The relationship between microvascular angina and De Ritis ratio in normal coronary artery patients with recurrent chest pain / De Ritis ratio and microvascular angina

Abstract

The relationship between microvascular angina and De Ritis ratio in normal coronary artery patients with recurrent chest pain / De Ritis ratio and microvascular angina

Abstract

Objective: De Ritis ratio (AST/ALT) is a strong predictor of outcomes in both heart failure and acute coronary syndromes. The usability of this parameter in patients with normal coronary arteries who had repeated application to health institutions due to chest pain has not been evaluated before. In this paper we aimed to investigate if De Ritis ratio may be used as a guiding in this group of patients. Methods: This retrospective study included 545 patients with normal coronary arteries according to the coronary angiographies performed in our clinic between January 2018 and June 2019. They were grouped into two according to hospital admittance with chest pain after angiography; group 1: no application, group 2: repeated application. At least 8 hours of fasting venous samples were collected for routine laboratory tests. Results: 545 patients with a mean age of 52.3 ± 11.2 (41.1%male) were included in the study. 16.5% of them had repeated applications with chest pain. Mean De Ritis ratio and CRP levels were different between the groups (p=0.028 and 0.045, respectively). In multivariate logistic regression analysis, De Ritis ratio was the only parameter that predicted repeated application with an Odds ratio (OR) = 3.062 ,95% CI= 1.267- 7.400 and p=0.013). Conclusion: Elevated De Ritis ratio and CRP conclude us that there may be microvascular coronary disease in this group of patients. The repeated application with chest pain, although normal coronary artery was obtained, should be taken into consideration and it should be kept in mind that additional tests may be required to rule out microvascular coronary disease.

Keywords

• atherosclerosis
• De Ritis ratio
• microvascular disease

References

1. 1.Lanza GA, De Vita A, Kaski JC. ‘Primary’Microvascular Angina: Clinical Characteristics,Pathogenesis and Management. Interv Cardiol.2018; 13: 108–11.