C反应蛋白与白蛋白比值对老年急性非 ST段抬高型心肌梗死病人住院期间新发心房颤动的预测价值

目的探讨 C反应蛋白(CRP)与白蛋白比值(CAR)对老年急性非 ST段抬高型心肌梗死(NSTEMI)住院期间新发心房颤(NOAF)的预测价值。方法连续入选 2019年 1月至 2020年 6月就诊于辽宁省健康产业集团抚矿总医院的 294例接受经皮冠动状动脉介入治疗( PCI)老年 NSTEMI病人，依据是否出现心房颤动(AF)分为 AF组( n=36)和对照组(n=258)比较两组病人的临床资料，分析 CAR对 NOAF的预测价值。结果 AF组病人心功能分级 Killip 2或 3级比例( 38.9%比 20.2%，P，=0.018)、房( LA)大小［( 38.2±8.5)mm比( 34.9±8.2)mm，P=0.029］、 AF组病人肌钙蛋白 I(cTnI)峰值［( 24 081.4±3 812.3)ng/L比左(19 634.8±2 931.5)ng/L，P=0.040］、血小板淋巴细胞比值(PLR)和 CAR显著高于对照组； AF病人左心室射血分数( LVEF)、AF组病人白蛋白显著低于对照组病人； AF组高危病人、高血栓负荷、慢血流 /无复流和校正 TIMI帧数显著高于对照组。多因素分析显示 LA增大，慢血流 /无复流， CAR增高， PLR增高是老年 NSTEMI病人术后 NOAF的独立预测因素。受试者操作特征曲线分析显示 CAR较 PLR和 LA具有更好的预测价值(P=0.035)。结论 CAR对老年 NSTEMI病人 NOAF具有良好的预测价值。

Predictive value of C-reactive protein to albumin ratio for new onset atrial fibrillation in elderly patients with acute non ST segment elevation myocardial infarction during hospitalization

Objective To investigate the predictive value of C-reactive protein (CRP) to albumin ratio (CAR) for new onset atrial fibrillation ( NOAF) in elderly patients with acute non ST segment elevation myocardial infarction (NSTEMI).Methods Two hundred and ninety-four elderly patients with NSTEMI who underwent percutaneous coronary intervention (PCI) in Fukuang General Hospital ofLiaoning Health Industry Group from January 2019 to June 2020 were continuously included and they were assigned into atrial fibrillation (AF) group (n = 36) and control group (n = 258) according to whether AF occurred. The clinical data of the two groups were compared and the predictive value of CAR for NOAF was analyzed.Results The proportion of killip with grade 2 or 3 (38.9% vs. 20.2%, P =0.018), the size of left atrial (LA) (38.2±8.5) mm vs. (34.9±8.2) mm, P=0.029], the peak value of troponin I (cTnI) (24 081.4±3 812.3) ng/L vs. (19 634.8±2 931.5) ng/L, P=0.040], platelet lymphocyte ratio (PLR) and CAR in AF group were significantly higher than thosein control group. The left ventricular ejection fraction (LVEF) and albumin in AF group were significantly lower than those in controlgroup. High risk patients, high thrombus load, slow flow / no reflow and corrected TIMI frames in AF group were significantly higherthan those in control group. Multivariate analysis showed that LA, slow flow / no reflow, CAR, PLR were independent predictors of postoperative NOAF in elderly patients with NSTEMI. ROC curve analysis showed that CAR had better predictive value than PLR and LA(P=0.035).Conclusion CAR has good predictive value for NOAF in elderly patients with NSTEMI.