精准医学杂志 (Jun 2023)
VALUE OF PLASMA NEUTROPHIL-TO-LYMPHOCYTE RATIO COMBINED WITH GLOBAL REGISTRY OF ACUTE CORONARY EVENTS SCORE IN EVALUATING THE LONG-TERM PROGNOSIS OF PATIENTS WITH NON-ST-ELEVATION MYOCARDIAL INFARCTION
Abstract
Objective To investigate the value of plasma neutrophil-to-lymphocyte ratio (NLR) combined with global registry of acute coronary events (GRACE) score in evaluating the long-term prognosis of patients with non-ST-elevation myocar-dial infarction (NSTEMI). Methods An analysis was performed for 278 patients with NSTEMI who were hospitalized in The Affiliated Hospital of Qingdao University in 2018 and received long-term follow-up after discharge, and related clinical data were collected to calculate plasma NLR and GRACE score. With the onset of major adverse cardiovascular events (MACE) during follow-up as the endpoint, the patients were divided into MACE group and non-MACE group, and clinical data were compared between the two groups. A multivariate logistic regression analysis was used to investigate the risk factors for MACE, and a receiver operating characteristic (ROC) curve analysis was performed for plasma NLR and GRACE score to investigate their value in eva-luating patient prognosis. The multivariate Cox regression model was used to explore the impact of plasma NLR and GRACE score on the specific survival time of patients. Results There were significant differences between the two groups in age, composition ratio of male patients, composition ratio of diabetic patients, plasma lymphocyte count, plasma NLR, serum low-density lipoprotein cholesterol, plasma B-type natriuretic peptide, left ventricular ejection fraction, and GRACE score (t=-2.748-5.054,χ2=5.067,8.952,Z=-3.108-4.442,P<0.05). The multivariate logistic regression analysis showed that both plasma NLR and GRACE score (P<0.05) were risk factors for long-term MACE in patients with NSTEMI. Plasma NLR alone, GRACE score alone, and their combination had an area under the ROC curve of 0.637, 0.705, and 0.734, respectively, in predicting MACE. The multivariate Cox regression analysis showed that high plasma NLR (HR=3.023,95%CI=1.788-5.112,P<0.01) and high-risk GRACE score (HR=4.145,95%CI=2.515-6.832,P<0.01) were risk factors affecting the MACE-free survival time of patients, and compared with low plasma NLR and medium- or low-risk GRACE score, high plasma NLR, and high-risk GRACE score (HR=12.100,95%CI=5.989-24.445,P<0.01) significantly reduced the survival time of patients. Conclusion Both plasma NLR and GRACE score are risk factors affecting the long-term prognosis of patients with NSTEMI, and compared with GRACE score alone, the combination of plasma NLR and GRACE score is more accurate in assessing the long-term prognosis of patients with NSTEMI.
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