Zuin Marco, Rigatelli Gianluca, Picariello Claudio, dell'Avvocata Fabio, Marcantoni Lina, Pastore Gianni, Carraro Mauro, Nanjundappa Aravinda, Faggian Giuseppe, Roncon Loris
Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy; Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy.
Unit of Cardiovascular Diagnosis and Endoluminal Interventions, Santa Maria della Misericordia Hospital, Rovigo, Italy.
Cardiovasc Revasc Med. 2017 Dec;18(8):565-571. doi: 10.1016/j.carrev.2017.05.007. Epub 2017 May 12.
BACKGROUND/PURPOSE: The neutrophil/lymphocyte ratio (NLR) has been proposed as a prognostic marker in acute myocardial infarction (AMI). The aim of our study is to demonstrates the correlation between SYNTAX score (SXs) and NLR and its association with 1-year cardiovascular (CV) mortality in patients with ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) treated with percutaneous coronary intervention (PCI).
METHODS/MATERIALS: Over 6 consecutive years, (1st January 2010 and 1st January 2016) 6560 patients (4841 males and 1719 females, mean age 64.36±11.77years) were admitted for AMI and treated with PCI within 24-h. The study population was divided into tertiles based on the SXs.
Both in STEMI and NSTEMI groups, neutrophils and the SXs were significantly higher (p<0.0001) in upper versus lower among NLR tertiles and a significant correlation was found between the NLR and SXs (r=0.617, p<0.0001 and r=0.252, p<0.0001 for STEMI and NSTEMI groups, respectively). One-year CV mortality significantly raised up among the NLR tertiles in both STEMI and NSTEMI patients (p<0.0001). Multivariate analysis revealed that, after adjusting SXs and PAD, an NLR (≥3.9 and ≥2.7 for STEMI and NTEMI patients, respectively) was an independent significant predictor of 1-year CV mortality (OR 2.85, 95% CI 1.54-5.26, p=0.001 and OR 2.57, 95% CI 1.62-4.07, p<0.0001 for STEMI and NSTEMI respectively.) CONCLUSIONS: NLR significantly correlates with SXs and is associated with 1-year CV mortality in patients with STEMI or NSTEMI treated with PCI within 24-h.
背景/目的：中性粒细胞/淋巴细胞比值（NLR）已被提议作为急性心肌梗死（AMI）的预后标志物。我们研究的目的是证明在接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）或非ST段抬高型心肌梗死（NSTEMI）患者中，SYNTAX评分（SXs）与NLR之间的相关性及其与1年心血管（CV）死亡率的关联。
方法/材料：在连续6年期间（2010年1月1日至2016年1月1日），6560例患者（4841例男性和1719例女性，平均年龄64.36±11.77岁）因AMI入院并在24小时内接受PCI治疗。根据SXs将研究人群分为三分位数。
在STEMI和NSTEMI组中，NLR三分位数中较高者的中性粒细胞和SXs均显著高于较低者（p<0.0001），并且在NLR与SXs之间发现显著相关性（STEMI组r=0.617，p<0.0001；NSTEMI组r=0.252，p<0.0001）。STEMI和NSTEMI患者的NLR三分位数中1年CV死亡率均显著升高（p<0.0001）。多变量分析显示，在调整SXs和外周动脉疾病（PAD）后，NLR（STEMI和NSTEMI患者分别≥3.9和≥2.7）是1年CV死亡率的独立显著预测因子（STEMI组OR 2.85，95%CI 1.54-5.26，p=0.001；NSTEMI组OR 2.57，95%CI 1.62-4.07，p<0.0001）。结论：NLR与SXs显著相关，并且与在24小时内接受PCI治疗的STEMI或NSTEMI患者的1年CV死亡率相关。
