Gao Weiwei, Yu Lingfeng, Jin Shouyue, Cai Lijuan, Fang Jingjing, Wang Xiaoqian, Yang Qingwei, Chen Xingyu, Ye Tao, Zhu Renjing
Department of Neurology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Front Neurol. 2024 Oct 8;15:1465144. doi: 10.3389/fneur.2024.1465144. eCollection 2024.
This study aimed to enhance the understanding of cardio-cerebral infarction (CCI) clinical features and identify key prognostic factors, thereby providing an empirical foundation for advancing prevention and treatment strategies and ultimately improving clinical outcomes for CCI patients.
We retrospectively analyzed 17,645 AIS and 7,584 AMI patients admitted to two hospitals from 2014 to 2023. Univariate analysis, Spearman correlation, and multivariate logistic regression were performed to identify independent risk factors. Receiver operating characteristic (ROC) curves were used to determine optimal cutoff values.
This study enrolled 85 patients with CCI, representing an overall CCI incidence of approximately 0.34%. Males comprised 64.71% of the cohort. ST-segment elevation myocardial infarction and cardiogenic cerebral infarction were the most predominant subtypes. The in-hospital mortality rate was 30.59%, with 65.38% of deaths attributed to cardiac causes. Multivariate logistic regression analysis identified three independent risk factors for in-hospital mortality: elevated neutrophil-to-lymphocyte ratio (NLR), decreased serum albumin, and increased peak N-terminal pro-B-type natriuretic peptide levels (NT-proBNP). ROC curve analysis demonstrated that the area under the curve (AUC) for the NLR, albumin concentration and peak NT-proBNP concentration were 0.863, 0.723, and 0.824, respectively. The optimal cutoff values were 6.914 for NLR, 33.80 g/L for albumin, and 9474.50 pg/mL for peak NT-proBNP. The AUC of the combined diagnostic model reached 0.959, significantly outperforming the individual indicators.
Elevated NLR, decreased serum albumin, and increased peak NT-proBNP levels independently predict in-hospital mortality in CCI patients. Combining these biomarkers enhances predictive capability for adverse outcomes.
本研究旨在加深对心脑梗死(CCI)临床特征的理解并确定关键预后因素,从而为推进预防和治疗策略提供实证依据,并最终改善CCI患者的临床结局。
我们回顾性分析了2014年至2023年期间两所医院收治的17645例急性缺血性卒中(AIS)患者和7584例急性心肌梗死(AMI)患者。进行单因素分析、Spearman相关性分析和多因素逻辑回归以确定独立危险因素。采用受试者工作特征(ROC)曲线确定最佳截断值。
本研究纳入了85例CCI患者,总体CCI发病率约为0.34%。男性占队列的64.71%。ST段抬高型心肌梗死和心源性脑梗死是最主要的亚型。住院死亡率为30.59%,65.38%的死亡归因于心脏原因。多因素逻辑回归分析确定了住院死亡的三个独立危险因素:中性粒细胞与淋巴细胞比值(NLR)升高、血清白蛋白降低和N末端B型脑钠肽原峰值水平(NT-proBNP)升高。ROC曲线分析表明,NLR、白蛋白浓度和NT-proBNP峰值浓度的曲线下面积(AUC)分别为0.863、0.723和0.824。NLR的最佳截断值为6.914,白蛋白为33.80 g/L,NT-proBNP峰值为9474.50 pg/mL。联合诊断模型的AUC达到0.959,显著优于单个指标。
NLR升高、血清白蛋白降低和NT-proBNP峰值水平升高可独立预测CCI患者的住院死亡率。联合这些生物标志物可增强对不良结局的预测能力。