Tanriverdi Zulkif, Colluoglu Tugce, Dursun Huseyin, Kaya Dayimi
Clinic of Cardiology, Balikligol State Hospital, Sanliurfa, Turkey.
Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
J Electrocardiol. 2017 Nov-Dec;50(6):876-883. doi: 10.1016/j.jelectrocard.2017.06.011. Epub 2017 Jun 8.
No study so far investigated fragmented QRS (fQRS) and neutrophil-to-lymphocyte ratio (NLR) together in ST segment elevation myocardial infarction (STEMI).
To investigate the relationship between NLR and fQRS, and determine the prognostic significance of the combined use of these two parameters in STEMI.
We included 368 patients with first acute STEMI who successfully revascularized with primary percutaneous coronary intervention.
Patients with fQRS had significantly higher NLR, and in-hospital mortality rate compared to patients with no-fQRS. The best cut-off value of NLR to predict mortality was 5.47. Patients with NLR≥5.47 had a higher frequency of fQRS and in-hospital mortality rate. Multivariate analysis showed that NLR was an independent predictor of the presence of fQRS (OR: 1.095, 95% CI: 1.039-1.153, P=0.001). When patients were stratified by fQRS and cut-off value of NLR, in-hospital mortality gradually increased (P<0.001).
NLR is independently associated with the presence of fQRS in STEMI patients. Combined use of both parameters provides additional prognostic contribution for identifying patients at higher cardiac risk.
迄今为止，尚无研究在ST段抬高型心肌梗死（STEMI）患者中同时研究碎裂QRS（fQRS）和中性粒细胞与淋巴细胞比值（NLR）。
探讨NLR与fQRS之间的关系，并确定这两个参数联合应用在STEMI中的预后意义。
我们纳入了368例首次发生急性STEMI且通过直接经皮冠状动脉介入治疗成功实现血运重建的患者。
与无fQRS的患者相比，有fQRS的患者NLR和院内死亡率显著更高。预测死亡率的NLR最佳截断值为5.47。NLR≥5.47的患者fQRS发生率和院内死亡率更高。多变量分析显示，NLR是fQRS存在的独立预测因素（比值比：1.095，95%可信区间：1.039-1.153，P=0.001）。当根据fQRS和NLR截断值对患者进行分层时，院内死亡率逐渐升高（P<0.001）。
NLR与STEMI患者fQRS的存在独立相关。联合使用这两个参数可为识别心脏风险较高的患者提供额外的预后价值。
