Anemia and Inflammation in ST-Segment Elevation Myocardial Infarction

作者：Zhang, Enyuan; Li, Zhenyu; Che, Jingjin; Chen, Xin; Qin, Tiantian; Tong, Qing; Zhao, Weiwei; Li, Guangping^*

来源：American Journal of the Medical Sciences, 2015, 349(6): 493-498.

DOI：10.1097/MAJ.0000000000000471

• STEMI
• Major adverse cardiovascular events
• Hemoglobin
• Neutrophil/lymphocyte ratio

Background: To investigate the factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) patients. Methods: Two hundred forty-eight STEMI patients (61.4 +/- 10.8 years, 186 men) who underwent successful primary percutaneous coronary intervention were enrolled. Patients were followed-up for 1 year. Univariate, multivariate analyses, and receiver operating characteristic curve analysis were performed to determine the factors predicting MACEs. Results: There were 36 patients (14.5%) who experienced MACEs in the follow-up period. Multivariate logistic regression analysis demonstrated that hemoglobin (HgB) (odds ratio = 0.972; 95% CI, 0.948-0.998; P = 0.033), neutrophil/lymphocyte ratio (NLR) (odds ratio = 1.511; 95% CI, 1.148-1.987; P = 0.003), Global Registry of Acute Coronary Event score, and post-procedure left ventricular ejection fraction (LVEF) were independent predictors of MACEs. Further subgroup analysis showed higher NLR (> 8.61), Global Registry of Acute Coronary Event score (> 167) and lower HgB (< 131 g/L) all show superior predictive value for patients with relatively higher LVEF (> 48%); moreover, the c-statistic of NLR and HgB both exceed 0.7. However, among patients with lower LVEF (<= 48%), higher NLR and lower HgB lost the ability for predicting 1 year MACEs independently. In addition, abnormally higher NLR (>8) could predict 1-month MACEs efficiently. Conclusions: In summary, among STEMI patients, elevated NLR, decreased HgB level on admission both predicted 1-year MACEs independently, especially for those with relatively preserved LVEF (>48%). Besides, abnormally higher NLR on admission should attract their attention for short-term MACEs.

• 出版日期2015-6
• 单位天津医科大学