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淋巴细胞与单核细胞比值与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死亡率的关系

Association of Lymphocyte-to-Monocyte Ratio With the Mortality in Patients With ST-Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention.

作者信息

Kiris Tuncay, Çelik Aykan, Variş Eser, Akan Erol, Akyildiz Zehra Ilke, Karaca Mustafa, Nazli Cem, Dogan Abdullah

机构信息

1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey.

出版信息

Angiology. 2017 Sep;68(8):707-715. doi: 10.1177/0003319716685480. Epub 2017 Jan 5.

Abstract

We investigated whether the lymphocyte-to-monocyte ratio (LMR) 48 hours after admission is related to 30-day and long-term mortality in patients with ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI). We evaluated 318 consecutive patients with STEMI who were undergoing primary PCI. The relationship between the LMR and all-cause mortality (30-day and long-term) was analyzed by categorizing the patients into tertiles (T) according to LMR-T1 (>2.46), T2 (1.67-2.46), and T3 (<1.67). The T3 group exhibited the highest risk of 30-day all-cause mortality (hazard ratio [HR]: 8.093 [1.006-65.074]; P = .049). For long-term mortality, a significantly higher mortality risk was observed in both T2 (HR: 2.005 [1.021-3.939]; P = .043) and T3 groups (HR: 2.374 [1.160-4.857]; P < .001) compared to the T1 group (reference group). In multivariate analysis, these associations remained unaltered even after adjusting for confounders. A low LMR at 48 hours after admission may be independently associated with both 30-day and long-term mortality in patients with STEMI who were treated with primary PCI. This marker may be used for identifying patients with STEMI at high risk.

摘要

我们研究了入院48小时后的淋巴细胞与单核细胞比值(LMR)是否与接受直接经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者的30天和长期死亡率相关。我们评估了318例连续接受直接PCI的STEMI患者。根据LMR将患者分为三分位数(T):T1(>2.46)、T2(1.67 - 2.46)和T3(<1.67),分析LMR与全因死亡率(30天和长期)之间的关系。T3组30天全因死亡率风险最高(风险比[HR]:8.093[1.006 - 65.074];P = 0.049)。对于长期死亡率,与T1组(参照组)相比,T2组(HR:2.005[1.021 - 3.939];P = 0.043)和T3组(HR:2.374[1.160 - 4.857];P < 0.001)的死亡率风险均显著更高。在多变量分析中,即使在调整混杂因素后,这些关联仍然不变。入院48小时时低LMR可能与接受直接PCI的STEMI患者的30天和长期死亡率均独立相关。该标志物可用于识别高风险的STEMI患者。

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