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Yin R, Ye Z, You H, Wu Y, Chen W, Jiang T. Elevated uric acid/albumin ratio as a predictor of poor coronary collateral circulation development in patients with non-ST segment elevation myocardial infarction. Clin Cardiol 2024; 47:e24215. [PMID: 38269629 PMCID: PMC10790324 DOI: 10.1002/clc.24215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/16/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Uric acid/albumin ratio (UAR) is a novel composite biomarker with superior predictive value for cardiovascular disease. OBJECTIVE To investigate the relationship between UAR and coronary collateral circulation (CCC) in patients with non-ST segment elevation myocardial infarction (NSTEMI). METHODS A total of 205 NSTEMI patients who underwent coronary arteriography with at least one major coronary stenosis, 95% were included. Patients were divided into two groups according to CCC development: poorly-developed CCC group (Rentrop 0-1) and well-developed CCC (Rentrop 2-3). Univariate analysis and logistic regression analysis were utilized to investigate the factors influencing adverse CCC formation in NSTEMI patients. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of UAR, C-reactive protein (CRP), uric acid, and albumin for patients with poorly developed CCC, and the area under the curve (AUC) was compared. RESULTS The UAR values of NSTEMI patients were significantly higher in the poorly developed CCC group than those in the well-developed CCC group (10.19 [8.80-11.74] vs. 7.79 [6.28-9.55], p < .001). In the multiple logistic regression tests, UAR (odds ratio [OR]: 1.365, 95% confidence interval [CI]: 1.195-1.560, p < .001), CRP (OR: 1.149, 95% CI: 1.072-1.231, p < .001), and diabetes (OR: 2.924, 95% CI: 1.444-5.920, p = .003) were independent predictors of poorly developed CCC. The ROC curve analysis showed that the optimal cut-off value of UAR was 8.78 in predicting poorly developed CCC with a sensitivity of 76.8% and specificity of 62.4%, with the AUC of 0.737 (95% Cl: 0.668-0.805, p < .001). CONCLUSION Elevated UAR may be an independent and effective biomarker for predicting poorly-developed CCC development in NSTEMI patients.
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Affiliation(s)
- Renlin Yin
- Department of CardiologyThe First Affiliated Hospital of Soochow UniversitySuzhouChina
- Department of CardiologySuzhou Ninth Hospital Affiliate to Soochow UniversitySuzhouChina
| | - Zongwei Ye
- Department of CardiologySuzhou Ninth Hospital Affiliate to Soochow UniversitySuzhouChina
| | - Hua You
- Department of CardiologySuzhou Ninth Hospital Affiliate to Soochow UniversitySuzhouChina
| | - Yanming Wu
- Department of CardiologySuzhou Ninth Hospital Affiliate to Soochow UniversitySuzhouChina
| | - Weixiang Chen
- Department of CardiologyThe First Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Tingbo Jiang
- Department of CardiologyThe First Affiliated Hospital of Soochow UniversitySuzhouChina
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Pei J, Wang X, Xing Z. Traditional Cardiovascular Risk Factors and Coronary Collateral Circulation: A Meta-Analysis. Front Cardiovasc Med 2021; 8:743234. [PMID: 34805302 PMCID: PMC8595282 DOI: 10.3389/fcvm.2021.743234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Patients with well-developed coronary collateral circulation (CC) usually have low mortality, improved cardiac function, and reduced infarct size. Currently, there is conflicting evidence on the association between traditional cardiovascular risk factors (diabetes, hypertension, and smoking habit) and CC. Design: We performed a meta-analysis of case-control studies to better understand such associations. Data Sources: We searched the MEDINE, EMBASE, and Science Citation Index databases to identify relevant studies. Eligibility Criteria for Selecting Studies: Case control studies reporting data on risk factors (smoking habit, hypertension, and diabetes mellites) in comparing cases between poor CC and well-developed CC groups. Well-developed CC was the primary outcome of this meta-analysis Data Extraction and Synthesis: Relevant data were extracted by two independent investigators. We derived pooled odds ratios (ORs) with random effects models. We performed quality assessments, publication bias, and sensitivity analysis to ensure the reliability of our results. Results: In total, 18 studies that had 4,746 enrolled patients were analyzed. Our results showed that hypertension and smoking habit did not (OR = 0.94, 95% CI: 0.75–1.17, p = 0.564 and OR = 1.00, 95% CI: 0.84–1.18, p = 0.970, respectively), and diabetes did (OR = 0.50, 95% CI: 0.38–0.67, p = 0.00001) affect the development of CC. Conclusion: Unlike hypertension and smoking habit, diabetes was associated with poor CC formation. Trial Registration Number:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=87821, identifier: CRD42018087821.
