Yavuz Karabağ1, Metin Çağdaş1, Ibrahim Rencuzogullari1, Süleyman Karakoyun1, İnanç Artaç1, Doğan İliş1, Mahmut Yesin2, Öznur Sadioğlu Çağdaş3, Bernas Altıntaş4, Cengiz Burak5, Halil Ibrahim Tanboğa6. 1. Department of Cardiology, Kafkas University Medical Faculty, Kars, Turkey. 2. Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey. 3. Department of Internal medicine, Kars Harakani State Hospital, Kars, Turkey. 4. Department of Cardiology, Diyarbakır Education and Research Hospital, Diyarbakır, Turkey. 5. Department of Cardiology, Midyat State Hospital, Mardin, Turkey. 6. Department of Cardiology, Ataturk University Medical Faculty, Erzurum, Turkey.
Abstract
BACKGROUND: The ratio of serum C-reactive protein (CRP) to albumin has been proven to be a more accurate indicator than albumin and CRP levels alone in determining the prognosis of patients with cancer and critical illness. The aim of this study was to determine whether the CRP/albumin ratio (CAR) can be linked to imperfect reperfusion that can worsen the prognosis of ST-elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (pPCI). MATERIALS AND METHODS: A total of 1217 consecutive STEMI patients who achieved epicardial vessel patency with pPCI were recruited to this study. RESULTS: The study population was divided into 2 groups: reflow (n = 874) and no-reflow (NR) (n = 343) groups. The white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR) and CAR (0.03 [0.01-0.04] vs 0.06 [0.03-0.12] (P < .001) were significantly higher in the NR group than in the reflow group, and these factors were found to be independent predictors of NR development. The best cut-off value of CAR predicting NR was 0.59 with a sensitivity of 54.7% and specificity of 86.7. The predictive power of CAR surpassed that of CRP, albumin, WBC count and NLR in the receiver operator curve (ROC) curve comparison. CONCLUSION: No-reflow can be predicted by systemic inflammation markers including WBC count, NLR and CAR measured from the blood sample obtained on admission. CAR has a higher clinical value than CRP, albumin level, WBC count and NLR in NR prediction.
BACKGROUND: The ratio of serum C-reactive protein (CRP) to albumin has been proven to be a more accurate indicator than albumin and CRP levels alone in determining the prognosis of patients with cancer and critical illness. The aim of this study was to determine whether the CRP/albumin ratio (CAR) can be linked to imperfect reperfusion that can worsen the prognosis of ST-elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (pPCI). MATERIALS AND METHODS: A total of 1217 consecutive STEMI patients who achieved epicardial vessel patency with pPCI were recruited to this study. RESULTS: The study population was divided into 2 groups: reflow (n = 874) and no-reflow (NR) (n = 343) groups. The white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR) and CAR (0.03 [0.01-0.04] vs 0.06 [0.03-0.12] (P < .001) were significantly higher in the NR group than in the reflow group, and these factors were found to be independent predictors of NR development. The best cut-off value of CAR predicting NR was 0.59 with a sensitivity of 54.7% and specificity of 86.7. The predictive power of CAR surpassed that of CRP, albumin, WBC count and NLR in the receiver operator curve (ROC) curve comparison. CONCLUSION: No-reflow can be predicted by systemic inflammation markers including WBC count, NLR and CAR measured from the blood sample obtained on admission. CAR has a higher clinical value than CRP, albumin level, WBC count and NLR in NR prediction.
Authors: Muhammed Süleymanoğlu; İbrahim Rencüzoğulları; Yavuz Karabağ; Metin Çağdaş; Mahmut Yesin; Ayça Gümüşdağ; Murat Çap; Murat Gök; İbrahim Yıldız Journal: Int J Cardiovasc Imaging Date: 2020-01-09 Impact factor: 2.357