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Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention

BACKGROUND: High D-dimer (DD) is associated with short-term adverse outcomes in patients with acute coronary syndrome (ACS). In ACS patients who underwent percutaneous coronary intervention (PCI), however, the value of DD (or combined with neutrophil to lymphocyte ratio [NLR]) to predict long-term m...

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Autores principales: Gu, Ling-Feng, Gu, Jie, Wang, Si-Bo, Wang, Hao, Wang, Ya-Xin, Xue, Yuan, Wei, Tian-Wen, Sun, Jia-Teng, Lian, Xiao-Qing, Liu, Jia-Bao, Jia, En-Zhi, Wang, Lian-Sheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Via Medica 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10508083/
https://www.ncbi.nlm.nih.gov/pubmed/34490603
http://dx.doi.org/10.5603/CJ.a2021.0097
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author Gu, Ling-Feng
Gu, Jie
Wang, Si-Bo
Wang, Hao
Wang, Ya-Xin
Xue, Yuan
Wei, Tian-Wen
Sun, Jia-Teng
Lian, Xiao-Qing
Liu, Jia-Bao
Jia, En-Zhi
Wang, Lian-Sheng
author_facet Gu, Ling-Feng
Gu, Jie
Wang, Si-Bo
Wang, Hao
Wang, Ya-Xin
Xue, Yuan
Wei, Tian-Wen
Sun, Jia-Teng
Lian, Xiao-Qing
Liu, Jia-Bao
Jia, En-Zhi
Wang, Lian-Sheng
author_sort Gu, Ling-Feng
collection PubMed
description BACKGROUND: High D-dimer (DD) is associated with short-term adverse outcomes in patients with acute coronary syndrome (ACS). In ACS patients who underwent percutaneous coronary intervention (PCI), however, the value of DD (or combined with neutrophil to lymphocyte ratio [NLR]) to predict long-term major adverse cardiovascular events (MACEs) has not been fully evaluated. METHODS: Patients diagnosed with ACS and receiving PCI were included. The primary outcome was MACEs. Cox proportional hazards regression and logistic regression were used to illustrate the relationship between clinical risk factors, biomarkers and MACEs. Survival models were developed based on significant factors and evaluated by the Concordance-index (C-index). RESULTS: The final study cohort was comprised of 650 patients (median age, 64 years; 474 males), including 98 (15%) with MACEs during a median follow-up period of 40 months. According to the cut-off value of DD and NLR, the patients were separated into four groups: high DD or nonhigh DD with high or nonhigh NLR. After adjusting for confounding variables, DD (adjusted hazard ratio [aHR]: 2.39, 95% confidence interval [CI]: 1.52–3.76) and NLR (aHR: 2.71, 95% CI: 1.78–4.11) were independently associated with long-term MACEs. Moreover, patients with both high DD and NLR had a significantly higher risk in MACEs when considering patients with nonhigh DD and NLR as reference (aHR: 6.19, 95% CI: 3.30–11.61). The area under curve increased and reached 0.70 in differentiating long-term MACEs when DD and NLR were combined, and survival models incorporating the two exhibited a stronger predictive power (C-index: 0.75). CONCLUSIONS: D-dimer (or combined with NLR) can be used to predict long-term MACEs in ACS patients undergoing PCI.
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spelling pubmed-105080832023-09-20 Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention Gu, Ling-Feng Gu, Jie Wang, Si-Bo Wang, Hao Wang, Ya-Xin Xue, Yuan Wei, Tian-Wen Sun, Jia-Teng Lian, Xiao-Qing Liu, Jia-Bao Jia, En-Zhi Wang, Lian-Sheng Cardiol J Clinical Cardiology BACKGROUND: High D-dimer (DD) is associated with short-term adverse outcomes in patients with acute coronary syndrome (ACS). In ACS patients who underwent percutaneous coronary intervention (PCI), however, the value of DD (or combined with neutrophil to lymphocyte ratio [NLR]) to predict long-term major adverse cardiovascular events (MACEs) has not been fully evaluated. METHODS: Patients diagnosed with ACS and receiving PCI were included. The primary outcome was MACEs. Cox proportional hazards regression and logistic regression were used to illustrate the relationship between clinical risk factors, biomarkers and MACEs. Survival models were developed based on significant factors and evaluated by the Concordance-index (C-index). RESULTS: The final study cohort was comprised of 650 patients (median age, 64 years; 474 males), including 98 (15%) with MACEs during a median follow-up period of 40 months. According to the cut-off value of DD and NLR, the patients were separated into four groups: high DD or nonhigh DD with high or nonhigh NLR. After adjusting for confounding variables, DD (adjusted hazard ratio [aHR]: 2.39, 95% confidence interval [CI]: 1.52–3.76) and NLR (aHR: 2.71, 95% CI: 1.78–4.11) were independently associated with long-term MACEs. Moreover, patients with both high DD and NLR had a significantly higher risk in MACEs when considering patients with nonhigh DD and NLR as reference (aHR: 6.19, 95% CI: 3.30–11.61). The area under curve increased and reached 0.70 in differentiating long-term MACEs when DD and NLR were combined, and survival models incorporating the two exhibited a stronger predictive power (C-index: 0.75). CONCLUSIONS: D-dimer (or combined with NLR) can be used to predict long-term MACEs in ACS patients undergoing PCI. Via Medica 2023-08-31 /pmc/articles/PMC10508083/ /pubmed/34490603 http://dx.doi.org/10.5603/CJ.a2021.0097 Text en Copyright © 2023 Via Medica https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially
spellingShingle Clinical Cardiology
Gu, Ling-Feng
Gu, Jie
Wang, Si-Bo
Wang, Hao
Wang, Ya-Xin
Xue, Yuan
Wei, Tian-Wen
Sun, Jia-Teng
Lian, Xiao-Qing
Liu, Jia-Bao
Jia, En-Zhi
Wang, Lian-Sheng
Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
title Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
title_full Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
title_fullStr Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
title_full_unstemmed Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
title_short Combination of D-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
title_sort combination of d-dimer level and neutrophil to lymphocyte ratio predicts long-term clinical outcomes in acute coronary syndrome after percutaneous coronary intervention
topic Clinical Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10508083/
https://www.ncbi.nlm.nih.gov/pubmed/34490603
http://dx.doi.org/10.5603/CJ.a2021.0097
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