Abstract

Objective

To evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW) for the no-reflow phenomenon in patients with ST-segment elevation myocardial infarction. Methods: Patients who underwent primary percutaneous coronary intervention from January 2017 to April 2019 were consecutively enrolled in this study and were split into the control and no-reflow groups. Logistic regression analysis was used to determine the independent predictors. Receiver operating characteristic curves were carried out to evaluate the predictive value. Results: A total of 455 patients were included and the incidence of the no-reflow was 19.6%. After the adjustment of confounding factors, logistic regression analyses showed that the NLR (odds ratio [OR] per unit increase: 1.107, 95% confidence interval [CI]: 1.044–1.172, p = .001), MPV (OR: 1.398, 95% CI: 1.010–1.937, p = .044), and PDW (OR: 1.392, 95% CI: 1.012–1.914, p = .042) were all independent predictors. In the prediction of the no-reflow, the NLR had the largest area under the curve of 0.650 (95% CI: 0.593–0.708) with 90% sensitivity and 36% specificity. The area under the curve of the combination of NLR + MPV was 0.676 and that of NLR + PDW was 0.654. Conclusions: The NLR, MPV and PDW are all associated with the no-reflow. However, there is no significant difference in the predictive value of these indicators. The combinations of NLR and platelet-associated parameters also do not show a better predictive value than NLR alone.

中文翻译：

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ST段抬高型心肌梗死患者中的中性粒细胞与淋巴细胞比例和血小板相关参数的组合，用于预测初次经皮冠状动脉介入治疗后的无复流现象。

摘要

目的

评估ST段抬高型心肌梗死患者中性粒细胞与淋巴细胞之比（NLR），平均血小板体积（MPV）和血小板分布宽度（PDW）对无复流现象的预测价值。方法：自2017年1月至2019年4月接受初次经皮冠状动脉介入治疗的患者入选本研究，分为对照组和无复流组。使用逻辑回归分析确定独立的预测因子。进行接收器工作特性曲线以评估预测值。结果：包括455例患者，无再流发生率为19.6％。调整混杂因素后，逻辑回归分析显示NLR（每单位优势比[OR]：1.107，95％置信区间[CI]：1.044–1.172，p  = .001），MPV（OR：1.398， 95％CI：1.010–1.937，p  = .044）和PDW（OR：1.392，95％CI：1.012–1.914，p  = .042）都是独立的预测因子。在无回流预测中，NLR在0.650曲线下的面积最大（95％CI：0.593–0.708），灵敏度为90％，特异性为36％。NLR + MPV的组合曲线下面积为0.676，NLR + PDW的曲线下面积为0.654。结论：NLR，MPV和PDW均与无回流相关。但是，这些指标的预测值没有显着差异。NLR和血小板相关参数的组合也没有比单独使用NLR更好的预测价值。