Efficacy and significance of heart rate variability combined with neutrophil count in predicting acute myocardial infarction in patients with stable coronary heart disease

WANG Ping-zheng; ZHANG Yu; WANG Shu-ping

doi:10.3969/j.issn.1672-5301.2024.12.008

Abstract：Objective To explore the efficacy and significance of heart rate variability(HRV)combined with neutrophil count(NEUT)in predicting acute myocardial infarction(AMI)in patients with stable coronary heart disease(SCAD).Methods A total of 168 patients with SCAD admitted to Jiaozhou Central Hospital of Qingdao from January 2020 to January 2022 were selected.24 h Holter monitoring was conducted on all patients to obtain HRV indicators,including time domain indicators including standard deviation(SDNN),standard deviation of mean RR interval(rMSSD)and frequency domain indicator such as low frequency(LF)and high frequency(HF);and the venous blood samples were taken at the same time to calculate NEUT.The patients were followed up for two years and divided into two groups(53 cases)and 115 cases)according to whether AMI occurred.The HRV indexes and NEUT indexes of the two groups were compared.Logistic regression was used to analyze the correlation between each factor and AMI occurrence in SCAD patients,and receiver characteristic(ROC)curve was drawn to verify its predictive value.Results Compared with the non-occurrence group,the SDNN,rMSSD and HF in the occurrence group were lower,while the LF index was higher,and the difference was statistically significant(P＜0.05).In addition,the NEUT index of the occurrence group was also higher than that of the non-occurrence group,and the difference was also statistically significant(P＜0.05).Logistic regression analysis showed that SDNN increasing(OR=1.021,95％CI 1.005-1.037),rMSSD increasing(OR=1.080,95％CI 1.034-1.128)and HF increasing(OR=1.016,95％C1 1.004-1.028)were the resk factors for AMI(OR＞1,P＜0.05).The increase of LF(OR=0.994,95％CI 0.990-0.999)and NEUT(OR=0.536,95％CI 0.429-0.671)were the protective factors for AMI(OR＜1,P＜0.05).According to ROC analysis,the AUC values of HRV parameters(SDNN,rMSSD,LF,HF),NEUT and joint indexes were all above 0.600,which showed that the above indexes had good predictive value for AMI in SCAD patients.Conclusion Both HRV and NEUT can predict AMI in SCAD patients,and the predictive value of the combined index is higher than that of the single factor,which provides reference for clinical practice.