AIM To investigate whether the neutrophil-lyimphocytes ratio (NLR) and CHA2DS2-VASc score could be used to predict coronary atheroscerotic burden and major adverse cardiova scular events (MACE)in-hospital in patients treated with percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).
METHODS Neutrophil-lyimphocytes ratio and CHA2DS2-VASc score were applied to consecutive 657 patients age (76±14)years presenting with ACS treated by PCI from January 2016 to January 2019 in the Hospital. There were 471 males and 186 females. The aim of the present study is to investigate whether NLR and CHA2DS2-VASc score could predict higher coronary atherosclerotic burden assessed by SYNTAX score (SS) and major adverse cardiova scular events (MACE) in-hospital in ACS. A total of patients who underwent coronary angiography were divided into 3ss tertiles stratified by SS:low (≤22)(n=332); intermediate (23 to 32)(n=230); and high (≥33)(n=95); The Baseline clinical data, laboratory examination, PCI related information, blood flow grades of thrombolysis in myocardial infarction trial (TIMI) of infract-related arteries (TRA) instant after PCI and MACE in-hospital was collected and analyzed. Independent risk factors of ACS after PCI were measured by univariate and multivariate regression analyses.
RESULTS After logistic analyses, risk factors associated with higher coronary atherosclerotic burden and major adverse cardiova scular events (MACE)in-hospital in ACS included smoking, NLR, chronic kidney disease and CHA2DS2-VASc评分 (P<0.01). In multivariate analyses, CHA2DS2-VASc score ≥3 (OR3.028, 95% CI1.627 to 5.517, P<0.01) and NLR ≥5.23 (OR2.901, 95% CI 1.260 to 5.370, P＜0.01) were an independent predictor of high SS in ACS. The NLR (HR2.20, 95%CI1.120-4.520, P＜0.05) and CHA2DS2-VASc score (HR1.365, 95%CI1.120-1.702, P＜0.01) were an independent predictor for ACS with in-hospital MACE in multivariate Cox regression analysis.
CONCLUSION CHA2DS2-VASc and NLR, as a simply calculated and reliable score, are independently associated with high SS and MACE in-hospital in patients treated with percutaneous coronary intervention for ACS. Thus, this score provides an additional level of risk stratification regarding coronary atherosclerotic burden and prognosis beyond that provided by traditional risk factors. The reasonable treatment could reduce the incidence of no-reflow without increasing MACE in-hospital. Combination CHA2DS2-VASc Score and NLR are predictive prognostic value in patients presenting with ACS treated by PCI.
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