Analysis Of The Predictive Value Of Neutrophil To Lymphocyte Ratio Combined With Uric Acid For Short-term Prognosis In Patients With Acute STEMI

Objective: The aim of this study was to analyze the relationship between the neutrophil to lymphocyte ratio(NLR),serum uric acid(SUA)levels and the occurrence of major adverse cardiovascular events(MACE)during hospitalization in patients with acute St-segment elevation myocardial infarction(STEMI)teeated with primary percutaneous coronary intervention(PCI),and to discuss the predictive value of the combination of the two indicators for the occurrence of MACE.Methods:A total of 174 consecutive patients diagnosed as STEMI with emergency PCI in our Hospital from July 2014 to July 2020 were collected.According to the cut-off vaules of NLR and SUA of ROC curves predicting the occurrence of nosocomial MACE,all subjects were divided into low NLR combined with low SUA group,low NLR and high SUA group,high NLR combined with low SUA group,high NLR combined with high SUA group.Patients were divided into the group with MACE and the group without MACE based on whether MACE occurred in the hospital or not.Comparisons of clinical data,laboratory examination,coronary angiography and the incidence of MACE were performed by NLR with SUA.Comparisons of clinical data,laboratory examination and coronary angiography were performed between the MACE and non-MACE groups.The influencing factors of post-PCI MACE in patients with STEMI were investigated by logistic regression analysis.The predictive value of NLR,SUA and NLR combined with SUA in predicting the occurrence of in-hospital MACE after PCI in STEMI patients was analyzed and judged by using ROC curves.Results:High NLR combined with high SUA group showed higher prevalence of coronary heart disease and higher rate of Killip class Ⅱ-Ⅳthan low NLR combined with low SUA group.In comparison with high NLR combined with high SUA group,low NLR combined with low SUA group had lower mean leukocyte count,neutrophil count,NLR,SUA,Serum creatinine(Scr),Aspartate aminotransferase(AST)and Alanine aminotransferase(ALT),and higher mean lymphocyte count(P <0.05).Multivariate Logistic regression analysis showed that diastolic blood pressure,systolic blood pressure,GRACE score,NLR,SUA were independent risk factors for the occurrence of in-hospital MACE in STEMI patients(P<0.05).The AUC of NLR,SUA and NLR combined with SUA for predicting MACE in STEMI patients after PCI was 0.690[95 %CI(0.589-0.791)],0.710[95 % CI(0.616-0.804)],and 0.779[95 %CI(0.689-0.868)],respectively.The risk of in-hospital MACE in high NLR combined with high SUA group was 27.625 times,6.729 times and 6.611 times as high as low NLR combined with low SUA group,low NLR combined with high SUA group and high NLR combined with low SUA group,respectively.Conclusion: Early admission NLR and SUA are significantly higher in acute STEMI patients and are independent risk factors for in-hospital MACE after emergency PCI in STEMI patients,and their combination is of better clinical use in predicting in-hospital MACE after PCI in STEMI patients.