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Abstract：
UNASSIGNED: Leukocyte parameters are associated with cardiovascular diseases. The aim of the present study was to investigate the role of leukocyte parameters in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) with high thrombus burden (HTB).
UNASSIGNED: A total of 102 consecutive STEMI patients with HTB who underwent PPCI within 12 h from the onset of symptoms between June 2020 and September 2021 were enrolled in this study. In addition, 101 age- and sex-matched STEMI patients with low thrombus burden (LTB) who underwent PPCI within 12 h from the onset of symptoms were enrolled as controls. Leukocyte parameters, such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), were calculated at the time of admission.
UNASSIGNED: The value of NLR and MLR were significantly higher in the HTB group than in the LTB group (6.24 ± 4.87 vs. 4.65 ± 3.47, p = 0.008; 0.40 ± 0.27 vs. 0.33 ± 0.20, p = 0.038). A cutoff value of >5.38 for NLR had a sensitivity and specificity of 53.9% and 74.3%, respectively, and MLR >0.29 had a sensitivity and specificity of 60.8% and 55.4%, respectively, for determining the STEMI patients with HTB [area under the receiver operating characteristic curve (AUC): 0.603, 95% confidence interval (CI): 0.524-0.681, p = 0.012; AUC: 0.578, 95% CI: 0.499-0.656, p = 0.046]. There was no significant difference of all-cause mortality rate and major adverse cardiac events (MACEs) between the STEMI patients with HTB or with LTB (3.92% in HTB group vs. 2.97% in LTB group, p = 0.712; 10.78% in HTB group vs. 8.91% in LTB group, p = 0.215). Compared with the HTB patients in the low NLR group, C-reactive protein, baseline troponin I, baseline brain natriuretic peptide, and leukocyte parameters, such as white blood cell, neutrophil, lymphocyte, NLR, PLR, and MLR, were also significantly higher in the high NLR group in STEMI patients who underwent PPCI with HTB (18.94 ± 19.06 vs. 35.23 ± 52.83, p = 0.037; 10.99 ± 18.07 vs. 21.37 ± 19.64, p = 0.007; 199.39 ± 323.67 vs. 430.72 ± 683.59, p = 0.028; 11.55 ± 3.56 vs. 9.31 ± 2.54, p = 0.001; 9.77 ± 3.17 vs. 5.79 ± 1.97, p = 0.000; 1.16 ± 0.44 vs. 2.69 ± 1.23, p = 0.000; 9.37 ± 4.60 vs 1.31 ± 2.58, p = 0.000; 200.88 ± 89.90 vs. 97.47 ± 50.99, p = 0.000; 0.52 ± 0.29 vs. 0.26 ± 0.14, p = 0.000, respectively). MACEs and heart failure in the high NLR group were significantly higher than that in the low NLR group of STEMI patients who underwent PPCI with HTB (20.45% vs. 4.25%, p = 0.041; 10.91% vs. 2.13%, p = 0.038).
UNASSIGNED: The value of NLR and MLR were higher in STEMI patients who underwent PPCI with HTB. In STEMI patients who underwent PPCI with HTB, a raised NLR could effectively predict the occurrence of MACEs and heart failure.
UNASSIGNED: A total of 102 consecutive STEMI patients with HTB who underwent PPCI within 12 h from the onset of symptoms between June 2020 and September 2021 were enrolled in this study. In addition, 101 age- and sex-matched STEMI patients with low thrombus burden (LTB) who underwent PPCI within 12 h from the onset of symptoms were enrolled as controls. Leukocyte parameters, such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), were calculated at the time of admission.
UNASSIGNED: The value of NLR and MLR were significantly higher in the HTB group than in the LTB group (6.24 ± 4.87 vs. 4.65 ± 3.47, p = 0.008; 0.40 ± 0.27 vs. 0.33 ± 0.20, p = 0.038). A cutoff value of >5.38 for NLR had a sensitivity and specificity of 53.9% and 74.3%, respectively, and MLR >0.29 had a sensitivity and specificity of 60.8% and 55.4%, respectively, for determining the STEMI patients with HTB [area under the receiver operating characteristic curve (AUC): 0.603, 95% confidence interval (CI): 0.524-0.681, p = 0.012; AUC: 0.578, 95% CI: 0.499-0.656, p = 0.046]. There was no significant difference of all-cause mortality rate and major adverse cardiac events (MACEs) between the STEMI patients with HTB or with LTB (3.92% in HTB group vs. 2.97% in LTB group, p = 0.712; 10.78% in HTB group vs. 8.91% in LTB group, p = 0.215). Compared with the HTB patients in the low NLR group, C-reactive protein, baseline troponin I, baseline brain natriuretic peptide, and leukocyte parameters, such as white blood cell, neutrophil, lymphocyte, NLR, PLR, and MLR, were also significantly higher in the high NLR group in STEMI patients who underwent PPCI with HTB (18.94 ± 19.06 vs. 35.23 ± 52.83, p = 0.037; 10.99 ± 18.07 vs. 21.37 ± 19.64, p = 0.007; 199.39 ± 323.67 vs. 430.72 ± 683.59, p = 0.028; 11.55 ± 3.56 vs. 9.31 ± 2.54, p = 0.001; 9.77 ± 3.17 vs. 5.79 ± 1.97, p = 0.000; 1.16 ± 0.44 vs. 2.69 ± 1.23, p = 0.000; 9.37 ± 4.60 vs 1.31 ± 2.58, p = 0.000; 200.88 ± 89.90 vs. 97.47 ± 50.99, p = 0.000; 0.52 ± 0.29 vs. 0.26 ± 0.14, p = 0.000, respectively). MACEs and heart failure in the high NLR group were significantly higher than that in the low NLR group of STEMI patients who underwent PPCI with HTB (20.45% vs. 4.25%, p = 0.041; 10.91% vs. 2.13%, p = 0.038).
