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在接受直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者中,嗜酸性粒细胞与白细胞比值的预后价值。

Prognostic Value of Eosinophil to Leukocyte Ratio in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

机构信息

Department of Cardiology, Hokkaido Cardiovascular Hospital.

Department of Cancer Pathology, Hokkaido University School of Medicine.

出版信息

J Atheroscler Thromb. 2017 Aug 1;24(8):827-840. doi: 10.5551/jat.37937. Epub 2016 Dec 1.

Abstract

AIM

Leukocyte profile has been related to clinical outcome in patients with ST-segment elevation (STE) myocardial infarction (MI). However, whether eosinophil to leukocyte ratio (ELR) predicts clinical outcome in patients who have undergone primary percutaneous coronary intervention (PCI) remains unclear. Therefore, we examined the prognostic value of ELR in this patient population.

METHODS

We retrospectively analyzed the data of 331 consecutive patients who underwent primary PCI for STEMI between January 2009 and March 2015. All leukocyte types were counted and ELR was calculated for all patients 24 h after hospital admission. The primary study endpoint was major adverse cardiac events (MACEs) within up to one year of follow-up duration.

RESULTS

MACEs including cardiac deaths in 9.4% of the patients, MI in 1.5%, and target lesion or vessel revascularization in 10.3%, occurred within one year in 68 patients (20.5%). The mean ELR was significantly lower in patients with MACEs than in patients without MACEs (0.20±0.51 vs.0.49±0.66, respectively; p<0.001). An ELR <0.1 at 24 h was identified as the best cut-off value for mortality prediction. Multivariate analysis identified that an ELR <0.1 (odds ratio [OR]=0.38; 95% confidence interval [CI]=0.22-0.67; p<0.001) and chronic kidney disease (OR=2.38; CI=1.33-4.24; p=0.003) are independent predictors of MACEs.

CONCLUSION

In primary PCI patients with STEMI, ELR at 24 h was an independent predictor of MACEs in addition to the usual coronary risk factors and commonly used biomarkers.

摘要

目的

白细胞谱与 ST 段抬高(STE)心肌梗死(MI)患者的临床结局相关。然而,在接受经皮冠状动脉介入治疗(PCI)的患者中,嗜酸性粒细胞与白细胞比值(ELR)是否预测临床结局尚不清楚。因此,我们在该患者人群中检查了 ELR 的预后价值。

方法

我们回顾性分析了 2009 年 1 月至 2015 年 3 月间接受 STE 心肌梗死患者的 331 例连续患者的资料。所有患者在入院后 24 小时内计数所有白细胞类型并计算 ELR。主要研究终点是在随访期间最长 1 年内的主要不良心脏事件(MACE)。

结果

68 例患者(20.5%)在 1 年内发生 MACE 包括心脏死亡 9.4%、心肌梗死 1.5%和目标病变或血管血运重建 10.3%。MACE 患者的平均 ELR 明显低于无 MACE 患者(分别为 0.20±0.51 和 0.49±0.66;p<0.001)。24 小时时 ELR<0.1 被确定为死亡率预测的最佳截断值。多变量分析确定 ELR<0.1(比值比[OR]=0.38;95%置信区间[CI]=0.22-0.67;p<0.001)和慢性肾脏病(OR=2.38;CI=1.33-4.24;p=0.003)是 MACE 的独立预测因子。

结论

在接受 STE 心肌梗死患者的 PCI 治疗中,除了常见的冠状动脉危险因素和常用的生物标志物外,24 小时 ELR 是 MACE 的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4273/5556190/c923bc196481/jat-24-827-g001.jpg

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