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Affiliation(s)
- Junyu Pei
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaopu Wang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhenhua Xing
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China.,Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China
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Wang J, Yan Y, Song D, Liu L, Liu B. The association of plasma miR-155 and VCAM-1 levels with coronary collateral circulation. Biomark Med 2017; 11:125-131. [PMID: 27885839 DOI: 10.2217/bmm-2016-0282] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Inflammation plays an important role in development of coronary collateral circulation (CCC). The aim of this study is to determine whether the inflammation-related miRNA miR-155 and the inflammation marker VCAM-1 could be a biomarker for CCC. Patients & methods: We measured levels of plasma VCAM-1 and miR-155 in patients with CCC according to Rentrop grade by ELISA or real-time polymerase chain reaction, respectively (n = 112). Results: Plasma miR-155 was negatively correlated with VCAM-1 in the poor CCC group and with Rentrop grade in all patients with CCC. In addition, plasma VCAM-1 was significantly decreased in CAD patients with CCC. Conclusion: Plasma miR-155 might be a potent independent predictor of collateral formation.
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Affiliation(s)
- Junnan Wang
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
| | - Youyou Yan
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
| | - Dandan Song
- Department of Clinical Laboratory, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
| | - Lulu Liu
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
| | - Bin Liu
- Department of Cardiology, Second Hospital of Jilin University, No. 218 Ziqiang Street, Changchun 130041, China
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Association of serum mimecan with angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion. Atherosclerosis 2016; 252:75-81. [PMID: 27508318 DOI: 10.1016/j.atherosclerosis.2016.07.916] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 07/20/2016] [Accepted: 07/21/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Mimecan/osteoglycin is identified as an emerging biomarker of coronary atherosclerosis. We investigated whether and to what extent serum mimecan reflects angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion. METHODS Serum levels of mimecan were determined in 559 consecutive patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as poor (Rentrop score of 0 or 1) or good coronary collateralization (Rentrop score of 2 or 3). RESULTS Serum mimecan was significantly higher in patients with poor collateralization than in those with good collateralization, and correlated inversely with Rentrop score (adjusted Spearmen's r = -0.443, p < 0.001). The prevalence of poor coronary collaterals increased stepwise from the lowest to the highest quartile of serum mimecan (OR 2.140, 95% CI 1.793-2.555; p for trend < 0.001). After adjusting for age, gender, traditional risk factors for coronary artery disease, history of myocardial infarction, severity of coronary artery disease, renal function and C-reactive protein, serum mimecan (per SD) remained an independent determinant for poor collateralization (OR 2.674, 95% CI 2.057-3.475, p < 0.001). The diagnostic value of mimecan (per SD) for detecting poor collateralization was consistent when the patients were specified by gender, age, body mass index, presence or absence of hypertension and diabetes, and status of renal function (OR 2.075-6.932, p interaction ≥ 0.059). CONCLUSION Increased serum mimecan is associated with poor angiographic coronary collateralization in patients with chronic total occlusion.
