Prognostic potentials of the modified shock index and neutrophil/lymphocyte ratio in predicting short-term poor prognosis in patients with acute non-ST elevation myocardial infarction
Objective To investigate the prognostic potentials of the modified shock index(MSI)and neutrophil/lymphocyte ratio(NLR)in predicting short-term poor prognosis in patients with acute non-ST elevation myocardial infarction(NSTEMI).Methods A total of 276 patients with initially diagnosed NSTEMI in the Emergency Department between March 2020 and September 2021 were recruited.Blood pressure(BP)and heart rate(HR)were monitored through the rapid emergency greenway.The complete blood count and bedside color Doppler ultrasound were performed within 10 minutes in the emergency department.According to the monitoring and laboratory testing results of NLR and MSI,patients were divided into NLR≥5.0 group(n=75)and NLR＜5.0 group(n=201),and MSI≥1.2 group(n=57)and MSI＜1.2 group(n=219).Baseline characteristics and the incidence of adverse cardiovascular events were compared between groups.The receiver operating characteristic(ROC)curves and the area under the curve(AUC)were used to evaluate the potential of NLR and MSI in predicting in-hospital adverse cardiovascular events in NSTEMI patients.Results Among 276 NSTEMI patients,there were 52(18.8%)cases of adverse cardiovascular events,15(5.4%)of cardiogenic shock,24(8.7%)of malignant arrhythmia and 13(4.7%)of deaths.There were significant differences in the cardiac function,systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in NSTEMI patients of NLR≥5.0 group versus NLR＜5.0 group,as well as those of MSI≥1.2 group versus MSI＜1.2 group(P＜0.05).The incidence of major adverse cardiovascular events(MACEs)in NSTEMI patients of NLR≥5.0 group was significantly higher than that of NLR＜5.0 group,which was significantly higher in MSI≥1.2 group than that of MSI＜1.2 group(P＜0.05).The AUC of NLR and MSI in predicting NSTEMI was 0.734 and 0.703,respectively,suggesting that both NLR and MSI exerted the potential in predicting short-term adverse cardiovascular events in NSTEMI patients.Conclusion MSI and NLR are simply detected,important,highly available indicators to predict the short-term poor prognosis of NSTEMI.
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