학술논문

Blood immune inflammatory indicators predict prognosis in patients with coronary artery disease
Document Type
article
Source
Medicine Advances, Vol 1, Iss 2, Pp 146-157 (2023)
Subject
all‐cause death
major adverse cardiovascular events
hematological parameters
mortality biomarkers
risk prediction
Medicine
Language
English
ISSN
2834-4405
2834-4391
Abstract
Abstract Background The relationship between the combined hematological parameters and echocardiography and long‐term prognosis in patients with coronary artery disease (CAD) remains unclear. Methods We examined the ability of hematological parameters to predict all‐cause death and major adverse cardiovascular events (MACE) based on Lasso Cox regression analysis. The significant predictors of hematological parameters from the Lasso Cox model were analyzed via multivariate Cox regression analysis and by adjusting for echocardiographic data. We calculated the continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) of the hematological parameters to assess the improvement in prediction. Results A low hemoglobin and lymphocyte ratio and high hematocrit, red blood cell distribution width‐coefficient of variation, and monocyte ratio significantly increased the risk of MACE and death in CAD patients. Neutrophil‐to‐lymphocyte ratio was associated with MACE but not death in CAD patients. After adjustment for echocardiographic parameters, hemoglobin, hematocrit, and lymphocyte ratio remained independently related to death and MACE. The addition of hematological and echocardiographic parameters to the Framingham risk score model significantly improved the area under the curve of mortality (0.794 vs. 0.713, p = 0.0007) and reclassification with cNRI of 30.6% (p = 0.002) and IDI of 0.055 (p