The Predictive Value Of Neutrophil/ Lymphocyte Ratio In The Level Of Criminal Blood Flow Perfusion In Patients With Acute Myocardial Infarction

Objective:To investigate the predictive value of Neutrophil/lymphocyte ratio on the level of blood perfusion in patients with acute myocardial infarction.Methods:Retrospective analysis of the clinical data of 894 patients with acute myocardial infarction in the Chest Pain Center of the People’s Hospital of Hunan Province from May 1,2016-December 31,2018.According to criminal vascular perfusion level from coronary angiography,patients were separated into TIMI 0-1 and TIMI 2-3 group to compare the general clinical data of two groups of patients(age and gender,smoking,high blood pressure,diabetes,hyperlipidemia),laboratory data(White blood cell count,neutrophil count,lymphocyte count,platelet count,neutrophil/lymphocyte ratio,creatinine,cardiac creatine kinase,troponin,fibrinogen,d-dimeric,serum triglyceride,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol were calculated)and coronary angiography results(the criminal vascular,total number of diseased vessels).Independent predictors of TIMI 0-1 patients were evaluated by multivariate Logistic regression analysis;the best prediction threshold of independent predictors of TIMI 0-1 patients was found through ROC curve analysis.Results:1.Comparison between TIMI0-1 group and TIMI2-3 group:mean of white blood cell count[(9.13±2.26)x10~9/L VS(7.06±1.43)x10~9/L],mean of neutrophil count[(6.76±1.98)x10~9/L VS(4.57±1.41)x10~9/L],neutrophil/lymphocyte ratio(5.37±3.23 VS 2.86±1.83),LDL cholesterol[(3.17±0.59)mmol/L VS(1.69±0.44)mmol/L],cardiac creatine kinase [(234.54±107.51)U/L VS(154.13±127.69)U/L] and troponin[(6.41±3.58)ng/ml VS(3.79±2.74)ng/ml]were higher in TIMI0-1 group.Mean of lymphocyte count[(1.55±0.73)x10~9/L VS(1.77±0.49)x10~9/L]was decreased in TIMI0-1 group,and the difference was statistically significant(P<0.05).2.Multivariate Logistic regression analysis showed that white blood cell count and neutrophil/lymphocyte ratio could be an independent predictor for patients with the criminal blood vessel of TIMI 0-1.3.According to ROC curve analysis,neutrophil/lymphocyte ratio was more predictive of TIMI 0-1 level than WBC count.The area under the ROC curve of TIMI 0-1 of WBC count was 0.78(95%CI:0.74~0.82),and the optimal cutoff value was 8.87x10~9/L,with a sensitivity of 63.4%and specificity of 93.6%;the area under the ROC curve of TIMI0-1 of neutrophils/lymphocytes was 0.82(95%CI:0.79~0.86),with an optimal cutoff value of 4.09,sensitivity of 65.7%and specificity of 94.7%.Conclusion:1.White blood cell count and neutrophil/lymphocyte ratio can be used as an independent predictor of criminal blood perfusion grade 0-1 in patients with acute myocardial infarction.2.The lower the criminal blood perfusion level,the higher the white blood cell count and neutrophil/lymphocyte ratio.3.Neutrophil/lymphocyte ratio is more predictive than white blood cell count when the criminal blood perfusion level is grade 0-1.