Risk Management and Healthcare Policy (Jan 2022)
The Predictive Value of the Monocyte-to-Lymphocyte Ratio and Monocyte-to-Haematocrit Ratio for Cardiac Rupture Patients with Acute Myocardial Infarction: A Propensity Score Matching Analysis
Abstract
Kai Dai,1,* Zhibing Li,2,* Yafei Luo,1,* Qianhui Xiong,1,* Yao Xiong,3,* Zhifang Song,1,* Wenjun Xiong1 1Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China; 2Department of Intensive Care Unit, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China; 3Department of Cardiovascular Medicine, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenjun XiongDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, No. 461 Bayi Avenue, Nanchang, 330006, Jiangxi, People’s Republic of China, Tel +8613767970074, Email [email protected]: Cardiac rupture (CR) is a serious complication of acute myocardial infarction (AMI). We aimed to explore the predictive value of blood cell parameters for identifying CR in patients with AMI using the introduction of propensity score matching (PSM).Methods: This retrospective study enrolled patients who were diagnosed with AMI from January 2013 to May 2020. A total of 109 patients with CR were included, and 327 hospitalized non-CR patients were randomly selected at a 1:3 ratio. Based on the 1:1 nearest neighbour matching method by using SPSS, the covariances of the two groups were balanced. After PSM, the independent risk factors for CR were selected by using multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve analysis was applied to evaluate the predictive value of blood cell parameters for CR. Ninety cases were matched successfully in each of the two groups.Results: Among the 180 patients with AMI after PSM, the results of multivariate logistic regression analysis showed that the monocyte-to-lymphocyte ratio (MLR) (OR = 3.57, 95% CI: 1.28– 9.97, P = 0.015) and monocyte-to-haematocrit ratio (MHR) (OR = 1.80, 95% CI: 1.02– 3.20, P = 0.043) were independently related to the risk of CR. Additionally, the MLR (area under the curve (AUC): 0.74) and MHR (AUC: 0.73) were useful for distinguishing CR patients after PSM. To differentiate CR patients from the control subjects, the optimal cut-offs of the MLR and MHR were 0.61 (63% sensitivity and 80% specificity) and 2.06 (57% sensitivity and 81% specificity), respectively.Conclusion: The blood cell parameters MLR and MHR were independently correlated with CR. Additional, the MLR and MHR were useful to predict CR in patients with AMI.Keywords: cardiac rupture, acute myocardial infarction, blood cell parameters, monocyte-to-lymphocyte ratio, inflammatory, monocyte-to-haematocrit ratio
