Correlation Between MPVLR、PLR And Severity Of Coronary Artery Disease In NSTEMI Patients With Type 2 Diabetes Mellitus

Objective:The correlation between platelet to lymphocyte ratio(PLR),mean platelet volume to lymphocyte ratio(MPVLR)and coronary SYNTAX score in patients with non-ST-segment elevation myocardial infarction(NSTEMI)combined with ype 2 diabetes mellitus(T2DM)was retrospectively analyzed.Methods:The clinical data of 200 NSTEMI patients admitted to the Hospital of Ningxia Medical University from January 2019 to December 2019 were selected and collected.According to whether T2 DM is combined,they are divided into:pure NSTEMI group,NSTEMI combined with T2 DM group,and all the selected patients are calculated according to coronary angiography to calculate the SYNTAX score.According to the SYNTAX score,the NSTEMI group and NSTEMI combined with T2 DM were divided into low-medium risk group(<35points)and high-risk group(≥ 35 points).Select the first peripheral blood test after admission,collect lymphocyte(LY),platelet(PLT),mean platelet volume(MPV),calculate PLR,MPVLR value,compare the pure NSTEMI group with the NSTEMI combined T2 DM group,and the patients with different SYNTAX scores for the differences in general data,PLR and MPVLR and other laboratory data,SPSS26.0 was used for statistical analysis of the data,and the difference was statistically significant at P<0.05.Results : 1.Comparison between the NSTEMI group and the NSTEMI combined with T2 DM group: the difference of c Tn I level [1.33(0.27,4.99)vs3.24(0.61,9.32)] is statistically significant;the difference of TG level[1.42(1.04,2.18)vs 1.92(1.45,2.55))] is statistically significant;the difference of HDL level(0.99±0.39 vs 0.83±0.18)is statistically significant.2.Comparison of NSTEMI group and NSTEMI combined with T2 DM group:the difference of WBC level(7.52±1.49 vs 9.87±2.31)is statistically significant;the difference of NE level(5.25± 1.28 vs 7.10± 2.19)is statistically significant;the difference of PLT level(204.04 ± 42.64 vs 232.74 ± 44.57)is statistically significant;the difference of MPV level(9.78 ± 1.36 vs 10.46 ± 1.06)is statistically significant.3.Comparison between the NSTEMI group and the NSTEMI combined T2 DM group:the difference of NLR level [2.75(2.11,3.68)vs 3.54(2.93,4.48)] is statistically significant;the difference of PLR level(130.43 ± 30.25 vs 145.44± 31.87)is statistically significant Significance;the difference of MPVLR level(6.32± 1.61 vs 6.62± 1.50)is statistically significant;the difference of CRP level[3.16(1.61,6.78)vs 6.74(2.32,18.40)] is statistically significant.4.The SYNTAX score of the simple NSTEMI group is low-medium-risk group compared with the high-risk group: the difference of NLR level [2.52(1.88,3.32)vs 3.04(2.60,4.07)] is statistically significant;the difference of PLR level(116.43 ± 27.10 vs 137.10 ± 28.73))is statistically significant;the difference of the MPVLR level(5.46 ± 1.42 vs 6.56 ± 1.43)is statistically significant.Spearman correlation analysis showed that there was a correlation between NLR,PLR,MPVLR and NSTEMI group patients’ SYNTAX score(r=0.301,r=0.354,r=0.412,P<0.05).5.NSTEMI combined with T2 DM group SYNTAX score low-medium-risk group and high-risk group comparison:the difference of NLR level [3.17(2.56,3.75)vs 4.36(3.37,5.89)] is statistically significant;the difference of PLR level(128.97 ± 25.80 vs 150.77 ± 30.02)is statistically significant;the difference of MPVLR level(5.67±1.28 vs 6.99±1.21)is statistically significant.Spearman correlation analysis showed that: NLR,PLR,MPVLR and NSTEMI combined with T2 DM group patients’ SYNTAX scores were correlated(r=0.435,r=0.471,r=0.534,P < 0.05);multivariate logistic regression analysis showed : PLR(OR=1.005,P=0.594),NLR(OR=1.609,P=0.033),MPVLR(OR=1.851,P=0.018).6.Use ROC curve to explore the diagnostic value of PLR,MPVLR and NLR in patients with coronary artery disease in pure NSTEMI and NSTEMI combined with T2 DM.The area under the curve of PLR,MPVLR,and NLR to diagnose the severity of coronary artery disease in patients with simple NSTEMI is as follows:area under the PLR curve 0.703,area under the MPVLR curve 0.715,area under the NLR curve 0.669;MPVLR diagnoses the severity of coronary artery disease in patients with simple NSTEMI,the best cutoff value is 5.82,sensitivity: 72.5%,specificity: 63.3%.The area under the curve for the diagnosis of coronary artery disease severity in patients with NSTEMI and T2 DM by PLR,MPVLR,and NLR are as follows: area under the PLR curve is 0.731,area under the MPVLR curve is0.817,and area under the NLR curve is 0.761;MPVLR diagnoses severe coronary artery disease in patients with NSTEMI and T2 D,the best cut-off value of degree is 6.08,sensitivity: 79.6%,specificity: 76.5%.Conclusion : 1.There is a positive correlation between the severity of coronary artery disease in patients with MPVLR,PLR and NSTEMI combined with T2 DM.2.The predictive value of MPVLR and PLR in the severity of coronary artery disease in patients with NSTEMI and T2 DM is higher than that in the NSTEMI group alone.3.MPVLR is an independent risk factor predicting the severity of coronary artery disease in patients with NSTEMI and T2 DM.