Impact of increased inflammation biomarkers on periprocedural myocardial infarction in patients undergoing elective percutaneous coronary intervention: a cohort study

Liding Zhao; Ya Li; Tian Xu; Yi Luan; Qingbo Lv; Yao Wang; Xue Lv; Guosheng Fu; Wenbin Zhang

doi:10.21037/jtd-20-1605

Impact of increased inflammation biomarkers on periprocedural myocardial infarction in patients undergoing elective percutaneous coronary intervention: a cohort study

J Thorac Dis. 2020 Oct;12(10):5398-5410. doi: 10.21037/jtd-20-1605.

Authors

Liding Zhao^{1

2}, Ya Li^{1

2}, Tian Xu^{1

2}, Yi Luan^{1

2}, Qingbo Lv^{1

2}, Yao Wang^{1

2}, Xue Lv^{1

2}, Guosheng Fu^{1

2}, Wenbin Zhang^{1

2}

Affiliations

¹ Department of Cardiovascular Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
² Key Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, China.

Abstract

Background: The fact that each inflammatory indicator has a forecasting capacity on the occurrence of periprocedural myocardial infarction (PMI) has a controversial existence. The purpose of this study was to explore the role of inflammation biological indicators on PMI in a group of patients undergoing selective percutaneous coronary intervention (PCI).

Methods: The study was carried out both in a retrospective and prospective manner in 7,413 and 1,189 subjects, respectively. In the retrospective cohort study, the association between inflammation biomarkers and PMI was assessed by univariate and multivariate logistic regression. WBC, CRP, and NLR were distributed using k-means clustering into a virtual variable "Inflammatory Trend", and multivariate logistic regression and subgroup analysis were performed. In the prospective cohort study, the endpoints were PMI, cardiovascular death or cardiac arrest. The chi-square test was performed to calculate the relative risk (RR).

Results: In the retrospective cohort study, except WBC, CRP, NLR and virtual variable "Inflammatory trend" were independent risk factors for PMI. The subgroup analysis revealed that CRP can serve as the most stable predictor. In the prospective cohort study, WBC (RR =1.134, P=0.416) has no effect on the incidence of PMI. However, an elevation in the incidence of PMI was observed with an increase of NLR (RR =1.354, P=0.041) and CRP (RR =1.412, P=0.025).

Conclusions: In patients with elective PCI for single-vessel lesions, high CRP increases the risk for PMI. The increase of NLR was an independent risk factor for PMI, especially for patients with hypertension and under the age of 70. WBC has no influence on the occurrence of PMI.

Keywords: C-reactive protein; White blood cell (WBC); neutrophil to lymphocyte ratio; percutaneous coronary intervention (PCI); periprocedural myocardial infarction (PMI).