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系统性免疫炎症指数预测 ST 段抬高型心肌梗死患者心肌灌注受损和短期死亡率。

The Systemic Immune-Inflammation Index Predicts Impaired Myocardial Perfusion and Short-Term Mortality in ST-Segment Elevation Myocardial Infarction Patients.

机构信息

Department of Cardiology, 175678Sakarya University Training and Research Hospital, Sakarya, Turkey.

Department of Biochemistry, 175678Sakarya University Training and Research Hospital, Sakarya, Turkey.

出版信息

Angiology. 2023 Apr;74(4):365-373. doi: 10.1177/00033197221106886. Epub 2022 Jun 7.

Abstract

In this study, we aimed to evaluate the utility of the immune-inflammation index (SII) in estimating the no-reflow phenomenon and short-term cardiovascular prognosis in patients with ST-segment elevation myocardial infarction (STEMI). 723 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PCI) were enrolled in our study. The receiver-operating characteristics (ROC) curve was used to determine the cut-off value of SII to predict the no-reflow. The multivariate regression analysis analyzed the correlation between no-reflow and SII. The median value of SII was significantly higher in patients with no-reflow in comparison with normal reperfusion [1466 (939-2409) vs 905 (566-1379), < .001]. The optimal threshold for SII in predicting the no-reflow phenomenon was 1036, with sensitivity and specificity of 70% and 59%, respectively. The area under the ROC curve (AUC) was 0.71 (95% CI, 0.66-0.75, < .001). In multivariate analysis, SII ≥ 1036 value showed an independent predictive value for the no-reflow (OR = 0.51, 95% CI: 0.29-0.92, = .02) and the 30-day cardiovascular mortality (OR = 2.37, 95% CI: 1.34-4.19, = .003). Our results suggest that higher SII levels are independently associated with the no-reflow phenomenon and 30-day mortality in STEMI patients undergoing primary PCI.

摘要

在这项研究中,我们旨在评估免疫炎症指数(SII)在评估 ST 段抬高型心肌梗死(STEMI)患者无复流现象和短期心血管预后中的作用。本研究纳入了 723 例接受直接经皮冠状动脉介入治疗(PCI)的 STEMI 患者。采用受试者工作特征(ROC)曲线确定 SII 的截断值以预测无复流。多变量回归分析分析了无复流与 SII 之间的相关性。与正常再灌注相比,无复流患者的 SII 中位数明显升高[1466(939-2409)比 905(566-1379),<0.001]。预测无复流现象的 SII 最佳阈值为 1036,灵敏度和特异性分别为 70%和 59%。ROC 曲线下面积(AUC)为 0.71(95%可信区间,0.66-0.75,<0.001)。在多变量分析中,SII≥1036 值对无复流具有独立的预测价值(OR=0.51,95%可信区间:0.29-0.92,=0.02)和 30 天心血管死亡率(OR=2.37,95%可信区间:1.34-4.19,=0.003)。我们的研究结果表明,较高的 SII 水平与 STEMI 患者直接 PCI 后无复流现象和 30 天死亡率独立相关。

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