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Evaluation of SI and NLR for Short-Term Prognosis in Acute ST-Segment Elevation Myocardial Infarction |
WANG Yanfei, WANG Huarong, YE Hui, et al |
The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China |
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Abstract Objective: To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) and shock index (SI) in short-term prognosis of emergency St-segment elevation myocardial infarction (STEMI) patients. Methods: A total of 280 first-visit emergency department patients with STEMI were included in this study.Demographic and clinical data of all patients were recorded.Key vital signs including systolic blood pressure (SBP),diastolic blood pressure (DBP),and heart rate (HR) were monitored dynamically.Blood routine tests were conducted using the emergency green channel,and SI and NLR values were calculated.The occurrence of major adverse cardiac events (MACE) within 14 days was recorded,and the patients were categorized into the MACE and non-MACE groups.Receiver operating characteristic curve (ROC curve) analysis was employed to compare the ability of SI and NLR to assess adverse outcomes in STEMI patients. Results: Among the 280 STEMI patients,52 experienced adverse cardiovascular events,resulting in an incidence of 18.57%.These events included 24 cases of malignant arrhythmias,18 cases of cardiogenic shock,and 10 all-cause deaths,while the remaining 228 patients did not experience adverse cardiovascular events.In the MACE group,SI,white blood cell count,neutrophil count,NLR,and cardiac function grade Ⅲ and Ⅳ were significantly higher compared to the non-MACE group (P<0.05).Additionally,the MACE group exhibited significantly lower DBP,SBP,and lymphocyte counts compared to the non-MACE group,and these differences were statistically significant (P<0.05).The areas under the ROC curves for SI,NLR,and the combined SI and NLR were 0.684,0.769,and 0.801,respectively. Conclusion: Both NLR and SI demonstrate substantial value in evaluating short-term adverse events in emergency STEMI patients.When used in combination,they offer even higher predictive value.
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