Prognostic value of the leuko-glycemic index in coronary chronic total occlusion patients

Yıl 2023, Cilt: 9 Sayı: 5 - September 2023, 1099 - 1104, 04.09.2023

Tezcan Peker , Mehmet Özbek , Bedrettin Boyraz , Selen Filiz Aslan , Muhammed Demir , Burhan Aslan

https://doi.org/10.18621/eurj.1342326

Cited By: 2

Öz

Objectives: Inflammation parameters are related to the prevalence and mortality of coronary artery disease (CAD). We aimed to evaluate the prognostic value of the leuko-glycemic index (LGI) and determine mortality in patients with chronic coronary total occlusion (CTO).

Methods: A total of 546 patients were evaluated in the study. All-cause death was the primary endpoint. The leuko-glycemic index was calculated from the blood samples at admission and patients were divided into 3 groups according to their LGI levels. Kaplan-Meier survival curves were performed and logistic regression analyses was used for all multivariable analysis.

Results: The mean age of the study population was 63.1 ± 11.1 years and 70.3% were male. Median follow-up time 58.2 ± 22.4 months. The mortality rate was 33.6% in the high LGI group and significantly higher compared to the other group. In multivariable analysis, LGI (OR: 1.05, 95% CI: 1,0-1.2; p = 0.02) and age (OR: 1.07, 95% CI: 1.04-1.11; p = 0.001) were found as predictors of all-cause death.

Conclusions: The study revealed that high LGI is associated with all-cause death in CTO patients and LGI was a predictor of all-cause death.

Anahtar Kelimeler

Leuko-glycemic index, coronary total occlusion, mortality, coronary artery disease

