The relationship between GLR and in-hospital MACE in acute STEMI patients after emergency PCI

Abstract Background At present, the incidence of major adverse cardiovascular events (MACE) in hospital after PCI of acute ST segment elevation myocardial infarction (STEMI) is still increasing gradually. Studies have shown that decreased lymphocyte and increased γ-glutamyl transferase (GGT) are significantly associated with poor outcomes in STEMI patients. Therefore, the purpose of this study was to investigate the association between GGT/ lymphocyte (GLR) and in-hospital MACE in acute STEMI patients after emergency PCI. Methods A total of 225 patients with acute STEMI who underwent emergency PCI were divided into MACE group(n = 54) and non-MACE group(n = 171) according to whether MACE occurred in hospital. The baseline data between the two groups were compared, and the relationship between GLR and occurrence of in-hospital MACE was analyzed by univariate and multivariate analysis. Subgroup analysis was used to examine the heterogeneity among specific populations. Finally, ROC was used to analyze the predictive value of GLR on the occurrence of in-hospital MACE. Results 1. Compared with non-MACE group, the proportion of heart rate, Killip grade II-IV, alanine aminotransferase, aspartate aminotransferase, GGT, creatinine, uric acid, GLR, and intra-aortic balloon pumping in MACE group were higher (P < 0.05). The proportion of systolic blood pressure, lymphocyte, estimated glomerular filtration rate and Killip grade I were lower (P < 0.05). 2. Multivariate Logistic regression analysis: the increase of GLR was significantly correlated with the occurrence of in-hospital MACE (P < 0.05). 3. In subgroup analysis, the extent to which GLR increased the incidence of in-hospital MACE with hypertension (OR = 1.11) was significantly better than that in non-hypertensive patients (OR = 1.05). 4. ROC showed that the AUC of GGT, lymphocyte and their ratio GLR for predicting the occurrence of in-hospital MACE were 0.623 (95%CI: 0.535–0.712, P = 0.006), 0.698 (95%CI: 0.620–0.775, P < 0.001) and 0.765 (95%CI: 0.690 ~ 0.840, P < 0.001), respectively. Conclusions This relationship between elevated GLR increases the incidence of in-hospital MACE after emergency PCI surgery in patients with acute STEMI is more pronounced in patients with hypertension. Meanwhile, GLR can be used as a predictor of in-hospital MACE in acute STEMI patients after emergency PCI.