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Lökoglisemik İndeks Akut Miyokard Enfarktüsünde Mortaliteyi Öngördürücü Benzersiz Bir Parametre Olabilir

Yıl 2023, , 118 - 123, 16.03.2023
https://doi.org/10.31832/smj.1222605

Öz

Amaç: Akut miyokard enfarktüsünde (AME) yüksek riskli hastaları öngörmek çok önemlidir. Bu çalışmada lökoglisemik indeksin (LGI) AME'de hastane içi mortaliteyi öngörmede benzersiz bir yeteneği olup olmadığını araştırmayı ve diğer inflamatuar parametrelerle karşılaştırmayı amaçlanmıştır.
Gereç ve Yöntemler: Bu tek merkezli çalışmada, hastaneye yatırılan ve tek operatör tarafından takip edilen tüm AME hastalarını retrospektif olarak inceledik. Hastalar hastane içi ölüm sonuçlarına göre ikiye ayrıldı. Diğer inflamatuar parametreler (sistemik immun-inflamatuar indeks, platelet-lenfosit oranı, nötrofil-lenfosit oranı, trigliserit-HDL oranı ve LDL-HDL oranı), C-reaktif protein (CRP) ve LGI daha önce açıklanan kriterlere göre hesaplandı. Bağımsız yordayıcıları bulmak için tek değişkenli ve çok değişkenli lojistik regresyon analizi kullanıldı. Mortaliteyi öngörmede LGI ve diğer parametrelerin kestirim noktasını bulmak için receiver operator characteristic (ROC) eğrisi kullanıldı.
Bulgular: Çalışmaya toplam 304 AMI hastası dahil edildi. Ortalama yaş 62,18±11,89 olup hastaların 74'ü (%24,3) kadındı. Toplam ölüm oranı 19 (%6,3) idi. Tek değişkenli değişken analizinde LGI, mortalitenin anlamlı bir yordayıcısı olarak bulundu (p<0.001). Çok değişkenli analizde risk faktörleri (yaş, koroner arter hastalığı öyküsü, ejeksiyon fraksiyonu, CHA2DS2VASc skoru, kreatinin ve CRP) modele eklendikten sonra LGI, kısa vadeli mortalitenin önemli bir göstergesi olarak bulundu. ROC eğrisi analizi, eğri altında kalan alanın 0,837 (0,704-0,971) olduğunu, duyarlılığın %76,5 ve özgüllüğün %91,5 olduğunu ve 3,39 cut-off değerini gösterdi.
Sonuç: Çalışmamız, LGI'nin AMI'de kısa vadeli mortaliteyi tahmin etmede diğer parametrelere göre benzersiz bir parametre olabileceğini gösterdi.

