Department of Cardiology, The First Branch, The First Affiliated Hospital of Chongqing Medical University, 191 Renmin Rd, Yuzhong, Chongqing, 400000, People's Republic of China.
Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400000, People's Republic of China.
BMC Cardiovasc Disord. 2022 Oct 5;22(1):434. doi: 10.1186/s12872-022-02870-9.
Neutrophils and high-density lipoprotein cholesterol (HDL-c) play critical roles in the pathogenesis of acute myocardial infarction. We aimed to investigate the value of neutrophils count to high-density lipoprotein cholesterol ratio (NHR) in predicting occurrence of in-hospital adverse events in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI).
We retrospectively analyzed 532 patients who had been diagnosed with acute STEMI and treated with PPCI. Demographic and clinical data, admission laboratory parameters and NHR values were recorded. Major adverse cardiac events (MACE) were defined as stent thrombosis, cardiac rupture, cardiac arrest, ventricular aneurysm, malignant arrhythmia and cardiac death. Based on the receiver operating characteristic (ROC) analysis, all patients were divided into 2 groups based on the cut-off NHR value (NHR ≤ 11.28, NHR > 11.28). Cox regression analyses and the Kaplan-Meier survival curve were used to assess the prognostic ability of NHR in in-hospital MACE.
MACE was observed in 72 patients (13.5%) during in-hospital follow-up. NHR was significantly higher in MACE group compared to MACE-free group (10.93 [6.26-13.97] vs. 8.13 [5.89-11.16]; P = 0.001). The incidence of in-hospital MACE was significantly higher in the NHR > 11.28 group than in NHR ≤ 11.28 group (24.8% vs. 9.6%; P < 0.001). In multivariable Cox regression analyses, ALT, Killip III-IV and increased NHR (hazard ratio, 2.211; 95% confidence interval,1.092-4.479; P = 0.027) were identified as independent predictive factors of occurrence of in-hospital MACE. Higher NHR group had worse cumulative survival compared with the lower group.
NHR value on admission, which is an easily calculated and universally available maker, may be useful in in-hospital risk classification of STEMI patients undergoing PPCI.
中性粒细胞和高密度脂蛋白胆固醇（HDL-c）在急性心肌梗死的发病机制中起着关键作用。我们旨在研究中性粒细胞计数与高密度脂蛋白胆固醇比值（NHR）在预测接受直接经皮冠状动脉介入治疗（PPCI）的 ST 段抬高型心肌梗死（STEMI）患者住院期间不良事件中的价值。
我们回顾性分析了 532 例被诊断为急性 STEMI 并接受 PPCI 治疗的患者。记录了人口统计学和临床数据、入院实验室参数和 NHR 值。主要不良心脏事件（MACE）定义为支架血栓形成、心脏破裂、心脏骤停、心室动脉瘤、恶性心律失常和心脏死亡。根据受试者工作特征（ROC）分析，根据截断 NHR 值将所有患者分为 2 组（NHR≤11.28，NHR>11.28）。Cox 回归分析和 Kaplan-Meier 生存曲线用于评估 NHR 在住院期间 MACE 中的预后能力。
住院期间观察到 72 例（13.5%）MACE。MACE 组的 NHR 明显高于 MACE 组（10.93[6.26-13.97]与 8.13[5.89-11.16]；P=0.001）。NHR>11.28 组的住院期间 MACE 发生率明显高于 NHR≤11.28 组（24.8%比 9.6%；P<0.001）。多变量 Cox 回归分析显示，ALT、Killip III-IV 和升高的 NHR（风险比，2.211；95%置信区间，1.092-4.479；P=0.027）是住院期间 MACE 发生的独立预测因素。较高的 NHR 组与较低的组相比，累积生存率更差。
入院时的 NHR 值是一种易于计算且普遍可用的标志物，可能有助于对接受 PPCI 的 STEMI 患者进行住院期间风险分层。
