Du Huanhua, Lu Zheng, Liu Yutong, Yan Jinsong, Ma Junli, Ao Jili, Chen Gang
Department of Cardiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai, 201399, China.
Department of Digital Subtraction Angiography, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, 2800 Gongwei Road, Pudong, Shanghai, 201399, China.
Eur J Med Res. 2025 Jun 24;30(1):522. doi: 10.1186/s40001-025-02804-z.
To analyze the predictive value of coronary plaque burden combined with serum creatinine (Scr), monocyte/lymphocyte ratio (MLR), and neutrophil/lymphocyte ratio (NLR) in the risk of reinfarction after percutaneous coronary intervention (PCI) in middle-aged and elderly patients with acute myocardial infarction (AMI).
A retrospective analysis was conducted on the clinical data of 1,582 patients with AMI who underwent PCI in our hospital from January 2021 to January 2024. Based on the occurrence of reinfarction within 6 months post-PCI, patients were divided into a reinfarction group (216 cases) and a non-reinfarction group (1,366 cases). To analyze the risk factors and related predictive values of reinfarction in middle-aged and elderly AMI patients after PCI.
Multivariate Logistic regression analysis showed that age, Killip grade, LVEF, cTnI, non-calcified plaque burden, calcified plaque burden, total calcified plaque burden, Scr, MLR, and NLR were all risk factors for reinfarction in middle-aged and elderly AMI patients after PCI (P < 0.05). ROC analysis showed that the combined detection of coronary plaque burden, Scr, MLR and NLR predicted the risk of reinfarction in middle-aged and elderly AMI patients after PCI, and the AUC was 0.998, 95%CI was 0.997 ~ 1.000, the sensitivity was 99.10%, and the specificity was 97.20%, all of them were significantly higher than the individual detection of each index (P < 0.05).
The combined detection of coronary plaque burden, Scr, MLR and NLR has a high predictive value for reinfarction after PCI in middle-aged and elderly AMI patients, and should be paid close attention to clinically.
分析冠状动脉斑块负荷联合血清肌酐（Scr）、单核细胞/淋巴细胞比值（MLR）和中性粒细胞/淋巴细胞比值（NLR）对中老年急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）后再梗死风险的预测价值。
回顾性分析2021年1月至2024年1月在我院接受PCI的1582例AMI患者的临床资料。根据PCI术后6个月内再梗死的发生情况，将患者分为再梗死组（216例）和非再梗死组（1366例）。分析中老年AMI患者PCI术后再梗死的危险因素及相关预测价值。
多因素Logistic回归分析显示，年龄、Killip分级、左心室射血分数（LVEF）、肌钙蛋白I（cTnI）、非钙化斑块负荷、钙化斑块负荷、总钙化斑块负荷、Scr、MLR和NLR均为中老年AMI患者PCI术后再梗死的危险因素（P＜0.05）。ROC分析显示，冠状动脉斑块负荷、Scr、MLR和NLR联合检测对中老年AMI患者PCI术后再梗死风险具有预测价值，AUC为0.998，95%CI为0.997～1.000，敏感度为99.10%，特异度为97.20%，均显著高于各指标单独检测（P＜0.05）。
冠状动脉斑块负荷、Scr、MLR和NLR联合检测对中老年AMI患者PCI术后再梗死具有较高的预测价值，临床应予以密切关注。
