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首页> 外文期刊>Journal of Cardiovascular and Thoracic Research >The Predictive Value of Total Neutrophil Count and Neutrophil/ Lymphocyte Ratio in Predicting In-hospital Mortality and Complications after STEMI
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The Predictive Value of Total Neutrophil Count and Neutrophil/ Lymphocyte Ratio in Predicting In-hospital Mortality and Complications after STEMI

机译：中性粒细胞总数和中性粒细胞/淋巴细胞比的总预测值在预测STEMI后住院死亡率和并发症中的价值

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Introduction: Leukocytosis, predominantly neutrophilia, has previously been described following ST elevation myocardial infarction (STEMI). The exact contribution of this phenomenon to the clinical outcome of STEMI is yet to be shown. We examined cellular inflammatory response to STEMI in the blood and its association with in-hospital mortality and/or adverse clinical events.Methods: In this cross-sectional study, 404 patients who were admitted with the diagnosis of acute STEMI at Madani Heart Hospital from March 2010 to March 2012 were studied. The complete blood cell count (CBC) was obtained from all patientswithin12-24 hours of the onset of symptoms. Total leukocytes were counted and differential count was obtained for neutrophils, lymphocytes and neutrophil/lymphocyte ratio (NLR) were evaluated. Association of cellular response with the incidence of post-MI mortality/complications was assessed by multiple logistic regression analyses.Results: In-hospital mortality and post-STEMI complication rate were 3.7% and 43.6%, respectively. Higher age (P=0.04), female gender (0.002), lower ejection fraction (P0.001) and absolute neutrophil count (P=0.04) were predictors of mortality. Pump failure in the form of acute pulmonary edema or cardiogenic shock occurred in 35 (8.9%) of patients. Higher leukocyte (P0.03) and neutrophil counts (P0.03) and higher NLR (P=0.01) were predictors of failure. The frequency of ventricular tachyarrhythmias (VT/VF) at the first day was associated with higher neutrophil count (P0.001) and higher NLR level (P0.001). In multivariate analysis neutrophil count was an independent predictor of mortality (OR=2.94; 1.1-8.4, P=0.04), and neutrophil count [OR=1.1, CI (1.01-1.20), P=0.02], female gender [OR=2.34, CI (1.02-4.88), P=0.04] and diabetes [OR=2.52, CI (1.21-5.2), P=0.003] were independent predictors of heart failure.Conclusion: A single CBC analysis may help to identify STEMI patients at risk for mortality and heart failure, and total neutrophil count is the most valuable in predicting both.
机译：简介：先前曾描述过ST抬高型心肌梗死（STEMI）后的白细胞增多症，主要是中性粒细胞增多。该现象对STEMI临床结果的确切贡献尚待证实。我们检查了血液中对STEMI的细胞炎症反应及其与院内死亡率和/或不良临床事件的关系。方法：在这项横断面研究中，从Madani心脏医院接受诊断的404例急性STEMI患者来自研究了2010年3月至2012年3月。在症状发作的12-24小时内从所有患者获得全血细胞计数（CBC）。计数总白细胞并获得中性粒细胞的差异计数，评估淋巴细胞并评估中性粒细胞/淋巴细胞比率（NLR）。通过多重logistic回归分析评估细胞反应与MI后死亡率/并发症发生率的关系。结果：住院死亡率和STEMI后并发症发生率分别为3.7％和43.6％。较高的年龄（P = 0.04），女性（0.002），较低的射血分数（P <0.001）和中性粒细胞绝对计数（P = 0.04）是死亡率的预测指标。 35例（8.9％）患者发生了以急性肺水肿或心源性休克形式出现的泵衰竭。高白细胞（P <0.03）和中性粒细胞计数（P <0.03）和高NLR（P = 0.01）是失败的预测指标。第一天的室性心律失常的频率（VT / VF）与中性粒细胞计数更高（P <0.001）和NLR水平更高（P <0.001）有关。在多变量分析中，中性粒细胞计数是死亡率的独立预测因子（OR = 2.94; 1.1-8.4，P = 0.04），中性粒细胞计数[OR = 1.1，CI（1.01-1.20），P = 0.02]，女性[OR = 2.34，CI（1.02-4.88），P = 0.04]和糖尿病[OR = 2.52，CI（1.21-5.2），P = 0.003]是心力衰竭的独立预测因素。结论：单次CBC分析可能有助于识别STEMI患者嗜中性白血球总数在预测两者中最有价值。

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