The relationship between serum uric acid to HDL-C ratio and the SYNTAX score in patients with acute coronary syndrome

Öz

Aim: The SYNTAX score is an essential angiographic scoring system that evaluates the complexity of coronary artery disease (CAD) and helps guide decision-making between coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). Elevated uric acid (UA) and reduced high-density lipoprotein cholesterol (HDL-C) have been linked to adverse cardiovascular events. The UA to HDL-C ratio (UHR) has been proposed as a biomarker for metabolic dysregulation and inflammation. This study aims to investigate the relationship between UHR and SYNTAX score in patients with acute coronary syndrome (ACS). Material and Methods: This retrospective study included 536 patients with ACS from three hospitals in Turkey, who underwent coronary angiography. Patients with chronic kidney disease, prior PCI/CABG, or on statins were excluded. Clinical data and biochemical parameters, including UA and HDL-C, were collected. The SYNTAX score was calculated using an online tool. Multivariate logistic regression was conducted to determine predictors of a high SYNTAX score (>22). Results: The mean SYNTAX score was 17.60 ± 8.57. Diabetes mellitus (OR: 1.911, p=0.013) and reduced left ventricular ejection fraction (LVEF) (OR: 0.951, p<0.001) were independently associated with a high SYNTAX score. UHR was not significantly associated with coronary complexity. Conclusion: UHR was not found to be a predictor for high SYNTAX score in ACS patients. These findings suggest that while UHR may reflect metabolic dysregulation, it may not be a reliable biomarker for coronary complexity in this patient population. Further studies are needed to explore UHR’s role in different cardiovascular settings.

Anahtar Kelimeler

• Uric acid
• HDL cholesterol
• coronary artery disease
• acute coronary syndrome

Akut koroner sendromlu hastalarda serum ürik asit / HDL-K oranı ile SYNTAX skoru ile değerlendirilen koroner arter hastalığı kompleksitesi arasındaki ilişki

Öz

Amaç: SYNTAX skoru, koroner arter hastalığı (KAH) kompleksitesini değerlendiren önemli bir anjiyografik araç olup, koroner arter bypass greftleme (KABG) ve perkütan koroner girişim (PKG) arasında karar vermede rehberlik eder. Yüksek ürik asit (ÜA) ve düşük yüksek yoğunluklu lipoprotein kolesterol (HDL-K) seviyeleri olumsuz kardiyovasküler olaylarla ilişkilidir. ÜA/ HDL-K oranı (ÜHO), metabolik disregülasyon ve inflamasyonun bir biyobelirteçi olarak önerilmiştir. Bu çalışmanın amacı, akut koroner sendrom (AKS) hastalarında ÜHO ile SYNTAX skoru arasındaki ilişkiyi incelemektir. Gereç ve Yöntemler: Retrospektif çalışmaya Türkiye’den üç merkezde AKS tanısı alan ve koroner anjiyografi yapılan 536 hasta dahil edilmiştir. Kronik böbrek hastalığı, geçirilmiş PKG/KABG veya statin tedavisi alan hastalar dışlanmıştır. Klinik veriler ve ÜA, HDL-K gibi biyokimyasal parametreler toplandı. SYNTAX skoru çevrimiçi bir hesaplama aracıyla belirlendi. Yüksek SYNTAX skorunun (>22) bağımsız öngördürücülerini belirlemek için çok değişkenli lojistik regresyon analizi yapıldı. Bulgular: Ortalama SYNTAX skoru 17.60 ± 8.57 bulundu. Diyabetes mellitus (OR: 1.911, p=0.013) ve düşük sol ventrikül ejeksiyon fraksiyonu (LVEF) (OR: 0.951, p<0.001), yüksek SYNTAX skoru ile bağımsız olarak ilişkilendirildi. ÜHO, koroner kompleksite ile anlamlı bir ilişki göstermedi. Sonuç: Çalışmamızda ÜHO’ nun, AKS hastalarında yüksek SYNTAX skorunu öngörmede etkili bir biyobelirteç olduğu saptanmamıştır. ÜHO' nun metabolik bozukluğu yansıttığı görülse de, bu hasta grubunda koroner kompleksiteyi öngörmek için güvenilir bir biyobelirteç olmayabilir. ÜHO'nun farklı kardiyovasküler durumlarda rolünü araştırmak için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Ürik asit
• HDL kolesterol
• koroner arter hastalığı
• akut koroner sendrom

Kaynakça

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