Fatih KAHRAMAN, Halil İbrahim DURMUŞ, Oğuz KILIÇ

Lökoglisemik İndeks Akut Miyokard Enfarktüsünde Mortaliteyi Öngördürücü Benzersiz Bir Parametre Olabilir

Amaç: Akut miyokard enfarktüsünde (AME) yüksek riskli hastaları öngörmek çok önemlidir. Bu çalışmada lökoglisemik indeksin (LGI) AME'de hastane içi mortaliteyi öngörmede benzersiz bir yeteneği olup olmadığını araştırmayı ve diğer inflamatuar parametrelerle karşılaştırmayı amaçlanmıştır. Gereç ve Yöntemler: Bu tek merkezli çalışmada, hastaneye yatırılan ve tek operatör tarafından takip edilen tüm AME hastalarını retrospektif olarak inceledik. Hastalar hastane içi ölüm sonuçlarına göre ikiye ayrıldı. Diğer inflamatuar parametreler (sistemik immun-inflamatuar indeks, platelet-lenfosit oranı, nötrofil-lenfosit oranı, trigliserit-HDL oranı ve LDL-HDL oranı), C-reaktif protein (CRP) ve LGI daha önce açıklanan kriterlere göre hesaplandı. Bağımsız yordayıcıları bulmak için tek değişkenli ve çok değişkenli lojistik regresyon analizi kullanıldı. Mortaliteyi öngörmede LGI ve diğer parametrelerin kestirim noktasını bulmak için receiver operator characteristic (ROC) eğrisi kullanıldı. Bulgular: Çalışmaya toplam 304 AMI hastası dahil edildi. Ortalama yaş 62,18±11,89 olup hastaların 74'ü (%24,3) kadındı. Toplam ölüm oranı 19 (%6,3) idi. Tek değişkenli değişken analizinde LGI, mortalitenin anlamlı bir yordayıcısı olarak bulundu (p<0.001). Çok değişkenli analizde risk faktörleri (yaş, koroner arter hastalığı öyküsü, ejeksiyon fraksiyonu, CHA2DS2VASc skoru, kreatinin ve CRP) modele eklendikten sonra LGI, kısa vadeli mortalitenin önemli bir göstergesi olarak bulundu. ROC eğrisi analizi, eğri altında kalan alanın 0,837 (0,704-0,971) olduğunu, duyarlılığın %76,5 ve özgüllüğün %91,5 olduğunu ve 3,39 cut-off değerini gösterdi. Sonuç: Çalışmamız, LGI'nin AMI'de kısa vadeli mortaliteyi tahmin etmede diğer parametrelere göre benzersiz bir parametre olabileceğini gösterdi.

Anahtar Kelimeler:

lökoglisemik indeks, akut miyokard enfaktüsü, mortalite, leukoglycemic index, acute myocardial infarction, mortality

Leukoglycemic Index may be a Unique Parameter to Predict Mortality in Patients with Acute Myocardial Infarction: Single Operator Experience

Background and Aim: Predicting high-risk patients is crucial in acute myocardial infarction (AMI). We aimed to investigate whether the leukoglycemic index (LGI) has a unique ability and to compare it with other inflammatory parameters in predicting in-hospital mortality in AMI. Methods: In this single-center study, we retrospectively analyzed all AMI patients hospitalized and followed by a single operator. Patients were divided into two according to in-hospital outcomes. Other inflammatory parameters (systemic immune-inflammatory index, platelet-lymphocyte ratio, neutrophil-lymphocyte ratio, triglyceride-HDL ratio, and LDL-HDL ratio), C-reactive protein (CRP), and LGI were calculated according to previously described criteria. Univariable and multivariable logistic regression analyses were used to find independent predictors. The receiver operating characteristic (ROC) curve was used to find the cut-off point of LGI and other parameters in predicting mortality. Results: A total of 304 patients with AMI were included in the study. The mean age was 62.18±11.89 and 74 (24.3%) of patients were female. The total death rate was 19 (6.3%). In univariate variable analysis, LGI was found as a significant predictor of mortality (p<0.001). After adjusting risk factors (age, coronary artery disease history, ejection fraction, CHA2DS2VASc score, creatinine, and CRP) in multivariable analysis, LGI was still found as a significant predictor of short-term mortality. ROC curve analysis showed that the area under the curve was 0.837 (0.704-0.971) with a sensitivity of 76.5% and with a specificity of 91.5% with a 3.39 cut-off value. Conclusion: Our study showed that LGI might be a unique parameter in predicting short-term mortality in AMI.

Keywords:

lökoglisemik indeks, akut miyokard enfaktüsü, mortalite leukoglycemic index, acute myocardial infarction, mortality, leukoglycemic index, acute myocardial infarction, mortality,

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