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全身免疫炎症指数和 NT-proBNP 在急性 ST 段抬高型心肌梗死患者中的预后价值。

Prognostic Value of Systemic Immune-Inflammation Index and NT-proBNP in Patients with Acute ST-Elevation Myocardial Infarction.

机构信息

Institute of Cardiovascular Diseases, Xuzhou Medical University, Xuzhou, People's Republic of China.

Department of Cardiology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, People's Republic of China.

出版信息

Clin Interv Aging. 2023 Mar 17;18:397-407. doi: 10.2147/CIA.S397614. eCollection 2023.

Abstract

OBJECTIVE

Our aim was to assess systemic immune-inflammation index (SII) and NT-proBNP value either in singly or in combination to predict acute ST-elevation myocardial infarction (STEMI) patient prognosis.

METHODS

Analyzed retrospectively the clinical features and laboratory data of STEMI confirmed patients in our hospital from January to December 2020. The levels of SII and NT-proBNP were detected. The Kaplan-Meier approach and Spearman's rank correlation coefficient were used to construct the overall major adverse cardiac event (MACE) curve. Multivariate Cox regression analysis was applied to detect MACE predictors. In addition, the Delong test and receiver operating characteristic (ROC) curve analyzed each factor performance on its own and composite multivariate index to predict MACEs.

RESULTS

The MACE group showed statistically significant differences in SII, NT- proBNP in comparison to the non-MACE group (=0.003, <0.001). Based on Kaplan-Meier analysis, SII and NT-proBNP showed positive correlation with MACE (log-rank < 0.001). SII and NT-proBNP were independent predicting factors for long-term MACEs in multivariate Cox regression analysis ( <0.001, : 2.952, 1.565-5.566; <0.001, : 2.112, 1.662-2.683). SII and NT-proBNP exhibited a positive correlation ( = 0.187, < 0.001) in correlation analysis. According to the ROC statistical analysis, the combination exhibited 78.0% sensitivity and 88.0% specificity in the prediction of MACE. According to the results of the AUC and Delong test, the combined SII and NT-proBNP performed better as a prognostic index than each of the individual factor indexes separately ( = 2.622, 0.009; = 3.173, < 0.001).

CONCLUSION

SII and NT-proBNP were independent indicators of clinical prognosis in acute STEMI patients, and they correlated positively. These factors could be combined to improve clinical prognosis.

摘要

目的

评估全身性免疫炎症指数(SII)和 NT-proBNP 值单独或联合用于预测急性 ST 段抬高型心肌梗死(STEMI)患者预后的能力。

方法

回顾性分析 2020 年 1 月至 12 月我院确诊的 STEMI 患者的临床特征和实验室数据。检测 SII 和 NT-proBNP 水平。采用 Kaplan-Meier 法和 Spearman 秩相关系数构建总主要不良心脏事件(MACE)曲线。多因素 Cox 回归分析检测 MACE 的预测因素。此外,Delong 检验和受试者工作特征(ROC)曲线分析各因素单独及复合多变量指数预测 MACE 的性能。

结果

MACE 组与非 MACE 组比较,SII、NT-proBNP 差异有统计学意义(=0.003,<0.001)。Kaplan-Meier 分析显示,SII 和 NT-proBNP 与 MACE 呈正相关(log-rank <0.001)。多因素 Cox 回归分析显示,SII 和 NT-proBNP 是长期 MACE 的独立预测因素(<0.001,:2.952,1.565-5.566;<0.001,:2.112,1.662-2.683)。相关性分析显示,SII 和 NT-proBNP 呈正相关(=0.187,<0.001)。ROC 统计分析显示,联合检测 SII 和 NT-proBNP 预测 MACE 的敏感性为 78.0%,特异性为 88.0%。根据 AUC 和 Delong 检验结果,联合 SII 和 NT-proBNP 作为预后指标的性能优于各单因素指标(=2.622,0.009;=3.173,<0.001)。

结论

SII 和 NT-proBNP 是急性 STEMI 患者临床预后的独立指标,两者呈正相关。这些因素可以联合起来改善临床预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c55/10029373/e3ddd9e43e64/CIA-18-397-g0001.jpg

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