Kaynakça

  • 1 Antman EM, Cohen M, Bernink PJLM, McCabe CH, Horacek T, Papuchis G et al. The TIMI Risk Score for Unstable Angina/Non–ST Elevation MI: A Method for Prognostication and Therapeutic Decision Making. JAMA 2000; 284: 835–842.
  • 2 Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP et al. Predictors of Hospital Mortality in the Global Registry of Acute Coronary Events. Arch Intern Med 2003; 163: 2345–2353.
  • 3 DA M, N R, EM A, DL W, CH M, CP C et al. C-reactive protein is a potent predictor of mortality independently of and in combination with troponin T in acute coronary syndromes: a TIMI 11A substudy. Thrombolysis in Myocardial Infarction. J Am Coll Cardiol 1998; 31: 1460–1465.
  • 4 M G, D F, F G, F O. Cardiac markers and risk stratification: an integrated approach. Clin Chim Acta 2001; 311: 9–17.
  • 5 Shen XH, Chen Q, Shi Y, Li HW. Association of neutrophil/lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Chin Med J (Engl) 2010; 123: 3438–3443.
  • 6 Çırakoğlu ÖF, Yılmaz AS. Systemic immune-inflammation index is associated with increased carotid intima-media thickness in hypertensive patients. Clinical and Experimantal Hypertension 2021; 43: 565–571.
  • 7 M C, E K, S N, A Ş. Relationship Between Systemic Immune-Inflammation Index (SII) and the Severity of Stable Coronary Artery Disease. Angiology 2021; 72: 575–581.
  • 8 B H, XR Y, Y X, YF S, C S, W G et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20: 6212–6222.
  • 9 Hansson GK. Inflammation, Atherosclerosis, and Coronary Artery Disease. http://dx.doi.org/101056/NEJMra043430 2009; 352: 1685–1695.
  • 10 Karahan S, Okuyan E. Systemic Inflammatory Index and Platelet-to-Lymphocyte Ratio Predict Mortality in Patients with Acute Myocardial Infarction. 2021; : 146–153.
  • 11 Zhang R, Fan Y, Xue Y, Feng Y, Dong C, Wang Y et al. The LDL/HDL ratio predicts long-term risk of coronary revascularization in ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: a cohort study. Brazilian Journal of Medical and Biological Research 2022; 55. doi:10.1590/1414-431X2021E11850.
  • 12 Chen HC, Lee WC, Fang HY, Fang CY, Chen CJ, Yang CH et al. Impact of high triglyceride/high-density lipoprotein cholesterol ratio (insulin resistance) in ST-segment elevation myocardial infarction. Medicine 2020; 99: e22848.
  • 13 Padilla-Cueto D, Hernández-Negrín H, Ramírez-Gómez JI, Pérez-Valdivia A, Cárdenas-Sánchez AL, Alfonso-Izquierdo A. The leucoglycaemic index is a predictor of all-cause mortality per year in Cuban patients with ST-segment elevation acute myocardial infarction. CorSalud 2019; 11: 21–29.
  • 14 Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2018; 39: 119–177.
  • 15 Collet JP, Thiele H, Barbato E, Bauersachs J, Dendale P, Edvardsen T et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021; 42: 1289–1367.
  • 16 Ates AH, Canpolat U, Yorgun H, Kaya EB, Sunman H, Demiri E et al. Total white blood cell count is associated with the presence, severity and extent of coronary atherosclerosis detected by dual-source multislice computed tomographic coronary angiography. Cardiol J 2011; 18: 371–377.
  • 17 T K, A Ç, E V, E A, ZI A, M K et al. Association of Lymphocyte-to-Monocyte Ratio With the Mortality in Patients With ST-Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Angiology 2017; 68: 707–715. 18 J T, M T, DE B, M F, W K, J W et al. C-reactive protein frequently colocalizes with the terminal complement complex in the intima of early atherosclerotic lesions of human coronary arteries. Arterioscler Thromb Vasc Biol 1998; 18: 1386–1392.
  • 19 Oylumlu M, Yıldız A, Oylumlu M, Yüksel M, Polat N, Bilik MZ et al. Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi 2015; 15: 277–283.
  • 20 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: 1–11.
  • 21 Huang J, Zhang Q, Wang R, Ji H, Chen Y, Quan X et al. Systemic immune-inflammatory index predicts clinical outcomes for elderly patients with acute myocardial infarction receiving percutaneous coronary intervention. Medical Science Monitor 2019; 25: 9690–9701.
  • 22 Qi LY, Liu HX, Cheng LC, Luo Y, Yang SQ, Chen X et al. Prognostic Value of the Leuko-Glycemic Index in Acute Myocardial Infarction Patients with or without Diabetes. Diabetes Metab Syndr Obes 2022; 15: 1725–1736.
  • 23 Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 2002; 106: 2067–2072.
  • 24 Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T et al. Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2008; 117: 1610–1619.
  • 25 Kılıç O, Buber I, Kahraman F. Predicting the Severity of Coronary Artery Disease: Can the Leukocyte Glucose Index be Used? Journal of the College of Physicians and Surgeons Pakistan 2022; 32: 1519–1523.

Leukoglycemic Index may be a Unique Parameter to Predict Mortality in Patients with Acute Myocardial Infarction: Single Operator Experience

Yıl 2023, , 118 - 123, 16.03.2023
https://doi.org/10.31832/smj.1222605

Öz

Background and Aim: Predicting high-risk patients is crucial in acute myocardial infarction (AMI). We aimed to investigate whether the leukoglycemic index (LGI) has a unique ability and to compare it with other inflammatory parameters in predicting in-hospital mortality in AMI.
Methods: In this single-center study, we retrospectively analyzed all AMI patients hospitalized and followed by a single operator. Patients were divided into two according to in-hospital outcomes. Other inflammatory parameters (systemic immune-inflammatory index, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, triglyceride-HDL ratio, and LDL-HDL ratio), C-reactive protein (CRP), and LGI were calculated according to previously described criteria. Univariable and multivariable logistic regression analyses were used to find independent predictors. The receiver operating characteristic (ROC) curve was used to find the cut-off point of LGI and other parameters in predicting mortality.
Results: A total of 304 patients with AMI were included in the study. The mean age was 62.18±11.89 and 74 (24.3%) of patients were female. The total death rate was 19 (6.3%). In univariate variable analysis, LGI was found as a significant predictor of mortality (p<0.001). After adjusting risk factors (age, coronary artery disease history, ejection fraction, CHA2DS2VASc score, creatinine, and CRP) in multivariable analysis, LGI was still found as a significant predictor of short-term mortality. ROC curve analysis showed that the area under the curve was 0.837 (0.704-0.971) with a sensitivity of 76.5% and with a specificity of 91.5% with a 3.39 cut-off value.
Conclusion: Our study showed that LGI might be a unique parameter in predicting short-term mortality in AMI.

