Objective:To explore the predictive value of peripheral blood neutrophil to lymphocyte ratio (NLR) and serum trimethylamine oxide (TMAO) on in-hospital mortality events in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) upon admission.Methods:A retrospective collection of medical records of 103 AMICS patients admitted to the Shanxi Yingkang Life General Hospital from January 2018 to June 2023 was conducted. The patients were divided into a survival group ( n=78) and a death group ( n=25) based on whether they experienced in-hospital mortality events. Two groups of peripheral blood NLR, serum TMAO, baseline data, and other laboratory indicators were compared. A logistic regression model was used to analyze the risk factors for in-hospital mortality in AMICS patients and a prediction model was constructed. We established receiver operating characteristic (ROC) curves to evaluate the predictive efficacy of peripheral blood NLR, serum TMAO, peripheral blood NLR+ serum TMAO, and predictive model indicators for in-hospital mortality events in AMICS patients. Results:The peripheral blood NLR and serum TMAO levels in the death group were significantly higher than those in the survival group (all P<0.05). The age of the death group was higher than that of the survival group, and the proportion of hypertension, alanine aminotransferase, creatinine, random blood glucose, proportion of patients who did not receive emergency percutaneous coronary intervention (PCI) treatment, peak cardiac troponin I, B-type natriuretic peptide, Gensini score of coronary artery disease, and C-reactive protein were all higher than those of the survival group. Systolic blood pressure and platelet count were lower than those of the survival group, heart rate and erythrocyte sedimentation rate were faster than those of the survival group, and the pre hospital time was longer than that of the survival group. The differences were statistically significant (all P<0.05). The results of binary logistic regression analysis showed that after adjusting for confounding factors such as age, male proportion, body mass index, proportion of old myocardial infarction, proportion of hypertension, and proportion of PCI history, advanced age, long pre hospital time, failure to receive emergency PCI, elevated peripheral blood NLR, and elevated serum TMAO were independent risk factors for in-hospital mortality in AMICS patients ( P<0.05). The predictive model was obtained as 0.734×age+ 0.277×pre hospital time+ 2.263×failure to receive emergency PCI+ 0.549×peripheral blood NLR+ 0.608×serum TMAO-26.923. The ROC curve results showed that the area under the curve (AUC) values of peripheral blood NLR, serum TMAO, peripheral blood NLR+ serum TMAO, and predictive model indicators for predicting in-hospital mortality events in AMICS patients were 0.744, 0.781, 0.825, and 0.921, respectively. When the optimal cutoff value was taken, the sensitivities were 0.880, 0.520, 0.680, and 0.880, and the specificities were 0.526, 0.923, 0.872, and 0.821, respectively. Conclusions:Advanced age, long pre hospital duration, failure to undergo emergency PCI, elevated peripheral blood NLR, and elevated serum TMAO are independent risk factors for in-hospital mortality in AMICS patients. Peripheral blood NLR, serum TMAO, peripheral blood NLR+ serum TMAO, and prediction models all have certain predictive value for in-hospital mortality events in AMICS patients. Among them, the sensitivity and specificity of the prediction models are high, and the efficacy is good.

Objective To evaluate the effect of percutaneous coronary intervention (PCI) on anxiety and depression among patients with coronary heart disease (CHD). Methods A total of 600 CHD patients were divided into the stent group (n = 400) and the non-stent group (n = 200) according to stent implantation during coronary angiography, and 400 cases in the stent group were further divided into the intervention group (n = 200) and the non-intervention group (n = 200) according to post-stenting psychological interventions. The anxiety and depression were scored using self-rating anxiety and depression scales 1 day after admission, 1 day after PCI and at discharge from hospital, and the anxiety and depression scores were compared at different time points. Results The mean age, sex ratio, hemoglobin, total cholesterol, triglyceride, high-density lipoprotein cholesteroland low-density lipoprotein cholesterol levels were comparable among the three groups (P > 0.05). There were no significant differences among the three groups in terms of anxiety or depression scores one day after admission (P > 0.05). One day after PCI, the anxiety and depression scores were significantly higher among CHD patients in the intervention and non-intervention groups than in the non-stent group (P < 0.05), and the anxiety (t = 11.21, P < 0.01; t = 9.96, P < 0.01) and depression scores (t = 8.56, P < 0.01; t = 6.73, P < 0.01) were significantly higher in the intervention and non-intervention groups one day after PCI than one day after admission. At discharge from hospital, there were significant differences among the three groups in terms of anxiety and depression scores (P < 0.05), and the anxiety (t = 21.57, P < 0.01; t = 15.77, P < 0.01) and depression scores (t = 24.33, P < 0.01; t = 15.01, P < 0.01) were significantly higher in the intervention and non-intervention groups at discharge from hospital than one day after PCI, while the anxiety and depression scores were significantly lower among CHD patients in the intervention group than in the non-intervention group (P < 0.05). Conclusion The anxiety and depression are aggravated among CHD patients after PCI, and psychological interventions may alleviate the anxiety and depression.