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中性粒细胞-淋巴细胞比值和血小板-淋巴细胞比值对急性心肌梗死患者住院死亡风险的联合预测价值:一项基于倾向性得分匹配的回顾性队列研究 后印本

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Combined predictive value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for risk of in-hospital mortality in patients with acute myocardial infarction: a propensity score-based retrospective cohort study

Краткое изложение: Background  Studies have shown that neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have important predictive value for cardiovascular diseases. No studies have investigated whether the combination of NLR and PLR can enhance its predictive value for in-hospital mortality in patients with acute myocardial infarction. Objective  To investigate whether the combined predictive model (NLR + PLR) constructed based on logistic regression algorithm can improve the predictive value of in-hospital mortality risk in patients with AMI. Methods A single-center, regression cohort study of 3246 AMI patients with complete medical history admitted to the Department of Cardiology of the Second Affiliated Hospital of Dalian Medical University from December 2015 to December 2021 was conducted. The outcome was defined as all-cause mortality during hospitalization. Results  (1) The patients who died during hospitalization were matched according to the ratio of 1:1 based on Propensity Score Matching (PSM). All patients who died were successfully matched, resulting in 115 pairs of patients. There was no significant difference between the groups of patients who died during hospitalization (N = 115) and those who did not (N = 115) on the 20 independent variables already included in the matching (P > 0.05). (2) NLR + PLR (NLR combined with PLR) was superior to NLR (AUC = 0.754) and PLR (AUC = 0.731) alone in predicting the risk of in-hospital mortality, with a significant difference in the area under the ROC curve (P = 0.037, P < 0.001, respectively). (3) the optimal cut-off value for NLR + PLR was 0.5491 (Youden index = 0.4087, sensitivity = 85.22%, specificity = 55.65%).Cox regression analysis showed that patients with NLR + PLR > 0.549 had a higher risk of death (HR 2.936; 95% CI 1.963 – 4.392; P < 0.001) than patients with NLR + PLR ≤ 0.549. (4) NLR + PLR had a higher predictive ability for the risk of in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) (AUC = 0.797) than in patients with non-ST-segment elevation myocardial infarction (NSTEMI) (AUC = 0.739). Conclusions  In this retrospective cohort study, we adjusted for multiple risk factors affecting in-hospital mortality in hospitalized AMI patients by propensity score matching.Our findings suggest that NLR combined with PLR can more accurately predict in-hospital mortality risk in AMI patients, especially in STEMI patients, than NLR or PLR alone.

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[V1] 2023-01-09 09:53:57 ChinaXiv:202301.00090V1 Скачать полный текст
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