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中性粒细胞与淋巴细胞比值可预测不稳定型心绞痛患者的冠状动脉病变严重程度及长期心血管死亡率。

Neutrophil-to-lymphocyte ratio predicts coronary artery lesion severity and long-term cardiovascular mortality in patients with unstable angina pectoris.

作者信息

Li Shunbao, Chen Hui, Zhou Li, Cui Hehe, Liang Siwen, Li Hongwei

机构信息

Internal Medical Department, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Department of Cardiology, Baoding First Central Hospital, Baoding, China.

出版信息

Acta Cardiol. 2022 Oct;77(8):708-715. doi: 10.1080/00015385.2021.1963564. Epub 2022 Aug 15.

Abstract

OBJECTIVES

Neutrophil-to-lymphocyte ratio (NLR), one of the composite biomarker of systemic inflammatory status, was proved promising in predicting clinical outcomes of acute coronary syndrome (ACS). However, there were no evidences that NLR was directly relative to the clinical outcomes of unstable angina pectoris (UAP). Therefore, this study was aimed to detect whether NLR could predict the coronary artery lesion severity (indicated as SYNTAX score) and clinical outcomes (especially long-term cardiovascular mortality) in patients with.

METHODS

In the single-centre retrospective study, 4110 patients with UAP were enrolled and divided into two groups according to their primary NLR values and followed up at a median time duration of 36 months. The differences of SYNTAX score and cardiovascular mortality between groups were analysed, and the predictive value of NLR was determined.

RESULTS

NLR was positively and linearly correlated with SYNTAX score ( = 0.270). Diabetes ( = 0.049), lymphocyte ( = 0.004), NLR ( = 0.002) and SYNTAX score ( < 0.001) were independent predictors of long-term cardiovascular mortality in patients with UAP. Kaplan-Meier analysis revealed higher occurrence of cardiovascular mortality when NLR > 2.38 ( = 0.015). Receiver operating characteristic (ROC) analysis showed that NLR = 2.76 is an effective cut point for predicting cardiovascular mortality (69.2% sensitivity, 64.8% specificity).

CONCLUSIONS

NLR value was positively related to the severity of coronary artery lesion and proved to be an independent predictor of cardiovascular mortality in patients with UAP. This study would contribute to therapy and prognosis optimisation of UAP.

摘要

目的

中性粒细胞与淋巴细胞比值(NLR)作为全身炎症状态的复合生物标志物之一,已被证明在预测急性冠状动脉综合征(ACS)的临床结局方面具有前景。然而,尚无证据表明NLR与不稳定型心绞痛(UAP)的临床结局直接相关。因此,本研究旨在检测NLR是否能够预测UAP患者的冠状动脉病变严重程度(以SYNTAX评分表示)及临床结局(尤其是长期心血管死亡率)。

方法

在这项单中心回顾性研究中,纳入4110例UAP患者,根据其初始NLR值分为两组,并进行了为期36个月的中位随访。分析了两组之间SYNTAX评分和心血管死亡率的差异,并确定了NLR的预测价值。

结果

NLR与SYNTAX评分呈正线性相关(=0.270)。糖尿病(=0.049)、淋巴细胞(=0.004)、NLR(=0.002)和SYNTAX评分(<0.001)是UAP患者长期心血管死亡率的独立预测因素。Kaplan-Meier分析显示,当NLR>2.38时,心血管死亡率的发生率更高(=0.015)。受试者工作特征(ROC)分析表明,NLR=2.7

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