Objective To investigate the predictive value of serum C-reactive protein/albumin ratio (CAR) with other inflammatory parameters for in-hospital adverse events in patients with acute ST segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). Methods A total of 340 patients with STEMI who underwent emergency PCI in 904 Hospital of PLA Joint Logistics Support Force from January 2016 to December 2020 were consecutively included in this retrospective analysis. Patients with STEMI were divided into two groups according to the presence or absence of adverse cardiovascular events during their hospital stay after emergent PCI: patients with major adverse cardiovascular events (MACEs, n=92) and non-MACEs (n=248). Serum C-reactive protein (CRP), white blood cells, neutrophils, lymphocytes, and other indicators were measured in both groups, and inflammatory parameters such as CAR, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) were calculated. Univariate and multivariate logistic regression analyses were used to screen the independent risk factors correlated with the occurrence of MACEs during the hospitalization after PCI in STEMI patients. Correlations between each inflammatory parameter and MACEs were analyzed by Spearman correlation analysis. Receiver operating characteristic (ROC) curve to evaluate the efficacy size of each inflammatory parameter in predicting the occurrence of MACEs during PCI hospitalization in patients with STEMI. Results Comparison of general data between the two groups revealed that patients in MACEs group had a higher frequency of age, history of diabetes mellitus, polydactyly, and serum composite inflammatory parameters (CAR, NLR, PLR, MLR, and SII) than those in non-MACEs group, the univariate and multivariate results showed that CAR was a risk factor for the occurrence of MACEs during the hospitalization after PCI in patients with STEMI. Spearman correlation analysis showed that CAR was significantly correlated with the occurrence of MACEs during hospitalization, such as cardiogenic shock (r=0.134, P<0.05), heart failure (r=0.436, P<0.05), and all-cause death (r=0.185, P<0.05). The results of ROC curves showed that CAR (AUC=0.751, 95%CI 0.691-0.811, P<0.001) had better predictive value for the occurrence of MACEs after PCI than NLR (AUC=0.643, 95%CI 0.576-0.711, P<0.001), PLR (AUC=0.598, 95%CI 0.530-0.665, P=0.006) and other inflammatory parameters. Conclusion Compared with traditional inflammatory parameters, CAR has better predictive efficacy for the occurrence of MACEs during hospitalization in STEMI patients undergoing emergency PCI, and can better guide the clinic.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |