NSTEMİ’de CRP/albümin oranının no-reflow ile ilişkisi

Abstract

Amaç: Bu çalışmada, perkütan koroner girişim yapılan NSTEMI hastalarında yüksek duyarlılıklı C-reaktif protein/albümin oranının (CAR) anjiyografik no-reflow gelişimini öngörmedeki prediktif değeri araştırılmıştır. Yöntem: 2021–2023 yılları arasında PKG ile tedavi edilen 400 NSTEMİ hastası retrospektif olarak değerlendirildi. Hastalar işlem sonrası TIMI akımına göre sınıflandırıldı: no-reflow (TIMI ≤2) ve normal reflow (TIMI 3). Klinik, laboratuvar ve anjiyografik değişkenler karşılaştırıldı. Lojistik regresyon ile bağımsız belirleyiciler saptandı ve ROC analizi CAR’ın ayırt ediciliğini değerlendirdi. Bulgular: No-reflow 45 hastada (%11,3) izlendi. Normal reflow grubuna kıyasla no-reflow grubunda hs-CRP daha yüksek, albümin daha düşük ve buna bağlı olarak CAR daha yüksekti (medyan 0,27 vs. 0,13; p<0,001). Çok değişkenli analizde CAR (OR 6,11; %95 GA 2,15–17,38; p=0,001), SYNTAX skoru ve stent uzunluğu bağımsız öngördürücüler olarak belirlendi. ROC analizi, CAR için yüksek doğruluk gösterdi (AUC 0,782) ve hs-CRP ile nötrofil/lenfosit oranından daha üstün bulundu. Sonuç: Yüksek duyarlıklı CRP/albümin oranı, PKG uygulanan NSTEMİ hastalarında anjiyografik no-reflow fenomenini bağımsız olarak öngörmektedir. CAR düşük maliyetli, yaygın olarak ulaşılabilir olup erken risk sınıflamasını destekleyebilir. Bulguların prospektif çalışmalarla doğrulanması gereklidir.

Keywords

• Non–ST elevasyonsuz miyokard enfarktüsü
• No-reflow fenomeni
• Perkütan koroner girişim
• C-reaktif protein
• Albümin

Association of CRP/albumin ratio with no-reflow in NSTEMI

Abstract

Objective: This study examined the predictive value of the high-sensitivity C-reactive protein/albumin ratio (CAR) for angiographic no-reflow in NSTEMI patients undergoing PCI. Methods: We retrospectively evaluated 400 NSTEMI patients treated with PCI between 2021 and 2023. Patients were classified by post-procedural TIMI flow: no-reflow (TIMI ≤2) or normal reflow (TIMI 3). Clinical, laboratory, and angiographic variables were compared. Logistic regression identified independent predictors, and ROC analysis assessed CAR’s discriminative ability. Results: No-reflow occurred in 45 patients (11.3%). Compared with normal reflow, the no-reflow group had higher hs-CRP, lower albumin, and thus elevated CAR (median 0.27 vs. 0.13, p<0.001). Multivariable analysis showed CAR (OR 6.11, 95% CI 2.15–17.38, p=0.001), SYNTAX score, and stent length as independent predictors. ROC analysis demonstrated strong accuracy for CAR (AUC 0.782), exceeding hs-CRP and neutrophil-to-lymphocyte ratio. Conclusion: The hs-CRP/albumin ratio independently predicts angiographic no-reflow in NSTEMI patients undergoing PCI. CAR is inexpensive, widely available, and may support early risk stratification. Prospective validation is warranted.

Keywords

• Non-ST elevated myocardial infarction
• No-reflow phenomenon
• Percutaneous coronary intervention
• C-reactive protein
• Albumin

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