Kaynakça

  • 1 Antman EM, Cohen M, Bernink PJLM, McCabe CH, Horacek T, Papuchis G et al. The TIMI Risk Score for Unstable Angina/Non–ST Elevation MI: A Method for Prognostication and Therapeutic Decision Making. JAMA 2000; 284: 835–842.
  • 2 Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP et al. Predictors of Hospital Mortality in the Global Registry of Acute Coronary Events. Arch Intern Med 2003; 163: 2345–2353.
  • 3 DA M, N R, EM A, DL W, CH M, CP C et al. C-reactive protein is a potent predictor of mortality independently of and in combination with troponin T in acute coronary syndromes: a TIMI 11A substudy. Thrombolysis in Myocardial Infarction. J Am Coll Cardiol 1998; 31: 1460–1465.
  • 4 M G, D F, F G, F O. Cardiac markers and risk stratification: an integrated approach. Clin Chim Acta 2001; 311: 9–17.
  • 5 Shen XH, Chen Q, Shi Y, Li HW. Association of neutrophil/lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Chin Med J (Engl) 2010; 123: 3438–3443.
  • 6 Çırakoğlu ÖF, Yılmaz AS. Systemic immune-inflammation index is associated with increased carotid intima-media thickness in hypertensive patients. Clinical and Experimantal Hypertension 2021; 43: 565–571.
  • 7 M C, E K, S N, A Ş. Relationship Between Systemic Immune-Inflammation Index (SII) and the Severity of Stable Coronary Artery Disease. Angiology 2021; 72: 575–581.
  • 8 B H, XR Y, Y X, YF S, C S, W G et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014; 20: 6212–6222.
  • 9 Hansson GK. Inflammation, Atherosclerosis, and Coronary Artery Disease. http://dx.doi.org/101056/NEJMra043430 2009; 352: 1685–1695.
  • 10 Karahan S, Okuyan E. Systemic Inflammatory Index and Platelet-to-Lymphocyte Ratio Predict Mortality in Patients with Acute Myocardial Infarction. 2021; : 146–153.
  • 11 Zhang R, Fan Y, Xue Y, Feng Y, Dong C, Wang Y et al. The LDL/HDL ratio predicts long-term risk of coronary revascularization in ST-segment elevation myocardial infarction patients undergoing percutaneous coronary intervention: a cohort study. Brazilian Journal of Medical and Biological Research 2022; 55. doi:10.1590/1414-431X2021E11850.
  • 12 Chen HC, Lee WC, Fang HY, Fang CY, Chen CJ, Yang CH et al. Impact of high triglyceride/high-density lipoprotein cholesterol ratio (insulin resistance) in ST-segment elevation myocardial infarction. Medicine 2020; 99: e22848.
  • 13 Padilla-Cueto D, Hernández-Negrín H, Ramírez-Gómez JI, Pérez-Valdivia A, Cárdenas-Sánchez AL, Alfonso-Izquierdo A. The leucoglycaemic index is a predictor of all-cause mortality per year in Cuban patients with ST-segment elevation acute myocardial infarction. CorSalud 2019; 11: 21–29.
  • 14 Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2018; 39: 119–177.
  • 15 Collet JP, Thiele H, Barbato E, Bauersachs J, Dendale P, Edvardsen T et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021; 42: 1289–1367.
  • 16 Ates AH, Canpolat U, Yorgun H, Kaya EB, Sunman H, Demiri E et al. Total white blood cell count is associated with the presence, severity and extent of coronary atherosclerosis detected by dual-source multislice computed tomographic coronary angiography. Cardiol J 2011; 18: 371–377.
  • 17 T K, A Ç, E V, E A, ZI A, M K et al. Association of Lymphocyte-to-Monocyte Ratio With the Mortality in Patients With ST-Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Angiology 2017; 68: 707–715. 18 J T, M T, DE B, M F, W K, J W et al. C-reactive protein frequently colocalizes with the terminal complement complex in the intima of early atherosclerotic lesions of human coronary arteries. Arterioscler Thromb Vasc Biol 1998; 18: 1386–1392.
  • 19 Oylumlu M, Yıldız A, Oylumlu M, Yüksel M, Polat N, Bilik MZ et al. Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi 2015; 15: 277–283.
  • 20 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: 1–11.
  • 21 Huang J, Zhang Q, Wang R, Ji H, Chen Y, Quan X et al. Systemic immune-inflammatory index predicts clinical outcomes for elderly patients with acute myocardial infarction receiving percutaneous coronary intervention. Medical Science Monitor 2019; 25: 9690–9701.
  • 22 Qi LY, Liu HX, Cheng LC, Luo Y, Yang SQ, Chen X et al. Prognostic Value of the Leuko-Glycemic Index in Acute Myocardial Infarction Patients with or without Diabetes. Diabetes Metab Syndr Obes 2022; 15: 1725–1736.
  • 23 Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 2002; 106: 2067–2072.
  • 24 Deedwania P, Kosiborod M, Barrett E, Ceriello A, Isley W, Mazzone T et al. Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2008; 117: 1610–1619.
  • 25 Kılıç O, Buber I, Kahraman F. Predicting the Severity of Coronary Artery Disease: Can the Leukocyte Glucose Index be Used? Journal of the College of Physicians and Surgeons Pakistan 2022; 32: 1519–1523.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Fatih Kahraman 0000-0003-3860-2755

Halil İbrahim Durmuş 0000-0003-2499-9464

Oğuz Kılıç 0000-0002-5126-0959

Yayımlanma Tarihi 16 Mart 2023
Gönderilme Tarihi 21 Aralık 2022
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

AMA Kahraman F, Durmuş Hİ, Kılıç O. Leukoglycemic Index may be a Unique Parameter to Predict Mortality in Patients with Acute Myocardial Infarction: Single Operator Experience. Sakarya Tıp Dergisi. Mart 2023;13(1):118-123. doi:10.31832/smj.1222605

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