UNASSIGNED: The value of NLR and MLR were higher in STEMI patients who underwent PPCI with HTB. In STEMI patients who underwent PPCI with HTB, a raised NLR could effectively predict the occurrence of MACEs and heart failure.
摘要：
■白细胞参数与心血管疾病相关。本研究的目的是研究白细胞参数在接受高血栓负担（HTB）的直接经皮冠状动脉介入治疗（PPCI）的ST段抬高型心肌梗死（STEMI）患者中的作用。
■本研究共纳入102名在2020年6月至2021年9月期间出现症状后12小时内接受PPCI的STEMI伴HTB患者。此外,101名年龄和性别匹配的低血栓负担（LTB）STEMI患者在症状发作后12小时内接受了PPCI治疗，作为对照组。白细胞参数,如中性粒细胞与淋巴细胞比率(NLR)，血小板与淋巴细胞比率（PLR），和单核细胞与淋巴细胞比率（MLR），是在入院时计算的。
■HTB组的NLR和MLR值明显高于LTB组（6.24±4.87vs.4.65±3.47，p=0.008；0.40±0.27vs.0.33±0.20，p=0.038）。NLR的临界值>5.38的敏感性和特异性分别为53.9%和74.3%，分别,MLR>0.29的敏感性和特异性分别为60.8%和55.4%，分别,用于确定STEMI患者的HTB[受试者工作特征曲线下面积（AUC）：0.603，95％置信区间（CI）：0.524-0.681，p=0.012；AUC：0.578，95％CI：0.499-0.656，p=0.046]。HTB或LTB的STEMI患者的全因死亡率和主要不良心脏事件（MACEs）没有显着差异（HTB组的3.92％与LTB组2.97%，p=0.712；HTB组的10.78%与LTB组8.91%，p=0.215）。与低NLR组的HTB患者相比，C反应蛋白,基线肌钙蛋白I,基线脑钠肽，和白细胞参数，比如白细胞，中性粒细胞,淋巴细胞，NLR,PLR,还有MLR,在接受HTB的PPCI的STEMI患者中，高NLR组也显着更高（18.94±19.06vs.35.23±52.83，p=0.037；10.99±18.07vs.21.37±19.64，p=0.007；199.39±323.67vs.430.72±683.59，p=0.028；11.55±3.56vs.9.31±2.54，p=0.001；9.77±3.17vs.5.79±1.97，p=0.000；1.16±0.44vs.2.69±1.23，p=0.000；9.37±4.60vs1.31±2.58，p=0.000；200.88±89.90vs.97.47±50.99，p=0.000；0.52±0.29vs.分别为0.26±0.14，p=0.000）。高NLR组的MACEs和心力衰竭明显高于低NLR组的STEMI患者接受HTB的PPCI（20.45％vs.4.25%,p=0.041;10.91%vs.2.13%,p=0.038)。
■接受HTB的STEMI患者NLR和MLR值较高。在接受HTBPPCI的STEMI患者中，升高的NLR可以有效预测MACE和心力衰竭的发生.
■本研究共纳入102名在2020年6月至2021年9月期间出现症状后12小时内接受PPCI的STEMI伴HTB患者。此外,101名年龄和性别匹配的低血栓负担（LTB）STEMI患者在症状发作后12小时内接受了PPCI治疗，作为对照组。白细胞参数,如中性粒细胞与淋巴细胞比率(NLR)，血小板与淋巴细胞比率（PLR），和单核细胞与淋巴细胞比率（MLR），是在入院时计算的。
■HTB组的NLR和MLR值明显高于LTB组（6.24±4.87vs.4.65±3.47，p=0.008；0.40±0.27vs.0.33±0.20，p=0.038）。NLR的临界值>5.38的敏感性和特异性分别为53.9%和74.3%，分别,MLR>0.29的敏感性和特异性分别为60.8%和55.4%，分别,用于确定STEMI患者的HTB[受试者工作特征曲线下面积（AUC）：0.603，95％置信区间（CI）：0.524-0.681，p=0.012；AUC：0.578，95％CI：0.499-0.656，p=0.046]。HTB或LTB的STEMI患者的全因死亡率和主要不良心脏事件（MACEs）没有显着差异（HTB组的3.92％与LTB组2.97%，p=0.712；HTB组的10.78%与LTB组8.91%，p=0.215）。与低NLR组的HTB患者相比，C反应蛋白,基线肌钙蛋白I,基线脑钠肽，和白细胞参数，比如白细胞，中性粒细胞,淋巴细胞，NLR,PLR,还有MLR,在接受HTB的PPCI的STEMI患者中，高NLR组也显着更高（18.94±19.06vs.35.23±52.83，p=0.037；10.99±18.07vs.21.37±19.64，p=0.007；199.39±323.67vs.430.72±683.59，p=0.028；11.55±3.56vs.9.31±2.54，p=0.001；9.77±3.17vs.5.79±1.97，p=0.000；1.16±0.44vs.2.69±1.23，p=0.000；9.37±4.60vs1.31±2.58，p=0.000；200.88±89.90vs.97.47±50.99，p=0.000；0.52±0.29vs.分别为0.26±0.14，p=0.000）。高NLR组的MACEs和心力衰竭明显高于低NLR组的STEMI患者接受HTB的PPCI（20.45％vs.4.25%,p=0.041;10.91%vs.2.13%,p=0.038)。
■接受HTB的STEMI患者NLR和MLR值较高。在接受HTBPPCI的STEMI患者中，升高的NLR可以有效预测MACE和心力衰竭的发生.
