A combination of NLR and sST2 is associated with adverse cardiovascular events in patients with myocardial injury induced by moderate to severe acute carbon monoxide poisoning

Abstract

Background: Indicators of adverse cardiovascular events in patients with acute carbon monoxide (CO) poisoning-induced myocardial injury have not yet been elucidated. Hypothesis: This study aimed at determining the risk factors for adverse cardiovascular events in patients with acute CO poisoning-induced myocardial injury. Methods: We enrolled patients with moderate-to-severe acute CO poisoning-induced myocardial injury. Based on the occurrence of adverse cardiovascular events, the patients were assigned into event and non-event group. Binary logistic regression analysis was performed to analyze the potential risk factors for cardiovascular adverse events. Results: A total of 413 eligible patients were enrolled. Among them, 61 (14.8%) patients presented adverse cardiovascular events and were assigned to the event group while 352 patients were assigned to the non-event group. Univariate analysis revealed that cTnI, Lac, and NLR levels at admission and sST2 at day 3 in the event group were significantly higher compared to those in the non-event group. Subsequent multivariate analysis revealed that sST2 at day 3 and NLR at admission were independent risk factors for adverse cardiovascular events in patients with acute CO poisoning-induced myocardial injury. Finally, the sensitivity, specificity, and AUC of sST2 at day 3 combined with NLR for event prediction were 79.5%, 82.8%, and 0.858, respectively. Conclusion: A combination of sST2 at day 3 and NLR is a potential predictor for the occurrence of adverse cardiovascular events in patients with acute CO poisoning-induced myocardial injury. Therefore, cardiovascular risk stratification should be taken into consideration, especially in patients with acute CO poisoning-induced myocardial injury.