St elevasyonlu miyokard enfarktüslü hastalarda enfarktüsle ilişkili arter açıklığı ile primer perkütan koroner girişim öncesi c-reaktif protein/ albümin oranı arasındaki ilişki

Öz

Amaç: C-reaktif protein ve Albumin gibi inflamatuar markerlar STEM’de daha önce kötü prognoz ile ilşkilendirilmiştir. Çalışmamızda ST elevasyonlu miyokard enfarktüsü (STEMI) geçiren hastalarda pirmer Perkütan Girişim (p-PKG) öncesi enfarktüsten sorumlu koroner arter açıklığı ile C-reaktif protein/Albumin oranı (CAR) arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: STEMI nedeni ile p-PKG uygulanmış 822 hasta çalışmaya dahil edildi. Hastalar IRA açıklığına göre TIMI akım 0-1 (n=551) ve TIMI akım 2-3 (n=271) olarak iki gruba ayrıldı. Başvuru sırasında ölçülen CAR oranı, IRA açıklığı ile karşılaştırıldı. Bulgular: 822 hastanın yaş ortalaması 55±12’ di ve %84,3 (693)’ ü erkekti. Tüm çalışma hastalarının ortalama CAR düzeyi 0.26 (0.08-0.48) olarak tespit edildi. CAR düzeyi TIMI akım 0-1 grubunda TIMI akım 2-3 grubuna göre istatiksel anlamlılıkla daha yüksek bulundu [0.31 (0.09-0.51) vs 0.23 (0.06-0.42); p<0.001]. Yapılan multivariete lojistik regresyon analizinde CAR (odds ratio [OR]:1.56, 95% confidence interval [CI]:1.22-1.97, p<0.001) ve nötrofil sayısı (OR:1.72, 95% CI:1.33-2.25, p<0,001) TIMI 0-1 akım ile arasında anlamlı ilişki saptanmıştır. Sonuç: Anterior STEMI hastalarında başvuru sırasında ölçülen inflamasyona dayalı bir risk indeksi olan CAR, olumsuz kardiyovasküler sonuçları tahmin etmek için yararlı bir prognostik araç olduğu bulunmuştur. Bununla birlikte, bu bulgunun gelecekteki prospektif çalışmalarda doğrulanması gerekmektedir

Anahtar Kelimeler

• C-reaktif protein/albümin oranı
• İnfaktüsten sorumlu koroner arter açıklığı
• ST elevasyonlu miyokard infarktüsü

The relationship between infarct-related arteries patency with c-reactive protein/albumin ratio before primary percutaneous coronary intervention in patients with st-segment elevation myocardial infarction

Öz

Aim: Inflammatory markers such as C-reactive protein and Albumin have previously been associated with poor prognosis in ST-elevation myocardial infarction (STEMI). The present study aims to investigate the relationship between the infarct-related arteries (IRA) patency and C-reactive protein/Albumin ratio (CAR) before primary percutaneous coronary intervention (p-PCI) in patients with STEMI. Material and Methods: A total of 822 patients who underwent p-PCI for acute STEMI were included in this study. Patients were divided into two groups according to IRA patency as TIMI flow 0-1 (n = 551) and TIMI flow 2-3 (n = 271). CAR ratio measured at admission was compared with IRA patency. Results: The average age of 822 patients was 55±12, and 84.3% (693) of the patients were male. The mean CAR level of the patients was determined as 0.26 (0.08-0.48). CAR level was statistically significantly higher in TIMI flow 0-1 group when compared to TIMI flow 2-3 group [0.31 (0.09-0.51) vs 0.23 (0.06-0.42); p<0.001]. In the multivariate logistic regression analysis a significant relation was found between CAR (odds ratio [OR]:1.56, 95% confidence interval [CI]:1.22-1.97, p<0.001), and neutrophil count (OR:1.72, 95% CI:1.33-2.25, p<0.001) in patients with TIMI flow 0-1 Conclusion: An inflammation-based risk index, CAR measured at admission in patients with anterior STEMI has been found to be a useful prognostic tool for predicting adverse cardiovascular outcomes. However, this finding needs to be confirmed in future prospective studies.

Anahtar Kelimeler

• C-reactive protein/albumin ratio
• infarct-related arteries
• ST-elevation myocardial infarction

Kaynakça

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