLR group and low PLR group according to the median of NLR and PLR.To compare the difference of MACE incidence between high and low NLR groups and high and low PLR groups.The receiver operation characteristic curve(ROC curve)was used to predict the occurrence of MACE by NLR and PLR.The area under the curve,the best critical point,sensitivity and specificity were calculated.Results:According to the relevant inclusion criteria,47 patients(20.26%)in MACEgroup and 185 patients(79.74%)in non-MACE group were enrolled.T-test and 2 test showed that there were significant differences in gender(male),age,Leu count,Neu count,Lym count,Plt count,PLR,NLR,LDL/HDL,LVEF,Killip grade,history of hypertension,number of lesion branches between MACE and non-MACE groups(P<0.05),and no significant differences in LDL,HDL,diabetes history and smoking history(P>0.05).The incidence of MACE in high NLR group and high PLR group was significantly different from that in low NLR group and low PLR group.Multivariate logistic regression analysis showed that NLR,Killip classification and history of hypertension were independent risk factors for MACE.NLR predicts the area under the ROC curve of MACE to be 0.781.When NLR=5.245,it is the best critical point.At this time,the sensitivity and specificity are 66%and 83.2%.The area under the ROC curve of MACE predicted by PLR is 0.669.When PLR is 161.73,it is the best critical point.The sensitivity and specificity are 63.8%and 69.2%respectively.CONCLUSION:1.NLR and PLR have certain value in predicting the occurrence of MACE after emergency PCI in patients with acute STEMI;when NLR=5.245 and PLR=161.73,they are the best critical points.2.NLR,Killip classification and history of hypertension were independent risk factors for in-hospital MACE in patients with acute STEMI after emergency PCI.