Chinese General Practice ›› 2023, Vol. 26 ›› Issue (20): 2482-2487.DOI: 10.12114/j.issn.1007-9572.2022.0877

Special Issue: 心肌梗死最新文章合集

• Original Research • Previous Articles     Next Articles

Combined Predictive Value of Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio for In-hospital Mortality Risk in Patients with Acute Myocardial Infarction

  

  1. Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian 116023, China
  • Received:2022-12-14 Revised:2023-02-26 Published:2023-07-15 Online:2023-03-30
  • Contact: ZHAO Xin
  • About author:
    CHEN Yan and CHEN Shengyue are co-first authors

中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值对急性心肌梗死患者住院死亡风险的联合预测价值

  

  1. 116023 辽宁省大连市,大连医科大学附属第二医院心血管内科
  • 通讯作者: 赵昕
  • 作者简介:
    陈焱与陈胜岳为共同第一作者
    作者贡献:陈焱、陈胜岳、韩元元、吕志博、徐清负责数据的收集和整理;陈焱、陈胜岳负责论文的构思、统计学处理及论文的撰写;陈焱负责统计学审核、论文修订;赵昕负责论文整体的质量把控。
  • 基金资助:
    科技部国家重点研发计划(2020YFC2004701); 辽宁省"揭榜挂帅"科技计划(重大)项目(2022JH1/10400004)

Abstract:

Background

Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to have significant predictive value for cardiovascular disease in previous studies, however, whether the combination of NLR and PLR can enhance the predictive value for in-hospital mortality risk in patients with acute myocardial infarction (AMI) has not been investigated.

Objective

To investigate the combined predictive value of NLR and PLR in the short-term prognosis of AMI patients.

Methods

The case data of 3 246 AMI patients hospitalized in the Department of Cardiology of the Second Hospital of Dalian Medical University from December 2015 to December 2021 were included, with the final outcome of all-cause death during hospitalization, who were divided into in-hospital death and non-death groupsand matched 1∶1 using propensity score matching (PSM). Receiver operating characteristic (ROC) curves were plotted for the predictive value of NLR+PLR, NLR, and PLR for the risk of in-hospital death in AMI patients. In order to better evaluate the predictive value of NLR+PLR for in-hospital mortality risk in patients with different types of AMI, patients were divided into NSTEMI and STEMI groups, and the predictive values of NLR+PLR, NLR, and PLR for in-hospital mortality risk in patients with NSTEMI and STEMI groups were analyzed.

Results

(1) Patients who died during hospitalization were matched based on PSM in a 1∶1 ratio, with 115 patients in each group. There was no significantly different in matching variables between the two groups after matching (P>0.05). (2) The area under the ROC curve of NLR + PLR for predicting the risk of in-hospital mortality in AMI patients (AUC=0.754) was greater than NLR (AUC=0.731) and PLR (AUC=0.577) (P<0.05). (3) NLR+PLR had a higher predictive ability for in-hospital mortality risk in STEMI patients (AUC=0.797) than in NSTEMI patients (AUC=0.739) .

Conclusion

Compared with NLR or PLR alone, the combination of NLR and PLR can better predict the risk of in-hospital mortality in AMI patients, especially with better efficacy in STEMI patients.

Key words: Myocardial infarction, Propensity score, Propensity score matching, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Risk of death

摘要:

背景

已有研究表明中性粒细胞/淋巴细胞比值(NLR)与血小板/淋巴细胞比值(PLR)对心血管疾病具有较好的预测价值,少有研究探讨NLR联合PLR能否增强对急性心肌梗死(AMI)患者住院期间死亡风险的预测价值。

目的

探讨NLR联合PLR对AMI患者短期预后的预测价值。

方法

2015年12月—2021年12月纳入在大连医科大学附属第二医院心血管内科住院的3 246例AMI患者的病例资料,最终结局为住院期间全因死亡,根据最终结局将患者分为院内死亡组和非死亡组,采用倾向性得分匹配(PSM)按1∶1匹配。绘制NLR+PLR、NLR和PLR对AMI患者住院死亡风险预测价值的受试者工作特征曲线(ROC曲线)。为了更好地评估NLR+PLR对不同类型AMI患者院内死亡风险的预测价值,将患者分为非ST段抬高型心肌梗死(NSTEMI)组和ST段抬高型心肌梗死(STEMI)组,并分析NLR+PLR、NLR和PLR对NSTEMI组和STEMI组患者住院死亡风险的预测价值。

结果

(1)基于PSM按照1∶1的比例对住院期间死亡患者进行匹配,每组115例。两组匹配后匹配变量比较,差异无统计学意义(P>0.05)。(2)NLR+PLR预测AMI患者住院死亡风险的ROC曲线下面积(AUC=0.754)大于NLR(AUC=0.731)和PLR(AUC=0.577)(P<0.05)。(3)NLR+PLR对STEMI患者住院死亡风险的预测能力(AUC=0.797)高于NSTEMI患者(AUC=0.739)。

结论

与单独的NLR或PLR相比,NLR联合PLR可以更好地预测AMI患者住院期间的死亡风险,尤其是在STEMI患者中效能更佳。

关键词: 心肌梗死, 倾向性评分, 倾向性评分匹配, 中性粒细胞与淋巴细胞, 血小板与淋巴细胞比率, 死亡风险