尿酸联合炎症指标对冠心病冠脉血流储备和MACE的预测价值

doi:10.3969/j.issn.1006-6233.2024.12.012

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Abstract Objective: To explore the predictive value of serum uric acid (SUA) combined with neutrophil to lymphocyte ratio (dNLR) on coronary blood flow reserve and major cardiovascular adverse events (MACE) in coronary artery disease (CAD).Methods: A total of 323 stable CAD patients who received percutaneous coronary intervention (PCI) in our hospital from January 2020 to December 2021 were selected as the research subjects. DNLR is defined as neutrophil count /(WBC count-neutrophil count). The blood flow reserve fraction (FFR) was quantitatively analyzed by coronary angiography. The end point of this study was MACE, including all-cause mortality and readmission of severe heart failure during follow-up.Results: Compared with the group without MACE, the cases of WBC count, neutrophil count, dNLR, SUA and FFR≤0.92 in MACE group were significantly higher (P<0.05), and the FFR was significantly lower (P<0.05). SUA (HR=1.886, 95%CI=1.545~2.303), dNLR (HR=1.479, 95%CI=1.241~1.762), FFR≤0.92(HR=3.208, 95%CI=1.468) were the influencing factors of MACE events in CAD patients (P<0.05). There was a significant negative correlation between SUA and FFR (r=-0.163, P=0.003). The combination of SUA and dNLR had the greatest ability to predict MACE of CAD patients undergoing PCI, with AUC of 0.908, sensitivity of 96.7% and specificity of 79.9%. According to ROC curve, the optimal critical values of SUA and dNLR were divided into subgroup 1(n=180), subgroup 2(n=116) and subgroup 3(n=27). There were 1 case, 13 cases and 16 cases in each subgroup, and the incidence rates were 99.4%, 88.8% and 40.7% respectively. Kaplan-Meier survival curve analysis showed that the incidence of MACE events increased significantly from subgroup 1 to subgroup 3 (Log Rank (Mantel-Cox)=94.912, P<0.001).Conclusion: In CAD patients receiving PCI, the increase of dNLR and SUA is independently related to the high risk of MACE, and the potential clinical utility of the combination of DNLR and SUA in identifying long-term MACE in CAD patients is emphasized.

Key words： Uric acid Derived neutrophil to lymphocyte ratio Coronary artery disease Blood flow reserve fraction

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.12.012 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I12/2005

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