Ding Haifeng, Chai Rui, Yin Yin, Li Wenwen, Jiang Shijiu
Division of Cardiology, The First Affiliated Hospital of Shihezi University, Shihezi, China.
Coron Artery Dis. 2025 Mar 1;36(2):117-125. doi: 10.1097/MCA.0000000000001445. Epub 2024 Nov 4.
Left ventricular aneurysm (LVA) is a common complication of acute myocardial infarction. We aimed to investigate the association of the platelet-to-albumin ratio (PAR) with LVA formation in patients with acute ST segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
A total of 767 consecutive patients with STEMI were prospectively enrolled. Logistic regression analysis and restricted cubic spline (RCS) were used to assess the association between PAR and LVA formation. The predictive ability of PAR and combined variable for LVA formation were assessed using receiver-operating characteristic (ROC) curve.
The prevalence of LVA was 14.1%. Univariable logistic regression analysis revealed that PAR was associated with the risk of LVA at both 1 month [odds ratio (OR) = 4.42, P < 0.001] and 6 months (OR = 4.35, P < 0.001) of follow-up. The predictive value of PAR remained significant even after multivariate logistic regression analysis at 1 month (OR = 3.42, P = 0.004) and 6 months (OR = 4.28, P < 0.001). RCS analysis revealed a nonlinear association between a higher PAR and an increased risk of LVA (nonlinear P < 0.05). In addition, the predictive abilities of PAR for LVA were 0.659. The combination of PAR, hemoglobin, left ventricular ejection fraction, and the use of angiotensin-converting enzym inhibitor/angiotensin receptor blocker significantly enhanced the ability to predict LVA formation (C statistic= 0.887).
A higher PAR was significantly associated with an increased risk of LVA formation in patients with acute STEMI who underwent primary PCI.
左心室室壁瘤（LVA）是急性心肌梗死的常见并发症。我们旨在研究血小板与白蛋白比值（PAR）与接受直接经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）患者LVA形成之间的关联。
前瞻性纳入767例连续的STEMI患者。采用逻辑回归分析和限制性立方样条（RCS）评估PAR与LVA形成之间的关联。使用受试者工作特征（ROC）曲线评估PAR及联合变量对LVA形成的预测能力。
LVA的患病率为14.1%。单因素逻辑回归分析显示，随访1个月时PAR与LVA风险相关[比值比（OR）=4.42，P<0.001]，随访6个月时（OR=4.35，P<0.001）也相关。即使在多因素逻辑回归分析后，PAR在1个月时（OR=3.42，P=0.004）和6个月时（OR=4.28，P<0.001）的预测价值仍具有统计学意义。RCS分析显示较高的PAR与LVA风险增加之间存在非线性关联（非线性P<0.05）。此外，PAR对LVA的预测能力为0.659。PAR、血红蛋白、左心室射血分数以及血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂的联合使用显著增强了预测LVA形成的能力（C统计量=0.887）。
在接受直接PCI的急性STEMI患者中，较高的PAR与LVA形成风险增加显著相关。
