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预测接受经皮冠状动脉介入治疗的急性冠状动脉综合征患者预后风险的复杂炎症和营养指标

The Complex Inflammatory and Nutritional Indices to Predict Prognostic Risk for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

作者信息

Song Ge, Wang Xinchen, Wei Chen, Qi Yuewen, Liu Yan, Zhang Ying, Sun Lixian

机构信息

Department of Cardiology, The Affiliated Hospital of Chengde Medical University, Chengde, China.

Hebei Key Laboratory of Panvascular Diseases, Chengde, China.

出版信息

Immun Inflamm Dis. 2025 Mar;13(3):e70180. doi: 10.1002/iid3.70180.

Abstract

PURPOSE

To investigate the role of the systemic inflammatory response index (SIRI) and high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels in predicting the risk of major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

PATIENTS AND METHODS

Overall, 1377 patients with ACS who underwent PCI between January 2016 and December 2018 were consecutively enrolled. The patients were divided into MACEs (n = 60) and non-MACEs (n = 1317) groups. The study endpoints were MACEs, including cardiac-related mortality and rehospitalization for severe heart failure (HF), myocardial infarction (MI), and in-stent restenosis.

RESULTS

Both groups showed significant differences in the patients with age > 65 years, history of HF, acute MI, cardiogenic shock, left ventricular ejection fraction < 40%, SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI × LDL-C ≥ 4.609. The Kaplan-Meier curve showed that the low SIRI group had higher cumulative survival than the high SIRI group. Additionally, the univariate and multivariate Cox proportional hazards model demonstrated that SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI × LDL-C ≥ 4.609 were independent risk factors for patients with ACS undergoing PCI. Restricted cubic spline models were generated to visualize the relationship between SIRI, SIRI/HDL-C, and SIRI × LDL-C and the prognostic risk.

CONCLUSION

SIRI ≥ 2.848, SIRI/HDL-C ≥ 1.977, and SIRI × LDL-C ≥ 4.609 were all independent prognostic risk factors in patients with ACS undergoing PCI, which may be useful markers for assessment for long prognosis.

摘要

目的

探讨全身炎症反应指数(SIRI)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平在预测接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者发生主要不良心血管事件(MACE)风险中的作用。

患者与方法

共连续纳入2016年1月至2018年12月期间接受PCI的1377例ACS患者。将患者分为MACE组(n = 60)和非MACE组(n = 1317)。研究终点为MACE,包括心脏相关死亡率以及因严重心力衰竭(HF)、心肌梗死(MI)和支架内再狭窄而再次住院。

结果

两组在年龄>65岁、有HF病史、急性MI、心源性休克、左心室射血分数<40%、SIRI≥2.848、SIRI/HDL-C≥1.977以及SIRI×LDL-C≥4.609的患者中存在显著差异。Kaplan-Meier曲线显示,低SIRI组的累积生存率高于高SIRI组。此外,单因素和多因素Cox比例风险模型表明,SIRI≥2.848、SIRI/HDL-C≥1.977以及SIRI×LDL-C≥4.609是接受PCI的ACS患者的独立危险因素。生成受限立方样条模型以可视化SIRI、SIRI/HDL-C和SIRI×LDL-C与预后风险之间的关系。

结论

SIRI≥2.848、SIRI/HDL-C≥1.977以及SIRI×LDL-C≥4.609均为接受PCI的ACS患者的独立预后危险因素,可能是评估长期预后的有用标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7ea/11931443/6ca9f88f49d5/IID3-13-e70180-g002.jpg

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