Kaynakça

• 1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol 2020;76:2982-3021.
• 2. Sianos G, Barlis P, Di Mario C, Papafaklis MI, Büttner J, Galassi AR, et al. European experience with the retrograde approach for the recanalisation of coronary artery chronic total occlusions. A report on behalf of the euroCTO club. EuroIntervention 2008;4:84-92.
• 3. Jeroudi OM, Alomar ME, Michael TT, El Sabbagh A, Patel VG, Mogabgab O, et al. Prevalence and management of coronary chronic total occlusions in a tertiary Veterans Affairs hospital. Catheter Cardiovasc Interv 2014;84:637-43.
• 4. Claessen BE, van der Schaaf RJ, Verouden NJ, Stegenga NK, Engstrom AE, Sjauw KD, et al. Evaluation of the effect of a concurrent chronic total occlusion on long-term mortality and left ventricular function inpatients after primary percutaneous coronary intervention. JACC Cardiovasc Interv 2009;2:1128-34.
• 5. Hoebers LP, Vis MM, Claessen BE, Van der Schaaf RJ, Kikkert WJ, Baan J Jr, et al. The impact of multivessel disease with and without a co-existing chronic total occlusion on short- and long-term mortality in ST-elevation myocardial infarction patients with and without cardiogenic shock. Eur J Heart Fail 2013;15:425-32.
• 6. Allahwala UK, Jolly SS, Džavík V, Cairns JA, Kedev S, Balasubramanian K, et al. The presence of a CTO in a non-infarct-related Artery during a STEMI treated with contemporary primary PCI is associated with increased rates of early and late cardiovascular morbidity and mortality: the CTO-TOTAL substudy. JACC Cardiovasc Interv 2018;11:709-711.
• 7. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-43.
• 8. Yang YL, Wu CH, Hsu PF, Chen SC, Huang SS, Chan WL, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest 2020;50:e13230.
• 9. Arbel Y, Finkelstein A, Halkin A, Birati EY, Revivo M, Zuzut M, et al. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis 2012;225:456-60.
• 10. Li C, Zhang F, Shen Y, Xu R, Chen Z, Dai Y, et al. Impact of neutrophil to lymphocyte ratio (NLR) index and its periprocedural change (NLRΔ) for percutaneous coronary intervention in patients with chronic total occlusion. Angiology 2017;68:640-46.
• 11. Gebhard C, Toma A, Min Z, Stähli BE, Mashayekhi K, Gick M, et al. Preprocedural leucocyte count predicts risk in patients with coronary chronic total occlusion. Thromb Haemost 2017;117:2105-15.
• 12. Quiroga CW, Conci E, Zelaya F, Isa M, Pacheco G, Sala J. [Risk stratification in acute myocardial infarction according to the leukoglycemic index. The “Killip-Kimball” laboratory?] Rev Fed Arg Cardiol 2010;39:29-34. [Article in Spanish]
• 13. Prado AH, Higa C, Merlo P, Domine E, Blanco P, Vazquez G, et al. Prognostic value of the leuko-glycemic index in acute myocardial infarction. Results from the SCAR multicenter registry. Rev Argent Cardiol 2014;82:475-80.
• 14. León-Aliz E, Moreno-Martínez FL, Pérez-Fernández GA, Vega-Fleites LF, Rabassa-López-Calleja MA. Leuko-glycemic index as an in-hospital prognostic marker in patients with ST-segment elevation myocardial infarction. Clin Investig Arterioscler 2014;26:168-75.
• 15. Libby P. Inflammation in atherosclerosis. Nature 2002;420:868-74.
• 16. Goff DC Jr, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129(25 Suppl 2):S49-73.
• 17. Christodoulidis G, Vittorio T, Fudim M, Lerakis S, Kosmas C. (2014). Inflammation in coronary artery disease. Cardiol Rev 2014;22:279-88.
• 18. Tousoulis D, Charakida M, Stefanadis C. Endothelial function and inflammation in coronary artery disease. Postgrad Med J 2008;84:368-71.
• 19. Kounis NG, Soufras GD, Tsigkas G, Hahalis G. White blood cell counts, leukocyte ratios, and eosinophils as inflammatory markers in patients with coronary artery disease. Clin Appl Thromb Hemost 2015;21:139-43.
• 20. Dragu R, Huri S, Zukermann R, Suleiman M, Mutlak D, Agmon Y, et al. Predictive value of white blood cell subtypes for long-term outcome following myocardial infarction. Atherosclerosis 2008;196:405-12.
• 21. Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The role of hematological indices in patients with acute coronary syndrome. Dis Markers 2017;2017:3041565.
• 22. Terlecki M, Bednarek A, Kawecka-Jaszcz K, Czarnecka D, Bryniarski L. Acute hyperglycaemia and inflammation in patients with ST-segment elevation myocardial infarction. Kardiol Pol 2013;71:260-7.
• 23. Planer D, Witzenbichler B, Guagliumi G, Peruga JZ, Brodie BR, Xu K, et al. Impact of hyperglycemia in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: the HORIZONS-AMI trial. Int J Cardiol 2013;167:2572-9.
• 24. Monteiro S, Monteiro P, Gonçalves F, Freitas M, Providência LA. Hyperglycaemia at admission in acute coronary syndrome patients: prognostic value in diabetics and non-diabetics. Eur J Cardiovasc Prev Rehabil 2010;17:155-9.
• 25. Demir M, Özbek M. A novel predictor in patients with coronary chronic total occlusion: systemic immune-inflammation index: a single-center cross-sectional study. Rev Assoc Med Bras (1992) 2022;68:579-85.
• 26. Khan Q, Sachdeva R, Malhotra A, Reddy R, Sukhija R, et al. 199 Hyperglycemia predicts failure in percutaneous intervention of coronary chronic total occlusıon. Journal of Investigative Medicine (2007), 55(1), S279.
• 27. Song Y, Cui K, Yang M, Song C, Yin D, Dong Q, et al. High triglyceride-glucose index and stress hyperglycemia ratio as predictors of adverse cardiac events in patients with coronary chronic total occlusion: a large-scale prospective cohort study. Cardiovasc Diabetol 2023;22:180.