CMR-derived GLS and peripheral blood NLR are both strongly associated with post-PCI prognosis in first-time AMI patients, and their combination allows more accurate prediction of MACEs to facilitate effective early risk stratification and clinical decision-making.
Among 134 first-time AMI patients who underwent PCI, 31 experienced MACEs and 103 did not over a median follow-up of 538 days.
Patients with MACEs had higher inflammatory and biochemical markers at baseline than those without MACEs.
Patients with MACEs had more extensive coronary disease and different infarct location characteristics at baseline.
CMR findings showed worse structural and functional features in patients with MACEs.
NLR and GLS were identified as independent predictors of MACEs in multivariate logistic regression.
Combining GLS and NLR yielded a higher AUC for predicting MACEs than either marker alone.
This study followed 134 patients who had a first heart attack and were treated with a procedure to reopen blocked heart arteries (PCI). Over a median of about 18 months, 31 patients had major adverse cardiovascular events, while 103 did not. The researchers compared the two groups using blood tests and cardiac magnetic resonance (CMR) imaging. Patients who later had major events tended to be older, had higher markers of inflammation (including the neutrophil-to-lymphocyte ratio, NLR), higher NT-proBNP, more extensive coronary disease, and more often had heart attacks involving the front wall of the heart. Their heart scans showed more scarring, weaker pumping, and reduced heart muscle strain. Two measures stood out as independent predictors: NLR, a simple ratio from a routine blood count, and global longitudinal strain (GLS), a CMR measure of how well the heart muscle shortens during each beat. Each measure alone predicted events fairly well (AUC about 0.82), and using them together improved prediction (AUC 0.921). This research suggests that combining an imaging measure with a routine blood test could help identify heart attack patients at higher risk after PCI. Because it was a single-center study with a modest sample, the findings would need confirmation in larger, multi-center groups.
He M, Jin C, Yu Y, Wang J, Tong X, Chen M, et al.. (2026). [Myocardium global longitudinal strain and peripheral blood neutrophil-to-lymphocyte ratio for predicting MACE risks following percutaneous coronary intervention for first-time acute myocardial infarction: a prospective cohort study].. Nan fang yi ke da xue xue bao = Journal of Southern Medical University. https://doi.org/10.12122/j.issn.1673-4254.2026.10.10