Correlation Between NLR And Cardiac Function After Emergency PCI In Acute Myocardial Infarction Patients With T2DM

Objective: To investigate the relationship between early cardiac diastolic function index and neutrophil/lymphocyte ratio(NLR)after emergency PCI in patients with acute myocardial infarction complicated with type 2 diabetes mellitus,and to analyze the predictive value of NLR for postoperative cardiac function and prognosis in these patientsMethods: A total of 124 patients with type 2 diabetes who underwent PCI due to acute myocardial infarction in the emergency Department of Jilin Provincial People’s Hospital from June 2021 to December 2022 were selected(screened by inclusion criteria and exclusion criteria).Blood routine,myocardial enzyme profile and other indexes(within 2hours before PCI)were collected before PCI and re-examined 24 hours after PCI.Blood routine,myocardial enzyme profile,brain natriuretic peptide(pro BNP),blood lipid test,hypersensitive C-reactive protein index and E/e ’index of cardiac color ultrasound within 1week after PCI were collected,and NLR values before and after surgery were calculated.The correlation between myocardial enzymes,brain natriuretic peptide,blood lipids,hypersensitive C-reactive protein and NLR values and postoperative cardiac diastolic function was examined by SPSS 21.0.The test methods were all considered statistically significant when P < 0.05.Results: 1.A total of 124 patients were enrolled after screening according to inclusion and exclusion criteria.There were 80 males and 44 females,ranging in age from 38 to 82 years old,with an average age of 63.17 ± 9.01 years old.According to the preoperative median NLR,they were divided into 2 groups with 62 persons in each group.NLR is less than the median array mean 2.43±0.73,and NLR is greater than the median array mean5.42±1.29.2.Comparison of NLR levels: The difference between preoperative NLR less than the median array and preoperative NLR greater than the median array is statistically significant,and there is a significant difference between groups.Creatine kinase,creatine kinase isoenzyme,hypersensitive C-reactive protein,brain natritic peptide and E/e ’with NLR larger than the median array were significantly higher than those with NLR smaller than the median array.3.Binary Logistic regression analysis indicated that the higher the preoperative NLR(OR=1.162,95%CI 1.017-1.360,P=0.028)and the 24 hours after surgery brain natriuretic peptide(OR=1.008,95%CI 1.001-1.015,P=0.027),the greater the postoperative E/e ’value.The results showed that the worse the diastolic function was,the results were statistically significant.The ROC curve was further improved,and the area under the curve of preoperative NLR(AUC=77.1%,P=0.000)was greater than that of brain natriuretic peptide(AUC=70.7%,P=0.000)at 24 hours after surgery.The results suggested that in terms of the accuracy of diagnosing early diastolic function impairment after PCI,The effect of NLR before surgery was better than that of NLR 24 hours after surgery.Conclusion: 1.In patients with acute myocardial infarction complicated with T2 DM,preoperative NLR level is correlated with the degree of myocardial damage.The higher preoperative NLR value,the more severe myocardial damage and the worse early postoperative diastolic function;2.In patients with acute myocardial infarction complicated with T2 DM,preoperative NLR and postoperative BNP level at 24 hours are correlated with early postoperative diastolic function,which is an independent risk factor for early postoperative diastolic function impairment.The higher the value,the worse the early postoperative diastolic function will be predicted.