Kardiyojenik Şok ile Komplike Olmuş ST Yükselmeli Miyokard Enfarktüslü Hastalarda C-reaktif Proteinin Albümin Oranına Prognostik Etkinliği

ÖZGİRİŞ ve AMAÇ: Bu çalışmada, yakın zamanda geliştirilen enflamasyon dayalı risk indeksi olan C-reaktif proteinin (CRP) /Albümin oranının (CAR), pompa yetersizliğine bağlı kardiyojenik şok ile komplike olmuş ST yükselmeli miyokard enfarktüs hastalarında (STYME) prognostik bir değere sahip olup olmadığını araştırmayı amaçladık.YÖNTEM ve GEREÇLER: Primer perkutan koroner girişim uygulanmış ve kardiyojenik şok ile komplike olmuş 79 ardışık STYME hastası geriye dönük olarak çalışmaya alındı.BULGULAR: Hastane içi takip sırasında 79 hastanın 40'ı (% 50,6) öldü. Ortalama CAR değeri sağ kalımı olmayanlarda sağ kalanlarına göre anlamlı derecede yüksekti (8.58 [4.68–12.25] vs. 4.67 [4.21–6.03]; p

Prognostic Efficacy of C-reactive Protein to Albumin Ratio in Patients with ST Elevation Myocardial Infarction Complicated by Cardiogenic Shock

ABSTRACTINTRODUCTION: In this study, we aimed to investigate whether C-reactive protein (CRP) to albumin ratio (CAR), recently developed inflammation based risk index, has aprognostic value in patients with ST elevation myocardial infarction (STEMI) complicated by cardiogenic shock due to a pump failure.METHODS: We retrospectively enrolled 79 consecutive STEMI patients who underwent a primary percutaneous coronary intervention and complicated by cardiogenic shock.RESULTS: During the in-hospital course, 40 of the 79 patients (50.6%) died. The mean value of CAR was significantly higher in patients with non-survivors than thosewho survived (8.58 [4.68–12.25] vs. 4.67 [4.21–6.03]; p

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  • 1. Bisoendial RJ, Boekholdt SM, Vergeer M, Stroes ES, Kastelein JJ. C-reactive protein is a mediator of cardiovascular disease. Eur Heart J. 2010; 31:2087-91.
  • 2. Akkus MN, Polat G, Yurtdas M, Akcay B, Ercetin N, Cicek D, et al. Admission levels of Creactive protein and plasminogen activator inhibitor1 in patients with acute myocardial infarction with and without cardiogenic shock or heart failure on admission. Int Hear J. 2009; 50:33–45.
  • 3. Van Diepen S, Newby LK, Lopes RD, Stebbins A, Hasselblad V, James S, et al. Prognostic relevance of baseline pro- and anti-inflammatory markers in STEMI: An APEX AMI substudy. Int J Cardiol. 2013; 168:2127–33.
  • 4. Brunetti ND, Pellegrino PL, Correale M, De Gennaro L, Cuculo A, Di Biase M. Acute phase proteins and systolic dysfunction in subjects with acute myocardial infarction. J Thromb Thrombolysis. 2008; 26:196–202.
  • 5. Nelson JJ, Liao D, Sharrett AR, Folsom AR, Chambless LE, Shahar E, et al. Serum albumin level as a predictor of incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000; 151:468–77.
  • 6. Oduncu V, Erkol A, Karabay CY, Kurt M, Akgün T, Bulut M, et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013; 24:88–94.
  • 7. Fairclough E, Cairns E, Hamilton J, Kelly C. Evaluation of a modified early warning system for acute medical admissions and comparison with Creactive protein/albumin ratio as a predictor of patient outcome. Clin Med. 2009; 9:30-3.
  • 8. Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-Reactive Protein/Albumin Ratio Predicts 90-Day Mortality of Septic Patients. Salluh JIF, editor. PLoS One. 2013; 8:e59321.
  • 9. Kinoshita A, Onoda H, Imai N, Iwaku A, Oishi M, Tanaka K, et al.The C-reactive protein/albumin ratio, a novel inflammation-based prognostic score, predicts outcomes in patients with hepatocellular carcinoma. Ann Surg Oncol. 2015; 22:803–10.
  • 10. 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: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018; 39:119-77.
  • 11. Gibson CM, de Lemos JA, Murphy SA, Marble SJ, McCabe CH, Cannon CP, et al. Combination therapy with abciximab reduces angiographically evident thrombus in acute myocardial infarction: a TIMI 14 substudy. Circulation. 2001; 103:2550–4.
  • 12. Fox KA, Steg PG, Eagle KA, Goodman SG, Anderson FA Jr, Granger CB, et al. Decline in rates of death and heart failure in acute coronary syndromes, 1999-2006. JAMA. 2007; 297:1892– 1900.
  • 13. Alonso DR, Scheidt S, Post M, Killip T. Pathophysiology of cardiogenic shock. Quantification of myocardial necrosis, clinical, pathologic and electrocardiographic correlations. Circulation. 1973; 48:588–96.
  • 14. Gąsior M, Pres D, Gierlotka M, Hawranek M, Słonka G, Lekston A, et al.The influence of diabetes on in−hospital and long−term mortality in patients with myocardial infarction complicated by cardiogenic shock: results from the PL−ACS registry. KardiolPol. 2012; 70:1215–24.
  • 15. Kuroki N, Abe D, Iwama T, Sugiyama K, Akashi A, Hamabe Y, et al. Prognostic effect of estimated glomerular filtration rate in patients with cardiogenic shock or cardiac arrest undergoing percutaneous veno-arterial extracorporeal membrane oxygenation. J Cardiol. 2016; 68: 439-46.
  • 16. Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH. Prospective Study of C-Reactive Protein and the Risk of Future Cardiovascular Events Among Apparently Healthy Women. Circulation. 1998; 98:731–3.
  • 17. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med. 1997; 336:973–9.
  • 18. Makrygiannis SS, Ampartzidou OS, Zairis MN, Patsourakos NG, Pitsavos C, Tousoulis D, et al. Prognostic usefulness of serial c-reactive protein measurements in st-elevation acute myocardial infarction. Am J Cardiol. 2013; 111:26–30.
  • 19. Lim SY, Jeong MH, Bae EH, Kim W, Kim JH, Hong YJ, et al. Predictive factors of major adverse cardiac events in acute myocardial infarction patients complicated by cardiogenic shock undergoing primary percutaneous coronary intervention. Circ J. 2005; 69:154–8.
  • 20. Kurtul A, Murat SN, Yarlioglues M, Duran M, Ocek AH, Koseoglu C, et al. Usefulness of Serum Albumin Concentration to Predict High Coronary SYNTAX Score and In-Hospital Mortality in Patients With Acute Coronary Syndrome. Angiology. 2016; 67:34–40.
  • 21. Kurtul A, Ocek AH, Murat SN, Yarlioglues M, Demircelik MB, Duran M, et al. Serum albumin levels on admission are associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Angiology. 2015; 66:278–85.
  • 22. Bisoendial RJ, Kastelein JJP, Peters SLM, Levels JH, Birjmohun R, Rotmans JI, et al. Effects of CRP infusion on endothelial function and coagulation in normocholesterolemic and hypercholesterolemic subjects. J Lipid Res. 2007; 48:952–60.
  • 23. Purdon AD, Rao AK. Interaction of albumin, arachidonic acid and prostanoids in platelets. Prostaglandins, Leukot Essent Fat Acids. 1989; 35:213–8.
Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -