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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1431137

Lymphocyte to C-reactive protein ratio is associated with in-hospital cardiac death in elderly patients with non-ST-segment elevation myocardial infarction

Provisionally accepted
Jun Luo Jun Luo Han Shao Han Shao Yu Song Yu Song Yali Chao Yali Chao *
  • The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

The final, formatted version of the article will be published soon.

    Background: Although percutaneous coronary intervention (PCI) is recommended by guidelines, data from the real world suggest that elderly non-ST-segment elevation myocardial infarction (NSTEMI) patients have a low rate of PCI and a high death rate.Lymphocyte to C-reactive protein ratio (LCR), a novel inflammatory marker, has been shown to be associated with prognosis in a variety of diseases. However, the relationship between LCR and in-hospital cardiac death in elderly NSTEMI patients is unclear. The aim of this study was to investigate the effect of LCR on in-hospital cardiac death in elderly NSTEMI patients without PCI therapy.This was a single-center retrospective observational study, consecutively enrolled elderly (≥ 75 years) patients diagnosed with NSTEMI and without PCI from February 2019 to February 2024. LCR was defined as lymphocyte count to C-reactive protein ratio. The endpoint of observation was in-hospital cardiac death. The predictive efficacy of the old and new models was evaluated by the net reclassification index (NRI) and the integrated discriminant improvement index (IDI).Results: A total of 506 patients were enrolled in this study, and in-hospital cardiac death occurred in 54 patients (10.7%). Univariate logistic regression analysis showed that left ventricular ejection fraction, LCR, Killip ≥ 2, and N-terminal B-type natriuretic peptide proteins (NT-proBNP) were associated with the occurrence of in-hospital cardiac death. After adjusting for potential confounders, the results showed that NT-proBNP (OR=1.695, 95% CI:1.238-2.322) and LCR (OR=0.262, 95% CI:0.072-0.959) were independent risk factors for in-hospital cardiac death. After the addition of LCR to NT-proBNP, the predictive ability of the new model for in-hospital cardiac death was significantly improved (NRI=0.278， P=0.030； IDI=0.017， P<0.001).Lower LCR is an independent risk factor for in-hospital cardiac death in elderly NSTEMI patients without PCI, and integrating LCR improves the prediction of in-hospital cardiac death occurrence.

    Keywords: lymphocyte to C-reactive protein ratio, Inflammation response, Non-ST-segment elevation myocardial infarction, In-hospital cardiac death, elderly patients

    Received: 11 May 2024; Accepted: 01 Aug 2024.

    Copyright: © 2024 Luo, Shao, Song and Chao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yali Chao, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

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