Neutrophil-to-high-density lipoprotein ratio: an independent predictor of infarct-related artery patency in patients with acute myocardial infarction

Abstract

Aims: The definition of an infarct-related artery (IRA) is a coronary artery occluded by a thrombus or atheroma that causes ischemia during acute myocardial infarction (AMI). Early patency of the IRA is the primary goal of treatment in patients with AMI. The neutrophil/ high-density lipoprotein cholesterol (HDL-C) ratio (NHR) has been recognized as a new inflammatory marker. We aimed to show the possible relationship between NHR and preprocedural IRA patency. Methods: Four hundred patients were screened, and 318 were included in the study after exclusion criteria. IRA flow rate before the coronary procedure was determined according to the previously described thrombolysis in myocardial infarction (TIMI). TIMI current 0,1 and 2 patients were considered IRA non-patent, and TIMI-3 patients were considered IRA patent and were divided into two groups. Regression analysis was performed for possible parameters in predicting IRA patency, evaluated in univariable analysis, and those with p-value <0.05 were assessed in multivariable analysis. Results: The mean age was 62.3 ± 11.9 years, and 73.4% were male. In multivariable logistic regression analysis, high peak troponin (ng/mL) (p<0.001, Odds Ratio (OR): 0.936, 95% Confidence Intervals (CIs): 0.910 - 0.962) and NHR (p= 0.020, OR: 0.043, 95% CIs: 0.003 - 0.603) levels were found to be independent predictors of patent IRA. Conclusion: Our study investigated the relationship between IRA patency and NHR in AMI patients. The main finding of our research is that significantly higher NHR and peak troponin levels were associated with non-patent IRA patients and were independent predictors.

Keywords

• acute myocardial infarction
• vascular patency
• high-density lipoprotein
• neutrophil

Nötrofil-yüksek yoğunluklu lipoprotein oranı: akut miyokart enfarktüsü hastalarında enfarkt ilişkili arter açıklığının bağımsız bir belirleyicisi

Abstract

Amaç: İnfarkt ilişkili arter (İRA) tanımı, akut miyokard infarktüsü (AMI) sırasında iskemiye neden olan bir trombüs veya aterom tarafından tıkanmış bir koroner arterdir. IRA'nın erken açıklığı, AMI'li hastalarında tedavinin birincil amacıdır. Nötrofil/yüksek yoğunluklu lipoprotein kolesterol (HDL-K) oranı (NHO) yeni bir inflamatuar belirteç olarak kabul edilmiştir. NHO ile işlem öncesi İRA açıklığı arasındaki olası ilişkiyi göstermeyi amaçladık. Yöntem: 400 hasta tarandı ve 318 dışlama kriterlerinden sonra çalışmaya dahil edildi. Koroner prosedür öncesi İRA akış hızı, daha önce tarif edilen miyokard enfarktüsünde tromboliz sınıflamasına (TIMI) göre belirlendi. TIMI mevcut 0,1 ve 2 hastalar IRA non-patent, TIMI-3 hastalar IRA patent olarak kabul edildi ve iki gruba ayrıldı. IRA açıklığını tahmin etmede olası parametreler için regresyon analizi yapıldı, tek değişkenli analizde değerlendirildi ve p değeri <0,05 olanlar çok değişkenli analizde değerlendirildi. Bulgular: Ortalama yaş 62,3 ± 11,9 ve %73,4'ü erkekti. Çok değişkenli lojistik regresyon analizinde, yüksek pik troponin (ng/mL) (p<0,001, Odds Ratio (OR): 0,936, %95 Güven Aralıkları (GA): 0,910 - 0,962) ve NHO (p= 0,020, OR: 0,043, %95 GA: 0.003 - 0.603) seviyeleri, patent IRA'nın bağımsız belirleyicileri olarak bulunmuştur. Sonuç: Çalışmamız, AMİ hastalarında İRA açıklığı ile NHO arasındaki ilişkiyi araştırdık. Araştırmamızın ana bulgusu, yüksek NHR ve pik troponin düzeylerinin, patent olmayan IRA hastalarıyla ilişkili olduğu ve bağımsız belirleyicileri olduğudur.

Keywords

• akut miyokart enfarktüsü
• vasküler açıklık
• yüksek dansiteli lipoprotein
• nötrofil

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