Pulmoner Tromboemboli ve Nötrofil Albümin Oranı Arasındaki İlişki

Abstract

Amaç: Pulmoner tromboemboli (PTE), tüm dünyada sık görülen ve erken tanı ve tedavi gerektiren ciddi bir klinik tablodur. Tanı koymada, hem laboratuvar verileri hem de radyolojik görüntüleme destek sağlamaktadır. Çalışmanın amacı, PTE tanılı hastalarda nötrofil albumin oranının (NAR) klinik önemini araştırmaktır. Gereç ve yöntem: Çalışmaya, PTE tanılı 100 hasta ve sigara içme öyküsü ve komorbidite öyküsü olmayan 50 sağlıklı gönüllü olmak üzere toplam 150 olgu dahil edildi. Tam kan sayımı ve biyokimyasal veriler retrospektif olarak elde edildi. NAR, nötrofilin albumine oranı olarak hesaplandı. Bulgular: Çalışmaya 84’ü erkek (%56) ve 66’sı (%44) kadın olmak üzere toplam 150 vaka dahil edildi. NAR, hasta grubunda istatistiksel olarak anlamlı düzeyde yüksek bulundu (p<0,001). Serum NAR değeri, serum d-dimer değeri ile pozitif korelasyon gösterdi (r:0,488, p<0,001). Sonuç: Yeni, ucuz ve kolay hesaplanabilen bir biyobelirteç olan NAR, PTE hastalarının tanısında yararlı bir parametre olabilir.

Keywords

• Pulmoner emboli
• Albumin
• Nötrofil
• İnflamasyon

Relationship Between Pulmonary Thromboembolism and Neutrophil Albumin Ratio

Abstract

Objective: Pulmonary Thromboembolism (PTE) is a serious clinical condition and is common all over the world, requiring early diagnosis and treatment. Laboratory data and radiological imaging provide support in its diagnosis. The purpose of the present study is to investigate the clinical significance of neutrophil to albumin ratio (NAR) in patients who are diagnosed with PTE. Material and Method: A total of 150 cases who of 100 patients with a diagnosis of PTE and 50 healthy volunteers without a history of smoking or any comorbidities were included in the study. Complete Blood Count (CBC) and biochemical data were evaluated retrospectively. NAR was calculated as the ratio of neutrophil to albumin. Results: A total of 150 cases (84 male (56%) and 66 (44%) female) were included in the study. Neutrophil Albumin Ratio (NAR), were found to be statistically and significantly elevated in the patient group (p<0.001).The Serum NAR value showed a positive correlation with the Serum d-dimer value (r:0.488, p<0.001). Conclusion: It is possible to argue that NAR, which is a novel, cheap, and easily calculable biomarker, can be a useful parameter for the diagnosis of patients with PTE.

Keywords

• pulmonary embolism
• inflammation
• albumin
• neutrophil

References

1. Huang J, Chen Y, Chai. Z, Chen P. Diagnostic value of platelet indexes for pulmonary embolism. Am J Emerg Med 2015; 33(6): 760-763.
2. Righini M, Le Gal G, De Lucia S, Roy PM, Meyer G, Aujesky D, et al. Clinical usefulness of D-dimer testing in cancer patients with suspected pulmonary embolism. Thromb Haemost. 2006;95(4):715-719
3. Carrier M, Righini M, Wells PS, Perrier A, Anderson DR, Rodger MA, et al. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications. A systematic review and meta-analysis of the management outcome studies. J Thromb Haemost. 2010;8(8):1716-1722.
4. Eagleton MJ, Henke PK, Luke CE, Hawley AE, Bedi A, Knipp BS, et al. Southern Association for Vascular Surgery William J. von Leibig Award. Inflammation and intimal hyperplasia associated with experimental pulmonary embolism. J Vasc Surg. 2002;36(3):581-588.
5. Soylu K, Gedikli O, Eksi A, Avcıoglu Y, Soylu AI, Yüksel S, et al Neutrophil-to-lymphocyte ratio for the assessment of hospital mortality in patients with acute pulmonary embolism. Arch Med Sci. 2016;12(1):95-100.
6. Şener A, Sivri HC, Sivri S, Ertem A, Çelik GK, Köseoğlu C, et al. The Prognostic Value of The Platelet/Lymphocyte Ratio in Predicting Short-Term Mortality in Patients with Acute Pulmonary Embolism. Sakarya Tıp Dergisi, 2015;5(4):204-208.
7. Hocanli, Iclal; Tanriverdi, Zulkif. The Clinical Importance of C-Reactive Protein to Albumin Ratio (CAR) in Patients with Pulmonary Thromboembolism. Clinical Laboratory, 2023;69(2).
8. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020;81(1):e6-e12.

