系统免疫炎症指数与 ST 段抬高型心肌梗死患者残余 SYNTAX 评分相关。
Systemic Immune-Inflammatory Index Is Associated with Residual SYNTAX Score in Patients with ST-Segment Elevation Myocardial Infarction.
机构信息
Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
Department of Cardiology, Faculty of Medicine, Kafkas University, Kars, Turkey.
出版信息
Anatol J Cardiol. 2023 Aug 1;27(8):472-478. doi: 10.14744/AnatolJCardiol.2023.3074. Epub 2023 Jun 7.
BACKGROUND
Systemic immune-inflammatory index (platelet count × neutrophil-lymphocyte ratio) is a new marker that predicts adverse clinical outcomes in coronary artery diseases. Our aim was to investigate the relationship between the systemic immune-inflammatory index and residual SYNTAX score in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
METHODS
In this retrospective study, 518 consecutive patients who underwent primary percutaneous coronary intervention (PCI) with the diagnosis of ST-segment elevation myocardial infarction were analyzed. The severity of coronary artery diseases was determined by residual SYNTAX score. In the receiver operating characteristic curve analysis, systemic immune-inflammatory index with an optimal threshold value of 1025.1 could detect the presence of a high residual SYNTAX score; the patients were divided into 2 groups as low (326) and high (192) according to the threshold value. In addition, binary multiple logistic regression analysis methods were used to evaluate independent predictors of high residual SYNTAX score.
RESULTS
In binary multiple logistic regression analysis, systemic immune-inflammatory index [odds ratio = 6.910; 95% CI = 4.203-11.360; P <.001] was an independent predictor of high residual SYNTAX score. In addition, there was a positive correlation between the systemic immune-inflammatory index and residual SYNTAX score (r = 0.350, P <.001). In the receiver operating characteristic curve analysis, the systemic immune-inflammatory index with an optimal threshold value of 1025.1 could detect the presence of a high residual SYNTAX score with 73.8% sensitivity and 72.3% specificity.
CONCLUSION
Systemic immune-inflammatory index, an inexpensive and easily measurable laboratory variable, was an independent predictor of the increased residual SYNTAX score in patients with ST-segment elevation myocardial infarction.
背景
全身性免疫炎症指数（血小板计数×中性粒细胞与淋巴细胞比值）是一种新的标志物，可预测冠心病不良临床结局。本研究旨在探讨接受直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者全身性免疫炎症指数与残余 SYNTAX 评分之间的关系。
方法
本回顾性研究纳入了 518 例行直接经皮冠状动脉介入治疗的 ST 段抬高型心肌梗死患者。采用残余 SYNTAX 评分评估冠状动脉疾病严重程度。在受试者工作特征曲线分析中，全身性免疫炎症指数的最佳截断值为 1025.1，可检测出高残余 SYNTAX 评分；根据截断值将患者分为低（326 例）和高（192 例）两组。此外，采用二元多因素 logistic 回归分析方法评估高残余 SYNTAX 评分的独立预测因子。
结果
在二元多因素 logistic 回归分析中，全身性免疫炎症指数[比值比=6.910；95%可信区间（CI）：4.203~11.360；P<0.001]是高残余 SYNTAX 评分的独立预测因子。此外，全身性免疫炎症指数与残余 SYNTAX 评分之间存在正相关（r=0.350，P<0.001）。在受试者工作特征曲线分析中，全身性免疫炎症指数的最佳截断值为 1025.1，检测高残余 SYNTAX 评分的敏感度为 73.8%，特异度为 72.3%。
结论
全身性免疫炎症指数是一种经济且易于测量的实验室变量，是 ST 段抬高型心肌梗死患者残余 SYNTAX 评分升高的独立预测因子。
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