ST段抬高型心肌梗死患者淋巴细胞与C反应蛋白比值与新发房颤的关系

Relationship between lymphocyte to C-reactive protein ratio and new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction

目的评估淋巴细胞与C反应蛋白比值(LCR)对行直接经皮冠状动脉介入治疗(pPCI)的ST段抬高型心肌梗死(STEMI)患者新发房颤(NOAF)的影响。方法回顾性选择2020年6月—2023年12月在徐州医科大学附属医院诊断为STEMI并成功行pPCI的患者。所有患者在住院期间行持续心电图监测,根据有无NOAF分为NOAF组和非NOAF组。采用单因素和多因素logistic回归分析影响NOAF的因素。结果住院期间NOAF的发生率为7.2%(44/607)。单因素logistic回归分析显示年龄、左室射血分数(LVEF)、LCR、Killip≥2级和右冠状动脉(RCA)与NOAF发生有关(P<0.05)。多因素logistic回归分析结果显示,年龄(OR=1.037,95%CI:1.009~1.067)、RCA(OR=3.118,95%CI:1.622~5.995)为NOAF发生的危险因素,LVEF(OR=0.935,95%CI:0.894~0.978)和LCR(OR=0.067,95%CI:0.009~0.473)为NOAF发生的保护因素。整合LCR可以明显提高模型对NOAF的预测能力(NRI=0.472,IDI=0.035,P<0.001)。结论术前LCR水平是STEMI患者pPCI术后NOAF的独立预测因子,对STEMI患者pPCI术后NOAF有较好的预测价值。

Objective To assess the effect of lymphocyte to C-reactive protein ratio(LCR)on new-onset atrial fibrillation(NOAF)in patients with ST-segment elevation myocardial infarction(STEMI)who underwent primary percutaneous coronary intervention(pPCI).Methods Patients who were diagnosed with STEMI and successfully underwent pPCI in the Affiliated Hospital of Xuzhou Medical University from June 2020 to December 2023 were selected and their clinical data were retrospectively analyzed.All patients received continuous ECG monitoring during hospitalization.According to the presence of NOAF,they were divided into two groups:a NOAF group and a non-NOAF group.Univariate and multivariate logistic regression analyses were conducted to screen out the influencing factors of NOAF.Results The incidence of NOAF during hospitalization was 7.2%(44/607).Univariate logistic regression analysis showed that age,left ventricular ejection fraction(LVEF),LCR,Killip grade≥2,and the right coronary artery(RCA)were associated with the occurrence of NOAF(P<0.05).According to multivariate logistic regression analysis,age(OR=1.037,95%CI:1.009-1.067)and RCA(OR=3.118,95%CI:1.622-5.995)were the risk factors for NOAF,while LVEF(OR=0.935,95%CI:0.894-0.978)and LCR(OR=0.067,95%CI:0.009-0.473)were the protective factors for NOAF.Integration of LCR significantly improved the predictive ability of the model for NOAF(NRI=0.472,IDI=0.035,P<0.001).Conclusions Preoperative LCR level is an independent predictor of NOAF after pPCI in STEMI patients,which can well predict NOAF after pPCI in STEMI patients.