9. Akirov A, Masri-Iraqi H, Atamna A, Shimon I. Low albumin levels are associated with mortality risk in hospitalized patients. Am J Med. 2017;130(12):1465. e11-19.
10. Porembskaya O, Zinserling V, Tomson V, Toropova Y, Starikova EA, Maslei VV, et al. Neutrophils Mediate Pulmonary Artery Thrombosis In Situ. Int J Mol Sci. 2022;23(10):5829.
11. Hoskin S, Chow V, Kritharides L, Ng ACC. Incidence and Impact of Hypoalbuminaemia on Outcomes Following Acute Pulmonary Embolism. Heart Lung Circ. 2019;29(2):280–287.
12. Lin Y, Lin Y, Yue J, Zou Q. The neutrophil percentage-to-albumin ratio is associated with all-cause mortality in critically ill patients with acute myocardial infarction. BMC Cardiovasc Disord. 2022;22(1):115.
13. Zhang X, Liu Y, Zhang S, Wang C, Zou C, Li A. Neutrophil-to-Albumin Ratio as a Biomarker of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage. World Neurosurg. 2021;147:e453-8.
14. Varim C, Yaylaci S, Demirci T, Kaya T, Nalbant A, Dheir H, et al. Neutrophil count to albumin ratio as a new predictor of mortality in patients with COVID-19 ınfection. Rev Assoc Med Bras (1992). 2020;66(2):77-81.
15. Arnault V, Beaulieu A, Lifante JC, Sitges Serra A, Sebag F, Mathonnet M, et al. Multicenter study of 19 aortopulmonary window parathyroid tumors: the challenge of embryologic origin. World J Surg. 2010;34(9):2211-2216.
16. Gülen ŞT, Yazıcı O, Ömürlü İK. The Prognostic Value of Hematological Parameters in Patients with Pulmonary Embolism. J Clin Anal Med. 2017;883): 207-210.
17. Çaltekin İ, Gökçen E. Evaluation of Changes in Lymphocyte to Monocyte Ratio and İnflammatory Markers in Stroke Subgroups. Bozok Tıp Dergisi. 2020; 10(1): 190-195.
18. Artac I, Omar T, Karakayali M, Ilis D, Karabag Y, Rencuzogullari I. Assessment of the relationship between C-reactive protein to albumin ratio and late-term mortality in patients with acute pulmonary embolism. Asian Cardiovasc Thorac Ann. 2023;31(4):332-339.
19. Kunutsor SK, Kurl S, Voutilainen A, Laukkanen JA. Serum C-reactive protein-to-albumin ratio may be a potential risk indicator for venous thromboembolism: Findings from a prospective cohort study. Nutrition, Metabolism and Cardiovascular Diseases, 2023;33(4): 864-867.
20. Tingle SJ, Severs GR, Goodfellow M, Moir JA, White SA. NARCA: A novel prognostic scoring system using neutrophil‐albumin ratio and Ca19‐9 to predict overall survival in palliative pancreatic cancer. J Surg Oncol. 2018;11(84):680‐686.
21. Gong Y, Li D, Cheng B, Ying B, Wang B. Increased neutrophil percentage‐to‐albumin ratio is associated with all‐cause mortality in patients with severe sepsis or septic shock. Epidemiol Infect. 2020;148:e87.
22. He X, Dai F, Zhang X, Pan J. The neutrophil percentage-to-albumin ratio is related to the occurrence of diabetic retinopathy. J Clin Lab Anal. 2022;36(4):e24334.
23. von Bruhl ML, Stark K, Steinhart A, Chandraratne S, Konrad I, Lorenz M, et al. Monocytes, neutrophils, and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo. J. Exp. Med. 2012;209(4):819–835.
24. Engelmann B., Massberg S. Thrombosis as an intravascular effector of innate immunity. Nat. Rev. Immunol. 2013;1381):34–45.
25. Eckart A, Struja T, Kutz A, Baumgartner A, Baumgartner T, Zurfluh S, et al. Relationship of nutritional status, iInflammation, and serum albumin levels during acute illness: a prospective study. Am J Med. 2020;133(6):713-722.
26. Arques S. Serum albumin and cardiovascular disease: state-ofthe-art review. Ann Cardiol Angeiol (Paris). 2020;69(4):192-200.
27. Peng R, Yin W, Wang F, Cong X, Lu B, Hua L, et al. Neutrophil levels upon admission for the assessment of acute pulmonary embolism with intermediate- and high-risk: an indicator of thrombosis and inflammation. Thromb J. 2023;21(1):28.
28. Tanık VO, Çınar T, Karabağ Y, Şimşek B, Burak C, Çağdaş M, et al. The prognostic value of the serum albumin level for long-term prognosis in patients with acute pulmonary embolism. Clin Respir J. 2020;14(6):578-585.
29. Prandoni P, Bilora F, Marchiori A, Bernardi E, Petrobelli F, Lensing AW, et al. An association between atherosclerosis and venous thrombosis. N Engl J Med. 2003;348(15):1435-1441.
30. Hasbek Z, Erselcan T, Gül S. Pulmoner emboli tanısında D-dimer düzeyleri ile ventilasyon/perfüzyon sintigrafisindeki bulgular arasındaki ilişki. Cumhuriyet Medical Journal. 2014:36; 320-326.
31. Aujesky D, Roy PM, Guy M, Cornuz J, Sanchez O, Perrier A. Prognostic value of D-dimer in patients with pulmonary embolism. Thromb Haemost 2006; 96(4): 478-482.
32. Eichinger S, Minar E, Bialonczyk C, Hirschl M, Quehenberger P, Schneider B, et al. D-dimer levels and risk of recurrent venous thromboembolism. JAMA 2003; 290(4):1071-1074.