Predictive value of systemic immune inflammation index for micro vascular occlusion after emergency percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction
BI Meng-ting
MIAO Hao
LI Jia-zheng
DUAN Yang
ZHANG Min
ZHANG Zhuo-qi
LU Yuan
Abstract：Objective To investigate the predictive value of the systemic immunoinflammatory index(SⅡ)for microvascular obstruction(MVO)in patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods 279 STEMI patients admitted to the Affiliated Hospital of Xuzhou Medical University from January 2019 to July 2021,who underwent cardiac magnetic resonance imaging within one week after PCI,were retrospectively analyzed and they were divided into the MVO positive(157 cases)and MVO negative groups(122 cases)based on wether the presence of MVO.Results Compared with the MVO negative group,the MVO positive group had significantly higher peak values of troponin T[4943(2847,7366)ng/L vs.1506(729.95,3526.50)ng/L],creatine kinase-MB(CK-MB)[176.70(80.28,300.00)ng/ml vs.78.82(24.93,204.45)ng/ml],SⅡ[1787.55(1267.24,2784.53)vs.1213.59(775.40,1956.83)mg/L],and C-reactive protein(CRP)levels[18.1(8.1,40.1)mg/L vs.8.0(3.4,26.4)mg/L]during hospitalization(P＜0.05).In contrast,the left ventricular ejection fraction(LVEF)was significantly lower in the MVO positive group[(43.65±9.51)％vs.(49.16±9.28)％,P＜0.05].Multivariate Logistic regression analysis revealed that the peak values of troponin T(OR=2.416,95％CI 1.692-3.450,P＜0.01)and SⅡ(OR=2.445,95％CI 1.510-3.991,P＜0.01)were the independent risk factors for MVO after PCI in STEMI patients.ROC curve analysis indicated that the combined predictive efficacy of troponin T and SⅡ for MVO was higher than that of either marker alone,with the area under the curve(AUC)for the combined indicators being 0.806,higher than the AUC of 0.783 for troponin T and 0.689 for SⅡ.Conclusion Troponin T and SⅡ are the independent predictive factors for the occurrence of MVO after PCI in STEMI patients.The combined use of these two indicators can more accurately predict MVO,providing a basis for assessing the risk of MVO after emergency PCI.
Keywords：Systemic immune-inflammation indexAcute ST-segment elevation myocardial infarctionMicrovascular obstruction
Publication Date：2025-02-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 140-145 )