JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

eISSN: 2717-7505
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Association of serum uric acid/albumin ratio with completely occluded infarct-related artery in patients with non-ST-segment elevation myocardial infarction
Abstract
Aims: 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
Methods: 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

Download Article


1. Stone GW, Cox D, Garcia E, et al. Normal flow (TIMI-3) beforemechanical reperfusion therapy is an independent determinantof survival in acute myocardial infarction: analysis from theprimary angioplasty in myocardial infarction trials. Circulation2001; 104: 636-41.
2. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTSGuidelines on myocardial revascularization. Eur Heart J 2019; 40:87-165.
3. Collet JP, Thiele H, Barbato E, et al. ESC Scientific DocumentGroup. 2020 ESC Guidelines for the management of acutecoronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021; 42: 1289-367.
4. Chan MY, Sun JL, Newby LK, et al. Long-term mortality ofpatients undergoing cardiac catheterization for ST-elevation andnon-ST-elevation myocardial infarction. Circulation 2009; 119:3110-7.
5. Hung CS, Chen YH, Huang CC, et al. Prevalence and outcomeof patients with non-ST segment elevation myocardial infarctionwith occluded &quot;culprit&quot; artery - a systemic review and meta-analysis. Crit Care 2018; 22: 34.
6. Khan AR, Golwala H, Tripathi A, et al. Impact of total occlusionof culprit artery in acute non-ST elevation myocardial infarction:a systematic review and meta-analysis. Eur Heart J 2017; 38:3082-9.
7. Varma R, Michos GA, Varma RS, Brown RD Jr. The protein-bound carbohydrates of seromucoid from normal human serum.J Clin Chem Clin Biochem 1983; 21: 273-7.
8. Arques S. Human serum albumin in cardiovascular diseases. EurJ Intern Med 2018;52:8-12.
9. Li X, Meng X, Timofeeva M, et al. Serum uric acid levelsand multiple health outcomes: umbrella review of evidencefrom observational studies, randomised controlled trials, andMendelian randomisation studies. BMJ 2017; 357: j2376.
10. Kanellis J, Kang DH. Uric acid as a mediator of endothelialdysfunction, inflammation, and vascular disease. Semin Nephrol2005; 25: 39-42.
11. Li S, Chen H, Zhou L, Cui H, Liang S, Li H. The uric acid toalbumin ratio: a novel predictor of long-term cardiac mortalityin patients with unstable angina pectoris after percutaneouscoronary intervention. Scand J Clin Lab Invest 2022; 82: 304-10.
12. Kalkan S, Cagan Efe S, Karag&ouml;z A, et al. A new predictor ofmortality in ST-elevation myocardial ınfarction: the uric acidalbumin ratio. Angiology 2022; 73: 461-9.
13. The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase Ifindings. TIMI Study Group. N Engl J Med 1985; 312: 932-6.
14. Hashimoto T, Ako J, Nakao K, et al. J-MINUET investigators.Pre-procedural thrombolysis in myocardial ınfarction flow inpatients with st-segment elevation myocardial infarction. IntHeart J 2018; 59: 920-5.
15. Hwang HJ, Park CB, Cho JM, et al. Clinical characteristics ofoccluded culprit arteries and collaterals in patients with non-ST-segment elevation myocardial infarction and impact on clinicaloutcomes. Exp Ther Med 2018; 16: 3710-20.
16. Kurtul A, Murat SN, Yarlioglues M, et al. Usefulness of serumalbumin concentration to predict high coronary SYNTAXscore and in-hospital mortality in patients with acute coronarysyndrome. Angiology 2016; 67: 34-40.
17. Celik IE, Yarlioglues M, Kurtul A, et al. Preprocedural albuminlevels and risk of in-stent restenosis after coronary stenting withbare-metal stent. Angiology 2016; 67: 478-83.
18. Suzuki S, Hashizume N, Kanzaki Y, Maruyama T, KozukaA, Yahikozawa K. Prognostic significance of serum albuminin patients with stable coronary artery disease treated bypercutaneous coronary intervention. PLoS One 2019; 14:e0219044.
19. Halliwell B. Albumin-an important extracellular antioxidant?Biochem Pharmacol 1988; 37: 569-71.
20. Jin M, Yang F, Yang I, et al. Uric acid, hyperuricemia and vasculardiseases. Front Biosci 2012; 17: 656-69.
21. Kanbay M, Segal M, Afsar B, Kang DH, Rodriguez-Iturbe B,Johnson RJ. The role of uric acid in the pathogenesis of humancardiovascular disease. Heart 2013; 99: 759.
22. &Ccedil;akmak E&Ouml;, Bayam E, &Ccedil;elik M, et al. Uric acid-to albuminratio: a novel marker for the extent of coronary artery diseasein patients with Non-ST-Elevated myocardial infarction. Pulse(Basel) 2021; 8: 99-107.
23. Şaylık F, &Ccedil;ınar T, Akbulut T, Sel&ccedil;uk M. Serum uric acid to albuminratio can predict contrast-ınduced nephropathy in ST-elevationmyocardial ınfarction patients undergoing primary percutaneouscoronary intervention. Angiology 2022: 33197221091605.
Article available in :
Volume 4, Issue 1, 2023
Page : 21-27
https://doi.org/10.47582/jompac.1217035
Article Information
Submitted : 09 Ara 2022
Accepted : 07 Oca 2023
Corresponding Author :

Orhan Karayiğit: Department of Cardiology, Yozgat City Hospital, Yozgat, Turkey

[email protected]
Citation : Karayiğit O. Association of serum uric acid/albumin ratio with completely occluded infarct-related artery in patients with non-ST-segment elevation myocardial infarction. J Med Palliat Care 2023; 4(1): 21-27.

Read: 52
Cited: 0
Download : 68
_Footer