The Predictive Value of Neutrophil/Lymphocyte Ratio Combined with Lipoprotein(a)on the Extent and Severity of Coronary Lesions in Patients with Acute Myocardial Infarction
Objective To explore the predictive value of neutrophil/lymphocyte ratio(NLR)combined with lipoprotein(a)[Lp(a)]for the extent and severity of coronary artery lesions in patients with acute myocardial infarction(AMI).Methods This study included clinical data of 399 patients diagnosed with AMI and undergoing coronary angiography at the First Affiliated Hospital of Anhui Medical University from May 2018 to July 2022.Coronary artery lesion extent was assessed based on the number of vessels involved(single-vessel disease,two-vessel disease,and multi-vessel disease).Severity of lesions was evaluated by using the Gensini score,categorizing patients into low-risk and high-risk groups based on the 50th percentile of the score.Multivariate logistic regression was used to analyze the correlation between NLR,Lp(a),and lesion extent/severi-ty.Receiver operating characteristic(ROC)curves were utilized to assess the predictive value of NLR and Lp(a)for coronary ar-tery lesion extent and severity.Results Significant differences were observed among groups in variables such as age,prevalence of hypertension and diabetes,body mass index(BMI),Lp(a),white blood cell(WBC)count,neutrophil count(NEU),Gensini score,and NLR(all P＜0.05).Spearman rank correlation analysis demonstrated significant positive correlations between age,Lp(a),WBC count,NEU count,NLR,Gensini score,and the number of coronary artery lesions(all P＜0.05).Multivariate logistic regression analysis revealed hypertension,Lp(a),and NLR were positively related to the number of coronary artery lesions(all P＜0.05),while age,Lp(a),NEU count,and NLR were positively associated with lesion severity in AMI patients(all P＜0.05).ROC curve analysis showed that the combined predictive value of NLR and Lp(a)(AUC=0.86)for single-vessel and two-vessel disease was higher than Lp(a)(AUC=0.78)and NLR(AUC=0.75)alone.Comparison between single-vessel and multi-vessel disease groups showed that the combined predictive value(AUC=0.88)was higher than Lp(a)(AUC=0.80)and NLR(AUC=0.72)alone.Comparison between two-vessel and multi-vessel disease groups indicated that the combined predictive value(AUC=0.78)was higher than Lp(a)(AUC=0.71)and NLR(AUC=0.70)alone.The combined predictive value(AUC=0.71)for lesion severity in AMI patients was higher than Lp(a)(AUC=0.60)and NLR(AUC=0.64)alone.Conclusion NLR and Lp(a)are significant predictors of the extent and severity of coronary artery lesions in AMI patients.The combined use of NLR and Lp(a)provides higher predictive value for assessing these outcomes.
万方数据
维普
