Araştırma Makalesi

The association between C-reactive protein to albumin ratio and infarct location in patients with ST-segment elevation myocardial infarction

Cilt: 49 Sayı: 1 29 Mart 2024
PDF İndir
EN TR

The association between C-reactive protein to albumin ratio and infarct location in patients with ST-segment elevation myocardial infarction

Abstract

Purpose: Inflammation has a crucial role in the pathogenesis of ST segment elevation myocardial infarction (STEMI). Recently, the C-reactive protein to albumin ratio (CAR) has emerged as a novel parameter of systemic inflammation. Although studies have demonstrated the that anterior STEMI location is associated with a higher infarct size and worse prognosis, no study has investigated the CAR in relation to infarct location. We herein aimed to evaluate whether there is a difference regarding the CAR between patients with anterior and non-anterior STEMI location. Materials and Methods: The study population comprised 273 consecutive STEMI patients who were divided into 2 groups based on the STEMI location, as the anterior STEMI group (n=114) and non-anterior STEMI group (n=159). Baseline characteristics were recorded, and the CAR was calculated for all patients. Results: Both groups were similar in terms of the baseline clinical characteristics. However, syntax score (p<0.001) was significantly higher and ejection fraction was lower (p<0.001) in the anterior STEMI group compared to the non-anterior STEMI group. The anterior STEMI patients had also significantly higher CAR (p<0.001). Correlation analysis showed that CAR was positively correlated with the syntax score (r = 0.249, p < 0.001) and troponin (r = 0.158, p = 0.009) whereas negatively correlated with ejection fraction (r = −0.124, p = 0.040). In the linear regression analysis, anterior STEMI location and syntax score were independently associated with the CAR. Conclusion: We found that STEMI patients with anterior location had significantly higher CAR. Also, anterior infarct location and syntax score were independently related to the CAR level. We suggest that a more widespread inflammatory response is triggered in patients with anterior STEMI compared to the patients with non-anterior STEMI.

Keywords

Infarct location , inflammation , C-reactive protein to albumin ratio , infarct size

Kaynakça

  1. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A et al. ESC scientific document group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44:3720-826.
  2. Li S, Zhao L, Lu A, Tian J, Gong L, Ma X. Comparison of left ventricular global strain in anterior and non-anterior wall myocardial infarction with CMR tissue tracking. Front Physiol. 2020;11:530108.
  3. Park DW, Clare RM, Schulte PJ, Pieper KS, Shaw LK, Califf RM et al. Extent, location, and clinical significance of non-infarct-related coronary artery disease among patients with ST-elevation myocardial infarction. JAMA. 2014;312:2019-27.
  4. Hands ME, Lloyd BL, Robinson JS, de Klerk N, Thompson PL. Prognostic significance of electrocardiographic site of infarction after correction for enzymatic size of infarction. Circulation. 1986;73:885-91.
  5. Stone PH, Raabe DS, Jaffe AS, Gustafson N, Muller JE, Turi ZG et al. Prognostic significance of location and type of myocardial infarction: independent adverse outcome associated with anterior location. J Am Coll Cardiol. 1988;11:453-63.
  6. Kosuge M, Kimura K. Clinical implications of electrocardiograms for patients with anterior wall ST-segment elevation acute myocardial infarction in the interventional era. Circ J. 2012;76:32-40.
  7. Masci PG, Ganame J, Francone M, Desmet W, Lorenzoni V, Iacucci I et al. Relationship between location and size of myocardial infarction and their reciprocal influences on post-infarction left ventricular remodelling. Eur Heart J. 2011;32:1640-8.
  8. Seropian IM, Sonnino C, Van Tassell BW, Biasucci LM, Abbate A. Inflammatory markers in ST-elevation acute myocardial infarction. Eur Heart J Acute Cardiovasc Care. 2016;5:382-95.
  9. Tudurachi BS, Anghel L, Tudurachi A, Sascău RA, Stătescu C. Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL-Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients. Int J Mol Sci. 2023;24:14378.
  10. Söğüt Ö, Akdemir T, Can MM. Prognostic value of the C-reactive protein to albumin ratio in patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Turk J Med Sci. 2021;51:1281-8.

Kaynak Göster

MLA
Tanrıverdi, Zülkif, ve Halil Fedai. “The association between C-reactive protein to albumin ratio and infarct location in patients with ST-segment elevation myocardial infarction”. Cukurova Medical Journal, c. 49, sy 1, Mart 2024, ss. 141-9, doi:10.17826/cumj.1423800.