Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation

Aim. To assess the value of cellular indices of systemic inflammation in the prognosis of in-hospital mortality in patients with ST-segment elevation myocardial infarction (MI) in combination with type 2 diabetes (T2D).Material and methods. The retrospective case-control study included 125 patients...

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Main Authors: I. F. Bokovikov, K. V. Protasov
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2024-08-01
Series:Российский кардиологический журнал
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Online Access:https://russjcardiol.elpub.ru/jour/article/view/5823
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author I. F. Bokovikov
K. V. Protasov
author_facet I. F. Bokovikov
K. V. Protasov
author_sort I. F. Bokovikov
collection DOAJ
description Aim. To assess the value of cellular indices of systemic inflammation in the prognosis of in-hospital mortality in patients with ST-segment elevation myocardial infarction (MI) in combination with type 2 diabetes (T2D).Material and methods. The retrospective case-control study included 125 patients with myocardial infarction and T2D, 25 of whom died during the index hospitalization. The cellular composition of the blood and the level of high-sensitivity C-reactive protein (hsCRP) were determined on the first and third days of hospitalization. In the groups of deceased and surviving patients, cellular indices of systemic inflammation were calculated and compared (neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation response index (SIRI)) and average hsCRP levels). The prognostic role of the studied parameters was assessed using univariate and multivariate logistic regression.Results. Deceased patients, compared with survived ones, had higher Killip class, body mass index, number of stents implanted, higher hsCRP levels, and lower left ventricular ejection fraction. Inhospital mortality was associated with hsCRP (odds ratio of 1,03 with 95% confidence interval of 1,003-1,05, p=0,029), NLR (2,56 [1,73-9,78], p<0,001), NMR (1,16 [1,001-1,35], p=0,04), MLR (23,7 [3,1-182,6], p=0,002), SII (1,001 [1,0-1,001], p=0,028), SIRI (1,29 [1,09-1,52], p=0,003) 48 hours after admission, as well as with the degree of hsCRP change (1,03 [1,003-1,05], p=0,025), NLR (1,58 [1,21-2,06], p=0,001), SII (1,001 [1,0-1,001], p=0,028) during the first three days. Adjusted multivariate regression analysis identified a set of independent predictors with greatest accuracy in assessing the death probability: NLR, SII and SIRI 48 hours after admission, the degree of hsCRP change, body mass index and the num ber of implanted stents.Conclusion. The work demonstrated the significance of cellular indices of systemic inflammation (NLR, SII and SIRI) in assessing the prognosis of in-hospital mortality in patients with MI combined with T2D.
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spelling doaj-art-f9300fc622f847d2a3fdf314ba1f2c122025-08-20T03:57:22Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202024-08-0129710.15829/1560-4071-202458234032Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammationI. F. Bokovikov0K. V. Protasov1Irkutsk State Medical Academy of Postgraduate Education — branch of the Russian Medical Academy of Continuous Professional Education; Irkutsk Regional Clinical HospitalIrkutsk State Medical Academy of Postgraduate Education — branch of the Russian Medical Academy of Continuous Professional EducationAim. To assess the value of cellular indices of systemic inflammation in the prognosis of in-hospital mortality in patients with ST-segment elevation myocardial infarction (MI) in combination with type 2 diabetes (T2D).Material and methods. The retrospective case-control study included 125 patients with myocardial infarction and T2D, 25 of whom died during the index hospitalization. The cellular composition of the blood and the level of high-sensitivity C-reactive protein (hsCRP) were determined on the first and third days of hospitalization. In the groups of deceased and surviving patients, cellular indices of systemic inflammation were calculated and compared (neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation response index (SIRI)) and average hsCRP levels). The prognostic role of the studied parameters was assessed using univariate and multivariate logistic regression.Results. Deceased patients, compared with survived ones, had higher Killip class, body mass index, number of stents implanted, higher hsCRP levels, and lower left ventricular ejection fraction. Inhospital mortality was associated with hsCRP (odds ratio of 1,03 with 95% confidence interval of 1,003-1,05, p=0,029), NLR (2,56 [1,73-9,78], p<0,001), NMR (1,16 [1,001-1,35], p=0,04), MLR (23,7 [3,1-182,6], p=0,002), SII (1,001 [1,0-1,001], p=0,028), SIRI (1,29 [1,09-1,52], p=0,003) 48 hours after admission, as well as with the degree of hsCRP change (1,03 [1,003-1,05], p=0,025), NLR (1,58 [1,21-2,06], p=0,001), SII (1,001 [1,0-1,001], p=0,028) during the first three days. Adjusted multivariate regression analysis identified a set of independent predictors with greatest accuracy in assessing the death probability: NLR, SII and SIRI 48 hours after admission, the degree of hsCRP change, body mass index and the num ber of implanted stents.Conclusion. The work demonstrated the significance of cellular indices of systemic inflammation (NLR, SII and SIRI) in assessing the prognosis of in-hospital mortality in patients with MI combined with T2D.https://russjcardiol.elpub.ru/jour/article/view/5823myocardial infarctiondiabetesin-hospital mortalitycellular index of systemic inflammation
spellingShingle I. F. Bokovikov
K. V. Protasov
Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation
Российский кардиологический журнал
myocardial infarction
diabetes
in-hospital mortality
cellular index of systemic inflammation
title Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation
title_full Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation
title_fullStr Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation
title_full_unstemmed Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation
title_short Prediction of in-hospital mortality in patients with myocardial infarction and type 2 diabetes: the role of cellular indices of systemic inflammation
title_sort prediction of in hospital mortality in patients with myocardial infarction and type 2 diabetes the role of cellular indices of systemic inflammation
topic myocardial infarction
diabetes
in-hospital mortality
cellular index of systemic inflammation
url https://russjcardiol.elpub.ru/jour/article/view/5823
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