title: Anemia and Inflammation in ST-Segment Elevation Myocardial Infarction.
abstract: BACKGROUND
  To investigate the factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) patients.
  
  
  METHODS
  Two hundred forty-eight STEMI patients (61.4 ± 10.8 years, 186 men) who underwent successful primary percutaneous coronary intervention were enrolled. Patients were followed-up for 1 year. Univariate, multivariate analyses, and receiver operating characteristic curve analysis were performed to determine the factors predicting MACEs.
  
  
  RESULTS
  There were 36 patients (14.5%) who experienced MACEs in the follow-up period. Multivariate logistic regression analysis demonstrated that hemoglobin (HgB) (odds ratio = 0.972; 95% CI, 0.948-0.998; P = 0.033), neutrophil/lymphocyte ratio (NLR) (odds ratio = 1.511; 95% CI, 1.148-1.987; P = 0.003), Global Registry of Acute Coronary Event score, and postprocedure left ventricular ejection fraction (LVEF) were independent predictors of MACEs. Further subgroup analysis showed higher NLR (> 8.61), Global Registry of Acute Coronary Event score (> 167) and lower HgB (< 131 g/L) all show superior predictive value for patients with relatively higher LVEF (> 48%); moreover, the c-statistic of NLR and HgB both exceed 0.7. However, among patients with lower LVEF (≤ 48%), higher NLR and lower HgB lost the ability for predicting 1 year MACEs independently. In addition, abnormally higher NLR (> 8) could predict 1-month MACEs efficiently.
  
  
  CONCLUSIONS
  In summary, among STEMI patients, elevated NLR, decreased HgB level on admission both predicted 1-year MACEs independently, especially for those with relatively preserved LVEF (> 48%). Besides, abnormally higher NLR on admission should attract their attention for short-term MACEs.
authors.affiliation: Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease (Key Lab-TIC) (EZ, JC, XC, GL), Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin, China; Intensive Care Unit (ZL), The Second Hospital, Tianjin Medical University, Tianjin, China; and Tianjin Medical University (TQ, QT, WZ), Tianjin, China.
authors.forename: Enyuan
authors.initials: E
authors.lastname: Zhang
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Li
authors.forename: Jingjin
authors.initials: J
authors.lastname: Che
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Tiantian
authors.initials: T
authors.lastname: Qin
authors.forename: Qing
authors.initials: Q
authors.lastname: Tong
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhao
authors.forename: Guangping
authors.initials: G
authors.lastname: Li
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology; D012042:Registries
chemical_list: D006454:Hemoglobins; C020622:hemoglobin B