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Published on: January 28, 2020
Neutrophil to high-density lipoprotein cholesterol ratio predicts left ventricular remodeling and MACE after PCI in
Jianlin Chen1, Anbang Liu2, Dan Zhang3
1School of Clinical Medicine, Shandong Second Medical University, Weifang, China.
Insights
The neutrophil-to-HDL cholesterol ratio (NHR) predicts left ventricular remodeling and major adverse cardiovascular events in ST-segment elevation myocardial infarction patients after PCI. Higher NHR indicates increased risk, aiding early identification of high-risk individuals.
Area of Science:
- Cardiology
- Biomarker Research
- Interventional Cardiology
Background:
- The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is a proposed cardiovascular event predictor.
- Its prognostic value post-percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is not well-established.
Purpose of the Study:
- To assess the predictive capability of NHR for left ventricular remodeling (LVR).
- To evaluate the association of NHR with long-term outcomes in STEMI patients undergoing PCI.
Main Methods:
- Retrospective analysis of 299 STEMI patients post-PCI with 24-month follow-up.
- Echocardiography used to assess LVR; logistic and Cox regression models applied for NHR correlation and outcome prediction.
- Receiver operating characteristic (ROC) and restricted cubic spline (RCS) analyses explored NHR's predictive performance.
Main Results:
- LVR occurred in 81 patients; the LVR group exhibited significantly higher NHR levels (P < 0.001).
- Elevated NHR independently predicted LVR and was associated with a 43% increased risk of major adverse cardiovascular events (MACE) (HR: 1.43).
- NHR demonstrated predictive value for LVR (AUC: 0.762) and MACE (AUC: 0.722), with a cut-off >8.13 linked to higher MACE risk.
Conclusions:
- NHR serves as an independent predictor of LVR and MACE in STEMI patients post-PCI.
- Monitoring NHR can help identify high-risk patients for tailored treatment strategies.
- NHR offers a valuable tool for risk stratification in STEMI patients following PCI.
Background:
The neutrophil to high-density lipoprotein cholesterol ratio (NHR) has been proposed as a potential marker for predicting cardiovascular events. However, its prognostic role following percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) remains unclear. This study aimed to evaluate the predictive value of NHR for left ventricular remodeling (LVR) and long-term outcomes in STEMI patients post-PCI.
Methods:
This retrospective study included 299 STEMI patients who underwent PCI and were followed for 24 months post-procedure. Echocardiography was performed upon admission and at 6 months post-myocardial infarction (MI). LVR was defined as an increase in left ventricular diastolic volume (LVEDV) of at least 20% from baseline. Based on their VR status, patients were divided into LVR (n = 81) and non-LVR (n = 218) groups and clinical data were compared. A weighted logistic regression model was used to study the correlation between NHR and LVR. Weighted Cox proportional risk models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for major adverse cardiovascular events (MACE). And the NHR was analyzed using receiver operating characteristic (ROC) curves to predict the occurrence of postoperative LVR and MACE in STEMI patients. Restricted cubic spline (RCS) analysis was used to explore the linear or non-linear relationship between NHR and LVR or MACE. Cox survival analysis was used to assess the relationship between NHR, LVR and survival time.
Results:
Among the 299 STEMI patients enrolled in the study, LVR was observed in 81 patients after 24 months of follow-up. The LVR group had significantly higher NHR levels compared to the non-LVR group (8.19 ± 1.95 vs. 6.23 ± 1.91, P < 0.001). After adjusting for potential confounders, a significant positive correlation was found between NHR and LVR. Each standard deviation increase in NHR was associated with a 43% higher risk of MACE (HR: 1.43, 95% CI: 1.25-1.64, P < 0.001). ROC curve analysis demonstrated that NHR could predict both LVR (AUC: 0.762) and MACE (AUC: 0.722). An NHR cut-off value of >8.13 was significantly linked to an increased risk of MACE (HR: 4.30, 95% CI: 2.41-7.69).
Conclusions:
NHR is an independent predictor of LVR and MACE after PCI in STEMI patients. Monitoring NHR may aid in identifying high-risk patients early, facilitating individualized treatment.
