Su-na SHI, Wei-na HOU, Zhen-lian LI, Xiang-ke JIA, Zhen-fang REN. Predictive value of inflammatory factors for in-hospital major adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention[J]. Chinese Heart Journal, 2022, 34(4): 422-427. DOI: 10.12125/j.chj.202110010
    Citation: Su-na SHI, Wei-na HOU, Zhen-lian LI, Xiang-ke JIA, Zhen-fang REN. Predictive value of inflammatory factors for in-hospital major adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention[J]. Chinese Heart Journal, 2022, 34(4): 422-427. DOI: 10.12125/j.chj.202110010

    Predictive value of inflammatory factors for in-hospital major adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

    •   AIM  To investigate the prognostic value of inflammatory factors for in-hospital major adverse cardiac events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).
        METHODS  A total of 500 STEMI patients admitted to our hospital from June 2015 to June 2019 were selected as the study subjects, and clinical data of the patients were collected. Fasting venous blood was taken for inflammatory factor detection on the next day after PCI, and patients were divided into MACE group (85 cases) and non-MACE group (415 cases) according to the occurrence of MACE in hospital. Univariate analysis and multivariate logistic regression were used to analyze the independent influencing factors of nosocomial MACE after PCI in STEMI patients. ROC curve was used to evaluate the predictive value of inflammatory indicators on nosocomial MACE in STEMI patients and a nomogram prediction model for nosocomial MACE in STEMI patients after PCI was constructed. The receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and Calibration curve were used to evaluate the differentiation, accuracy and consistency of the model.
        RESULTS  Age, prevalence of diabetes mellitus and D-dimer (DD) index in MACE group were significantly higher than those in MACE group (all P<0.05), LVEF index was significantly lower than those in MACE group (P<0.05). Smoking rate, serum creatinine (Scr), creatine kinase isoenzyme (CK-MB), cardiac calcium protein I (cTnI), white blood cell count (WBC), hypersensitive C-reactive protein (hs-CRP), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), procalcitonin (PCT) and interleukin-6 (IL-6) were significantly higher than those in MACE group (ALL P<0.01). Multivariate regression analysis showed that age (P<0.05), diabetes mellitus (P<0.05), Scr (P<0.05), CK-MB (P<0.05), inflammatory factors hs-CRP, NLR, PLR, PCT and IL-6 (all P<0.01) were the only factors of MACE in STEMI patients after PCI LVEF (P<0.05) was a protective factor for nosocomial MACE. Inflammatory factors hs-CRP, NLR, PLR, PCT and IL-6 all had certain predictive value. The fitting effect of the line graph model based on independent prognostic factors was good, and the area under ROC curve was 0.761 (95% CI was 0.680~0.839), indicating that the model had good predictive ability.
        CONCLUSION   Inflammatory factors hs-CRP, NLR, PLR, PCT and IL-6 are independent risk factors for nosocomial MACE after PCI in STEMI patients and they have good predictive value for the short-term prognosis of patients. The nomogram model constructed in this study can be used as a quantitative tool to predict the risk of in-hospital MACE for STEMI patients after PCI, which can help formulate postoperative care for STEMI patients and reduce the risk of complications.
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