The evaluation value of early admission WMR,PLR,degree of coronary artery stenosis,and major adverse cardiovascular events in ACS patients

WANG Qiong; ZHANG Xiao-wei; LIU Zhi-qiang

doi:10.3969/j.issn.1672-5301.2024.09.005

Abstract：Objective To explore the correlation between white blood cell count to mean platelet volume ratio(WMR)and platelet to lymphocyte ratio(PLR)with the severity of coronary artery disease in patients with acute coronary syndrome(ACS)and the predictive value of WMR and PLR for the major adverse cardiovascular events(MACE)during the hospitalization.Methods Data from 391 patients who were first diagnosed with ACS due to chest pain and chest tightness and received percutaneous coronary intervention(PCI)treatment in the emergency room of the First Affiliated Hospital of Xinjiang Medical University from December 2020 to November 2022 were recored.Based on the clinical classification,147 cases were divided into the unstable angina(UA)group,114 cases into the non-ST-segment elevation myocardial infarction(NSTEMI)group and 130 cases into the ST-segment elevation myocardial infarction(STEMI)group.Further,the patients were divided into a MACE group with 106 cases and a non-MACE group with 285 cases based on whether MACE occurred during hospitalization.According to the median Gensini score,196 cases were divided into a severe lesion group(Gensini score≥53)and 195 cases into a mild lesion group(Gensini score＜53).The basic data and laboratory test indicators of patients in each group were compared.Binary multivariate logistic regression models were used to screen for the influencing factors of coronary artery stenosis and in-hospital MACE and analyze the correlation between WMR and PLR and the degree of coronary artery stenosis;and the ROC curve was used to assess the predictive diagnostic value of WMR and PLR,and their combination for the degree of coronary artery stenosis and in-hospital MACE.Results Both WMR and PLR were positively correlated with the degree of coronary artery stenosis in ACS patients(r=0.336,P＜0.001;r=0.374,P＜0.001).Multivariate logistic regression analysis showed that both WMR and PLR were independent risk factors for the degree of coronary artery stenosis and in-hospital MACE.ROC curve results indicated that the AUCs for predicting in-hospital MACE using WMR,PLR,and their combination were 0.748,0.722,and 0.792,respectively;the AUCs for predicting the degree of coronary artery stenosis were 0.694,0.716,and 0.770,respectively.Conclusion The early WMR and PLR at admission in ACS patients are positively correlated with the degree of coronary artery stenosis and have clinical value in predicting in-hospital MACE and the degree of coronary artery stenosis.Their combined test is more effective in diagnostic outcomes.