KAROTİD ARTER STENTLEME SONRASI GELİŞEN STENTİÇİ RESTENOZUN YENİ BİR ÖNGÖRDÜRÜCÜSÜ: CRP/ ALBUMİN ORANI The CRP/Albumin Ratio: A Novel Predictor of In-stent Restenosis After Carotid Artery Stenting

Yıl 2020, Cilt: 10 Sayı: 1, 154 - 160, 25.03.2020

Ali Nazmi Çalık Tufan Çınar Duygu İnan Duygu Genç Hüseyin Kuplay Mehmet Baran Karataş Ayşe Emre

Öz

ÖZET
Amaç: Çalışmamızda, karotid arter stentleme (KAS) işlemi öncesi bakılan C-reaktif protein/albumin oranının
(CAO) stent içi restenozu (SİR) öngördürme potansiyelini araştırmayı amaçladık.
Gereç ve Yöntem: Retrospektif olarak dizayn edilen bu çalışmaya tersiyer merkezimizde başarılı bir şekilde
karotid arter stentleme yapılan toplam 206 hasta alındı. İşlem öncesi her hastanın C-reaktif protein (CRP) ve
serum albumin değerleri çalışıldı. CAO değeri, CRP değeri serum albumin değerine bölünerek hesaplandı.
Çalışmanın primer sonlamın noktası takip sırasında gelişen SİR olarak belirlendi.
Bulgular: 206 hastanın ortalama 24.2 ± 1.5 ay takibi sonunda SİR toplam 34 (%16.5) hastada izlendi. SİR
gelişmeyen hastalarla karşılaştırıldığında, CAO, SİR gelişen hastalarda anlamlı olarak daha yüksek saptandı
(0.15 [0.2] vs. 0.99 [1.3], p < 0.01, sırasıyla). Çok değişkenli COX analizinde, CAO, SİR ‘un bağımsız öngördürücüsü
olarak saptandı (HR: 1.85, %95 CI: 1.29 – 2.64, p < 0.01). ROC eğrisi analizinde CAO değerinin > 0.53
olması, SİR ‘u %100 duyarlılık ve %97.1 özgüllük ile öngördürmekteydi (AUC) 0.98, p < 0.01).
Sonuç: Çalışmamızın sonuçları göstermiştir ki, inflamatuar bazlı yeni bir belirteç olan CAO KAS işlemi yapılan
hastaların takiplerinde gelişen SİR ‘un güçlü ve bağımsız bir öngördürücüsüdür. Hızlı ve kolayca bakılabilen
bu parametre, KAS işlemi yapılan hastalarda SİR gelişimini değerlendirmek için kullanılabilir.
Anahtar kelimeler: CAO; Stent içi restenoz; Karotis arter stentleme; İnflamasyon
ABSTRACT
Objective: The present study aimed to assess the predictive value of preprocedural C-reactive protein/
albumin ratio (CAR) for in-stent restenosis (ISR) after carotid artery stenting (CAS).
Materials and Method: In this retrospective study, 206 patients who underwent successful CAS procedure
in a tertiary heart centre were included. For each patient, both C-reactive protein (CRP) and serum albumin
were determined before the index procedure. The CAR was calculated by dividing serum CRP by serum
albumin level. The main end-point of the study was ISR during long-term follow-up.
Results: ISR developed in 34 (16.5%) out of 206 patients after a mean follow-up of 24.2 ± 1.5 months. The
CAR was significantly elevated in patients with ISR compared to those who were not (0.99 [1.3] vs. 0.15
[0.2], p < 0.01, respectively). In a multivariate Cox regression analysis, the CAR was an independent predictor
of ISR (HR: 1.85, %95 CI: 1.29 – 2.64, p < 0.01). A ROC curve analysis revealed that the optimal value
of CAR in predicting ISR was > 0.53 with a sensitivity of 100 % and a specificity of 97.1 % [area under curve
(AUC) 0.98, p < 0.001].
Conclusion: The present study demonstrated that CAR, a new inflammatory-based index, is a strong independent
predictor of ISR after CAS. As a simple and easily accessible parameter, this index may be used for
the assessment of ISR in patients who are treated with CAS.
Keywords: CAR; In-stent restenosis; Carotid artery stenting; Inflammation

Anahtar Kelimeler

KAROTİD ARTER STENTLEME SONRASI GELİŞEN STENTİÇİ RESTENOZUN YENİ BİR ÖNGÖRDÜRÜCÜSÜ: CRP/ ALBUMİN ORANI The CRP/Albumin Ratio: A Novel Predictor of In-stent Restenosis After Carotid Artery Stenting

Kaynakça

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