The Associate Between Left Ventricular Ejection Fraction And Platelet To Lymphocyte Ratio In Patients With ST Elevation Myocardial Infarction

Objective: To analyze the risk factors of left ventricular systolic dysfunction in patients with ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),to explore the associate between left ventricular ejection fraction(LVEF)and platelet to lymphocyte ratio(PLR)in patients with STEMI.Methods: A total of 339 patients with STEMI who underwent emergency PCI from the Department of Cardiology,Affiliated Hospital of Zunyi Medical University from January2019 to December 2020 were retrospectively.Echocardiogram test of the heart were taken within 24 hours of admission.According to left ventricular ejection fraction(LVEF)on admission,patients were divided to two different groups,as Group I(LVEF< 50%,n=195)and Group II(LVEF ≥ 50%,n=144),The general clinical data,blood routine and biochemical indexes within 24 hours of admission were recorded.Comparing two groups of patients with clinical characteristics,did correlation analysis between LVEF and statistically significant variables.So that we could analysis the relationship between PLR and the left ventricular ejection fraction.The first step was to do the single factor analysis,then do the multivariate Logistic regression among the statistically significant variables in order to filter risk that influence LVEF in STEMI patients treated with primary PCI.Drawing ROC curve,analysing the accuracy of PLR for diagnosis of LVEF in STEMI patients treated with primary PCI.Results:1.There was no significant difference in smoking,hypertension,systolic blood pressure,diastolic blood pressure,heart rate,WBC,NEUT,MONO,PC,PDW,TG,TC,HDL-C,LDL-C,CK,CK-MB,FIB,D dimer between the two groups.There were significant differences in age,sex,history of diabetes,LYMPH,MPV,FBG,NT-pro BNP,hs-TNT and PLR.The values of MPV,FBG,NT-pro BNP,hs-TNT and PLR in group I were significantly higher than group II,but the value of Lymph in group I was lower than that in group II.2.Age,sex,diabetes,CM,CK-MB,hs-TNT,NT-pro BNP and PLR were risk factors of left ventricular ejection fraction in STEMI patients treated with PCI.Multivariate logistic regression analysis revealed that diabetes,PLR and MPV were associated with left ventricular ejection fraction in STEMI patients treated with PCI.3.Studying their basic clinical and laboratory indicators,we found that left ventricular ejection fraction was negatively correlated with the level of PLR and MPV(r =-0.135,P< 0.05,vs r =-0.134,P < 0.05).4.The PLR threshold value was 183.12 and the PLR area under the ROC curve was0.62(95%CI:0.56-0.68)with a sensitivity of 49.20% and a specificity of 69.40% for the diagnosis of left ventricular ejection fraction in STEMI patients treated with PCI.The MPV threshold value was 11.55 f L and the MPV area under the ROC curve was 0.59(95%CI:0.53-0.66)with a sensitivity of 54.90% and a specificity of 60.40%.The PLR united MPV area under the ROC curve was 0.649(95%CI: 0.59-0.71)for the predicts of left ventricular ejection fraction in STEMI patients treated with PCI.Conclusion:1.PLR and MPV were significantly higher in left ventricular systolic dysfunction than that of normal left ventricular function in STEMI patients who underwent emergency PCI,and LVEF lower with elevated levels of PLR and MPV,they have a negative correlation relationship.2.PLR is better than MPV for STEMI patients to predict the left ventricular ejection fraction,and PLR united MPV used to predict left ventricular systolic dysfunction in patients with such disorders have greater predictive value than a single indicators.3.PLR,MPV and diabetes are risk factors for left ventricular systolic dysfunction in patients with STEMI.