ST segment yükselmeli miyokard infarktüsü olan hastalarda C-reaktif protein/albümin oranı ile infarktüs lokalizasyonu arasındaki ilişki

Year 2024, Volume: 49 Issue: 1, 141 - 149, 29.03.2024

Zülkif Tanrıverdi Halil Fedai

https://doi.org/10.17826/cumj.1423800

Abstract

Amaç: ST yükselmeli miyokard enfarktüsünün (STYMİ) patogenezinde inflamasyonun önemli bir rolü vardır. Son zamanlarda, C-reaktif protein/albümin oranı (CAO), sistemik inflamasyonun yeni bir parametresi olarak ortaya çıkmıştır. Çalışmalar anterior STYMİ lokalizasyonunun daha fazla infarktüs boyutu ve kötü prognoz ile ilişkili olduğunu göstermesine rağmen, hiçbir çalışma CAO'nun infarktüs lokalizasyonu ile ilişkisini araştırmamıştır. Bu çalışmada, anterior ve anterior yerleşimli olmayan STYMİ hastalar arasında CAO açısından fark olup olmadığını değerlendirmeyi amaçladık.
Gereç ve Yöntem: Çalışma popülasyonu, STEMI lokasyonuna göre anterior STEMI grubu (n=114) ve anterior olmayan STEMI grubu (n=159) olmak üzere 2 gruba ayrılan 273 ardışık STEMI hastasından oluşmuştur. Temel özellikler kaydedildi ve tüm hastalar için CAO hesaplandı.
Bulgular: Her iki grup da bazal klinik özellikler açısından benzerdi. Ancak anterior STYMİ grubunda, anterior olmayan STYMİ grubuna kıyasla syntax skoru anlamlı derecede yüksek (p<0.001) ve ejeksiyon fraksiyonu daha düşüktü (p<0.001). Anterior STYMİ hastaları aynı zamanda anlamlı olarak daha yüksek CAO (p<0.001) seviyesine sahipti. Korelasyon analizi, CAO'nun syntax skoru (r=0.249, p<0.001) ve troponin (r=0.158, p=0.009) ile pozitif, ejeksiyon fraksiyonu (r= −0.124, p=0.040) ile negatif korelasyon gösterdiğini saptadı. Lineer regresyon analizinde anterior STYMİ lokalizasyonu ve syntax skoru, CAO seviyesi ile bağımsız olarak ilişkili idi.
Sonuç: Anterior yerleşimli STYMİ hastalarının anlamlı olarak daha yüksek CAR’a sahip olduğunu bulduk. Ayrıca, anterior enfarktüs yerleşimi ve syntaks skoru bağımsız olarak CAR düzeyi ile ilişkiliydi. Anterior STEMI hastalarında, anterior olmayan STEMI hastalarına kıyasla daha geniş bir inflamatuvar yanıtın tetiklendiğini düşünüyoruz.

Keywords

Enfarktüs yeri, inflamasyon, C-reaktif protein/albümin oranı

Ethical Statement

Ethical approval was obtained from the Harran University Clinical Research Ethics Committee with the decision number: HRÜ.22/04/18.

Supporting Institution

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Thanks

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The association between C-reactive protein to albumin ratio and infarct location in patients with ST-segment elevation myocardial infarction

Abstract

Purpose: Inflammation has a crucial role in the pathogenesis of ST segment elevation myocardial infarction (STEMI). Recently, the C-reactive protein to albumin ratio (CAR) has emerged as a novel parameter of systemic inflammation. Although studies have demonstrated the that anterior STEMI location is associated with a higher infarct size and worse prognosis, no study has investigated the CAR in relation to infarct location. We herein aimed to evaluate whether there is a difference regarding the CAR between patients with anterior and non-anterior STEMI location.
Materials and Methods: The study population comprised 273 consecutive STEMI patients who were divided into 2 groups based on the STEMI location, as the anterior STEMI group (n=114) and non-anterior STEMI group (n=159). Baseline characteristics were recorded, and the CAR was calculated for all patients.
Results: Both groups were similar in terms of the baseline clinical characteristics. However, syntax score (p<0.001) was significantly higher and ejection fraction was lower (p<0.001) in the anterior STEMI group compared to the non-anterior STEMI group. The anterior STEMI patients had also significantly higher CAR (p<0.001). Correlation analysis showed that CAR was positively correlated with the syntax score (r = 0.249, p < 0.001) and troponin (r = 0.158, p = 0.009) whereas negatively correlated with ejection fraction (r = −0.124, p = 0.040). In the linear regression analysis, anterior STEMI location and syntax score were independently associated with the CAR.
Conclusion: We found that STEMI patients with anterior location had significantly higher CAR. Also, anterior infarct location and syntax score were independently related to the CAR level. We suggest that a more widespread inflammatory response is triggered in patients with anterior STEMI compared to the patients with non-anterior STEMI.

Keywords

Infarct location, inflammation, C-reactive protein to albumin ratio, infarct size

Ethical Statement

Ethical approval was obtained from the Harran University Clinical Research Ethics Committee with the decision number: HRÜ.22/04/18.

Supporting Institution

Yok

Thanks

Yok

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