Exploratory predictive value of novel inflammatory biomarkers for microvascular obstruction after emergency revascularization in STEMI patients

PurposeTo assess the associations of blood cell-derived inflammatory markers with the formation of microvascular obstruction (MVO) and their exploratory predictive performance in STEMI patients after PCI.Patients and methodsA retrospective analysis was conducted based on a prospective cohort, which included the patients with ST-segment elevation myocardial infarction (STEMI) who underwent emergency percutaneous coronary intervention (PCI) at Nanjing Drum Tower Hospital. All patients underwent cardiac magnetic resonance imaging within 7 days post-surgery, and were classified into MVO and non-MVO groups based on the examination results. Emergency and first post-PCI routine blood test and other clinical data were collected from patients, and various cell ratios were calculated, including the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI). The risk factors for MVO were evaluated by univariate and multivariate logistic regression analysis.ResultsA total of 311 patients with STEMI were included. Among them, 198 developed MVO and the other 113 were MVO free. After adjustment for clinical covariates, higher post-PCI WBC, NEU, SIRI and NLR and greater peri-PCI eosinophil decline were associated with MVO. In the correlation-reduced joint analysis, post-PCI SIRI retained the most robust association.ConclusionPostoperative WBC, NEU, SIRI, NLR, ΔEOS, ΔEOS% showed exploratory predictive performance for the formation of MVO after PCI in STEMI patients, and post-PCI SIRI showed the most robust association after accounting for biomarker intercorrelation.