Anemia and Inflammation in ST-Segment Elevation Myocardial Infarction. (June 2015)

• Record Type: Journal Article
• Authors: Zhang, Enyuan; Li, Zhenyu; Che, Jingjin; Chen, Xin; Qin, Tiantian; Tong, Qing; Zhao, Weiwei; Li, Guangping
• Is Part Of: American journal of the medical sciences. Volume 349:Number 6(2015)
• Publication Date: 2015-06
• Subjects: Medicine -- Periodicals; Internal medicine -- Periodicals; 610.5
• DOI: 10.1097/MAJ.0000000000000471
• Languages: English
• ISSNs: 0002-9629

Abstract

<abstract> <title>Abstract:</title> <sec> <title>Background:</title> <p>To investigate the factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) patients.</p> </sec> <sec> <title>Methods:</title> <p>Two hundred forty-eight STEMI patients (61.4 ± 10.8 years, 186 men) who underwent successful primary percutaneous coronary intervention were enrolled. Patients were followed-up for 1 year. Univariate, multivariate analyses, and receiver operating characteristic curve analysis were performed to determine the factors predicting MACEs.</p> </sec> <sec> <title>Results:</title> <p>There were 36 patients (14.5%) who experienced MACEs in the follow-up period. Multivariate logistic regression analysis demonstrated that hemoglobin (HgB) (odds ratio = 0.972; 95% CI, 0.948–0.998; <italic>P</italic> = 0.033), neutrophil/lymphocyte ratio (NLR) (odds ratio = 1.511; 95% CI, 1.148–1.987; <italic>P</italic> = 0.003), Global Registry of Acute Coronary Event score, and postprocedure left ventricular ejection fraction (LVEF) were independent predictors of MACEs. Further subgroup analysis showed higher NLR (>8.61), Global Registry of Acute Coronary Event score (>167) and lower HgB (<131 g/L) all show superior predictive value for patients with relatively higher LVEF (>48%); moreover, the c-statistic of NLR and HgB both exceed 0.7. However, among patients with lower LVEF (⩽48%), higher NLR and lower HgB lost the ability for predicting 1 year MACEs independently. In addition, abnormally higher NLR (>8) could predict 1-month MACEs efficiently.</p> </sec> <sec> <title>Conclusions:</title> <p>In summary, among STEMI patients, elevated NLR, decreased HgB level on admission both predicted 1-year MACEs independently, especially for those with relatively preserved LVEF (>48%). Besides, abnormally higher NLR on admission should attract their attention for short-term MACEs.</p> </sec> </abstract>