ST-segment yükselmesiz miyokard enfarktüslü hastalarda serum ürik asit/albümin oranı ile tamamen tıkalı enfarkt ilişkili arter arasındaki ilişki

Amaç: Akut koroner sendromlu hastalarda, primer perkütan koroner girişim (PKG) öncesi enfarkt ilişkili arter (EİA) açıklığı, daha iyi klinik sonlanımlar ve düşük mortalite ile ilişkilidir. Bu çalışmada, ST-segment yükselmesiz miyokard enfarktüslü (NSTEMI) hastalarda serum ürik asit/albümin oranı (UAR) ve EİA açıklığı arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Toplam 430 ardışık NSTEMI hastası geriye dönük olarak değerlendirildi. Çalışma popülasyonu, PKG öncesi Miyokard Enfarktüsünde Tromboliz (TIMI) akış derecesi ile değerlendirilen EİA açıklığına göre 2 gruba ayrıldı. Tamamen tıkalı EİA TIMI derece 0/1 olarak tanımlandı ve patent EİA TIMI 2/3 olarak tanımlandı. Bulgular: İşlem öncesi 110 (%25.5) hastada EİA tıkalı olarak bulundu. EİA tıkalı olan grupta, patent olan gruba göre UAR düzeyi (p=<0.001) daha yüksek saptandı. Regresyon analizi UAR (OR:3.125, %95 GA:1.186-8.232; p<0.001), sol ventrikül ejeksiyon fraksiyonu (OR:0.917, %95 GA:0.885-0.951; p<0.001) ve sorumlu arter çapının (OR:0.917, %95 GA:0.885-0.951; p<0.001) tıkalı bir EİA için bağımsız öngördürücüleri olduğunu ortaya koydu. >1.40’lık bir UAR eşik değerinin, %62.7 duyarlılık ve %63.8 özgüllük ile tıkalı bir EİA’yı öngördüğü bulundu (AUC: 0.722, %95 GA: 0.671-0.773; p<0.001). Sonuç: UAR, NSTEMI’li hastalarda işlem öncesi EİA açıklığının bağımsız bir öngördürücüsüdür. Böylece, UAR acil invaziv stratejiden (<2 saat) fayda görecek yüksek riskli NSTEMI hastalarını belirlemede kolay erişilebilir bir parametre olabilir.

Anahtar Kelimeler:

serum ürik asit/albümin oranı, ST yükselmesiz miyokard enfarktüsü, enfarkt ilişkili arter

Association of serum uric acid/albumin ratio with completely occluded infarct-related artery in patients with non-ST-segment elevation myocardial infarction

Aim: Infarct-related artery (IRA) patency before primary percutaneous coronary intervention (pPCI) is linked to improved clinical outcomes and lower mortality in patients with acute coronary syndrome. The purpose of this research was to examine the association between serum uric acid/albumin ratio (UAR) and IRA patency in patients with non-ST-segment elevation myocardial infarction (NSTEMI).Material and Method: We evaluated 430 consecutive patients with NSTEMI in total retrospectively. The study population was divided into 2 groups according to the IRA patency as assessed by the degree of Thrombolysis in Myocardial Infarction (TIMI) flow before pPCI. As a result, completely occluded IRA was defined as TIMI grade 0-1, while patent IRA was defined as TIMI grade 2-3.Results: IRA was found to be occluded in 110 (25.5%) patients prior to the procedure. UAR level (p=<0.001) was found to be higher among the patients with IRA occlusion when compared to the patent group. Regression analysis revealed that UAR (OR:3.125; 95% CI:1.186-8.232, p<0.001), left ventricular ejection fraction (OR:0.917, 95% CI:0.885-0.951, p<0.001) and culprit artery diameter (OR:0.917, 95% CI:0.885-0.951, p<0.001) were independent predictors for an occluded IRA. An UAR cut-off value of >1.40 was detected to prognosticate the occluded IRA with 62.7% sensitivity and 63.8% specificity (AUC: 0.722, 95% CI: 0.671-0.773, p<0.001).Conclusion: UAR is an independent predictor of preprocedural IRA patency in patients with NSTEMI. Thus, UAR may be an easily accessible parameter to diagnose high-risk NSTEMI patients who would benefit from an immediate invasive strategy (<2 hours).

Keywords:

Serum uric acid/albumin ratio, infarct-related artery, non-ST elevation myocardial infarction,

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