The Predictive Value Of MHR Combined With CAMI-STEMI Score On Major Cardiovascular Adverse Events After PCI In STEMI Patients

Objective:1.To explore the correlation between monocyte,high density lipoprotein(HDL-C),monocyte count/high density lipoprotein cholesterol ratio(MHR)and CAMI-STEMI score in patients with acute ST segment elevation myocardial infarction(STEMI)2.According to the occurrence of major adverse cardiovascular events(MACE events)in patients with STEMI within 6 months after-percutaneous coronary intervention(PCI),we will analyze whether MHR combined with CAMI-STEMI score can improve the predictive value of CAMI-STEMI score in patients with STEMI after PCIMethods:1.The retrospective study included 236 STEMI patients who were hospitalized in the Department of Cardiology,affiliated Hospital of Yangzhou University and underwent emergency PCI from January 2017 to June 2019.The results of biochemical indexes and cardiac echocardiography were collected,including blood routine,liver and kidney function,blood lipids,electrolytes,EF value,etc.MHR was calculated according to the ratio of monocyte count and high-density lipoprotein(HDL).According to the median value of MHR group,the study population was divided into low-level group(MHR ≤0.50,n=119)and high-level group(MHR>0.50,n=117).The differences of basic and biochemical data among MHR groups were compared,and CAMI-STEMI scores were performed on all selected patients.Then the differences of monocyte count,high-density lipoprotein level,MHR level and CAMI-STEMI score between the two groups were compared.Pearson correlation test was used to analyze the correlation between monocyte count,HDL-C,MHR and CAMISTEMI score2.All follow-up data including the all-cause mortality during hospitalization and the occurrence of MACE events within 6 months from the two study populations were collectedBased on whether MACE events occurred within 6 months after PCI,the patients were divided into event group(n=51)and non-event group(n=185),The differences of basic data between event group and non-event group were compared.Logistic regression analysis was performed on 236 patients as a whole,and the combined variables of MHR and CAMI-STEMI scores were obtained.The analysis of MHR,CAMI-STEMI scores and the combination of the two were independent risk factors for MACE events in STEMI patients within 6 months after PCI.The predictive value of MHR level,CAMI-STEMI score,MHR combined with CAMISTEMI score in patients with STEMI after PCI was analyzed by receiver working curve(ROC).Results:1.Pearson correlation test was used to analyze the correlation between monocyte count,HDL-C,MHR and CAMI-STEMI score.There was a positive correlation between monocyte count and CAMI-STEMI score(r=0.707,P<0.05),a negative correlation between high density lipoprotein level and CAMI-STEMI score(r=-0.353,P<0.05),and a positive correlation between MHR level and CAMI-STEMI score(r=0.742,P<0.05).The correlation between MHR and CAMISTEMI score was higher than that between monocyte count and CAMI-STEMI score,and between high density lipoprotein level and CAMI-STEMI score2.The number of deaths during hospitalization of the included population was 1 case(0.42%).There was no significant difference in the number of deaths during hospitalization between the event group and the non-event group,and there was no statistical significance.The number of MACE events in the study population was 51,accounting for 21.61%of the total population.Both MHR and CAMI-STEMI scores can be used to independently predict MACE events after PCI in STEMI patients through Logistic regression analysis.The areas under the ROC curve of MHR,CAMI-STEMI score and their combination to predict the occurrence of MACE events within 6 months after PCI in STEMI patients were 0.766,0.783 and 0.801,respectively.The area under the ROC curve of MHR combined with CAMI-STEMI score to predict the occurrence of MACE events in STEMI patients within 6 months after PCI was larger than that of MHR and CAMI-STEMI score,and the difference was statistically significant(P<0.05)Conclusion:1.There is a positive correlation between MHR level and CAMI-STEMI score,and the correlation between MHR and CAMI-STEMI score is higher than that between monocyte count and CAMI-STEMI score2.The area under the ROC curve of MHR combined with CAMI-STEMI score to predict the occurrence of MACE events in STEMI patients within 6 months after PCI was greater than that of MHR and CAMI-STEMI scores.The combination of the two has improved the predictive value of CAMI-STEMI score in PCI MACE events in STEMI patients.