Pivina Lyudmila, Batenova Gulnara, Ygiyeva Diana, Orekhov Andrey, Pivin Maksim, Dyussupov Altay
Department of Emergency Medicine, Semey Medical University, Semey 071400, Kazakhstan.
Department of Internal Medicine, Semey Medical University, Semey 071400, Kazakhstan.
Diagnostics (Basel). 2024 Oct 11;14(20):2262. doi: 10.3390/diagnostics14202262.
The neutrophil-to-lymphocyte ratio (NLR) is an independent predictor of the severity of coronary heart disease and COVID-19. This study aims to assess the predictive ability of the NLR in patients with in-stent restenosis after COVID-19.
a cross-sectional study included 931 patients who underwent repeated myocardial revascularization between May 2020 and May 2023. The 420 patients of the main group had in-stent restenosis, of which 162 patients had COVID-19 previously. The control group included 511 patients without stent restenosis (107 patients had COVID-19 previously). All reported events were verified by hospital electronic records from the Complex Medical Information System.
The mean values of the NLR were 2.51 and 2.68 in the study groups, respectively. A statistically significant positive relationship in both groups was found between the NLR and troponin, D-dimer, C-reactive protein, creatinine, ALT, and AST. A statistically significant positive relationship was found between NLR and myocardial infarction (MI) in patients of both groups ( = 0.004; < 0.001, respectively) and a negative relationship with the ejection fraction ( = 0.001; < 0.036, respectively). An evaluation of the predictive ability of the clinical and laboratory predictors of recurrent myocardial infarction shows a high degree of utility of this model. The area under the ROC curve for AUC for NLR was 0.664 with 95% CI from 0.627 to 0.700 ( < 0.001).
NLR is one of the significant factors for predicting the development of adverse outcomes in patients with revascularized myocardium after COVID-19.
中性粒细胞与淋巴细胞比值（NLR）是冠心病和新冠病毒病（COVID-19）严重程度的独立预测指标。本研究旨在评估NLR对COVID-19后支架内再狭窄患者的预测能力。
一项横断面研究纳入了931例在2020年5月至2023年5月期间接受重复心肌血运重建的患者。主要组的420例患者发生了支架内再狭窄，其中162例患者既往感染过COVID-19。对照组包括511例无支架再狭窄的患者（107例患者既往感染过COVID-19）。所有报告的事件均通过综合医疗信息系统的医院电子记录进行核实。
研究组中NLR的平均值分别为2.51和2.68。两组中NLR与肌钙蛋白、D-二聚体、C反应蛋白、肌酐、谷丙转氨酶（ALT）和谷草转氨酶（AST）之间均存在统计学显著正相关。两组患者中NLR与心肌梗死（MI）之间均存在统计学显著正相关（分别为P = 0.004；P < 0.001），与射血分数呈负相关（分别为P = 0.001；P < 0.036）。对复发性心肌梗死的临床和实验室预测指标的预测能力评估显示该模型具有高度实用性。NLR的ROC曲线下面积（AUC）为0.664，95%可信区间为0.627至0.700（P < 0.001）。
NLR是预测COVID-19后心肌血运重建患者不良结局发生的重要因素之一。
