The Neutrophil-to-Lymphocyte Ratio Is an Important Indicator Predicting In-Hospital Death in AMI Patients
Autor: | Jia-Qi Guo, Wenjie Zuo, Jie Lin, Genshan Ma, Rui Zhang, Yangyang Qu, Yamin Su, Yuyu Yao, Abdlay Carvalho, Zhenjun Ji, Guiren Liu |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
acute myocardial infarction (AMI)
medicine.medical_specialty Youden's J statistic Cardiovascular Medicine Logistic regression chemistry.chemical_compound Internal medicine Diabetes mellitus blood routine examination Medicine Diseases of the circulatory (Cardiovascular) system Medical history Neutrophil to lymphocyte ratio neutrophil to lymphocyte ratio Original Research Creatinine business.industry fungi medicine.disease chemistry RC666-701 Biomarker (medicine) biomarker Observational study prognosis Cardiology and Cardiovascular Medicine business |
Zdroj: | Frontiers in Cardiovascular Medicine, Vol 8 (2021) Frontiers in Cardiovascular Medicine |
Popis: | Objective: To explore the role of neutrophil-to-lymphocyte ratio (NLR) in predicting the short-term prognosis of NSTEMI and STEMI.Methods: This study was a single-center, retrospective and observational study. 2618 patients including 1289 NSTMI and 1329 STEMI patients were enrolled from June 2013 to February 2018 in Zhongda Hospital, Southeast University. The demographic information, clinical characteristics, medical history, laboratory examination, treatment, and outcome of individuals at admission and during hospitalization were extracted from the electronic medical record system. Outcome was defined as the all-cause death during hospitalization.Results: (1) In the NSTEMI group, the ability of NLR in predicting in-hospital death (AUC = 0.746) was higher than the neutrophil-monocyte ratio (NMR) (AUC = 0.654), the platelet-lymphocyte ratio (PLR) (AUC = 0.603) and the lymphocyte-monocyte ratio (LMR) (AUC = 0.685), and also higher than AST (AUC = 0.621), CK (AUC = 0.595), LDH (AUC = 0.653) and TnI (AUC = 0.594). The AUC of NLR in the STEMI group was only 0.621. (2) The optimal cut-off value of NLR in NSTEMI group was 5.509 (Youden index = 0.447, sensitivity = 77.01%, specificity = 67.72%). After adjusting variables including age, sex, diabetes history, smoking history, LDL-C and Cr, the logistic regression showed that the patients with NLR>5.509 had higher hazard risk of death (HR4.356; 95%CI 2.552–7.435; P < 0.001) than the patients with NLR ≤ 5.509. (3) Stratification analysis showed that the in-hospital mortality of patients with NLR > 5.509 was 14.611-fold higher than those with NLR ≤ 5.509 in patients aged P = 0.009), while the HR was only 4.117 in patients with creatinine levels > 71. The HR in patients with or without diabetes were 6.586 and 3.375, respectively. The HR in smoking or no smoking patients were 6.646 and 4.145, respectively. The HR in patients with LDL-C ≥ 2.06 or Conclusion: Compared to NMR, PLR, and LMR, NLR had the best ability in predicting in-hospital death after NSTEMI. Age, creatinine, LDL-C, diabetes and smoking history were all important factors affecting the predictive efficiency in NSTEMI. NLR had the limited predictive ability in STEMI. |
Databáze: | OpenAIRE |
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