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Serum Cystatin C Reflects Angiographic Coronary Collateralization in Stable Coronary Artery Disease Patients with Chronic Total Occlusion. PLoS One 2015; 10:e0137253. [PMID: 26402227 PMCID: PMC4581619 DOI: 10.1371/journal.pone.0137253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/13/2015] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE We investigated whether and to what extent cystatin C was associated with angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion. METHODS Serum levels of cystatin C and high-sensitive C-reactive protein (hsCRP) and glomerular filtration rate (GFR) were determined in 866 patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as poor (Rentrop score of 0 or 1) or good coronary collateralization (Rentrop score of 2 or 3). RESULTS In total, serum cystatin C was higher in patients with poor collateralization than in those with good collateralization (1.08 ± 0.32 mg/L vs. 0.90 ± 0.34 mg/L, P < 0.001), and correlated inversely with Rentrop score (adjusted Spearmen's r = -0.145, P < 0.001). The prevalence of poor coronary collateralization increased stepwise with increasing cystatin C quartiles (P for trend < 0.001). After adjusting for age, gender, risk factors for coronary artery disease, GFR and hsCRP, serum cystatin C ≥ 0.97 mg/L remained independently associated with poor collateralization (OR 2.374, 95% CI 1.660 ~ 3.396, P < 0.001). The diagnostic value of cystatin C levels for detecting poor coronary collateralization persisted regardless of age, gender, presence or absence of diabetes, hypertension or renal dysfunction. CONCLUSIONS Serum cystatin C reflects angiographic coronary collateralization in patients with stable coronary artery disease, and cystatin C ≥ 0.97 mg/L indicates a great risk of poor coronary collaterals.
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Balta S, Duran M. Comment on: Renal impairment and coronary collaterals in patients with acute coronary syndrome. Herz 2014; 39:481-2. [DOI: 10.1007/s00059-013-3948-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Akın F, Ayça B, Çelik Ö, Şahin C. Predictors of poor coronary collateral development in patients with stable coronary artery disease: neutrophil-to-lymphocyte ratio and platelets. Anatol J Cardiol 2014; 15:218-23. [PMID: 25880175 PMCID: PMC5337058 DOI: 10.5152/akd.2014.5263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective: The heterogeneity in the degree of collateralization among patients with coronary artery disease (CAD) remains incompletely understood. We evaluated the predictors of poorly developed coronary collateral circulation (CCC) in patients with stable coronary artery disease. Methods: Current study is a retrospective study, consisting of 118 patients with poor CCC and 130 patients with good CCC. We investigated predictors of poor coronary collaterals in a cohort of 248 patients who had high-grade coronary stenosis or occlusion on their angiograms. To classify CCC, we used the Rentrop classification. Results: Patients with poorly developed CCC had significantly higher neutrophil-to-lymphocyte ratio (N/L) compared with those with well-developed CCC, (4.2±2.8 vs. 3±3.1, p=0.001), whereas mean platelet volume, red cell distribution width and uric acid were not significantly different. Logistic regression analysis showed that N/L ratio (odds ratio 1.199, 95% confidence interval 1.045-1.375) and serum triglyceride levels [odds ratio (OR)=1.006, 95% confidence interval (CI)=1.001-1.010] were independent predictors of poorly developed CCC. Conclusion: An elevated level of N/L ratio is independently associated with a significant impairment in coronary collateralization. Our findings suggest that N/L ratio is an inexpensive, universally available hematological marker for sufficiency of CCC in patients with stable coronary artery disease.
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Affiliation(s)
- Fatih Akın
- Department of Cardiology, Faculty of Medicine, Muğla Sıtkı Koçman University; Muğla-Turkey.
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Canpolat U, Cagli K, Aras D, Kisacik HL, Aydogdu S. The association of serum uric acid level with coronary collateral circulation should be interpreted together with renal function and cardiovascular medications in stable coronary artery disease. Angiology 2014; 65:236-237. [PMID: 24202664 DOI: 10.1177/0003319713509003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Ugur Canpolat
- 1Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Shen Y, Lu L, Ding FH, Sun Z, Zhang RY, Zhang Q, Yang ZK, Hu J, Chen QJ, Shen WF. Association of increased serum glycated albumin levels with low coronary collateralization in type 2 diabetic patients with stable angina and chronic total occlusion. Cardiovasc Diabetol 2013; 12:165. [PMID: 24209601 PMCID: PMC4225762 DOI: 10.1186/1475-2840-12-165] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/05/2013] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND We investigated whether serum glycated albumin (GA) levels are related to coronary collateralization in type 2 diabetic patients with chronic total occlusion. METHODS Blood levels of GA and glycosylated hemoglobin (HbA1c) were determined in 317 diabetic and 117 non-diabetic patients with stable angina and angiographic total occlusion of at least one major coronary artery. The degree of collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded as low (Rentrop score of 0 or 1) or high collateralization (Rentrop score of 2 or 3). RESULTS For diabetic patients, GA (21.2 ± 6.5% vs. 18.7 ± 5.6%, P < 0.001) but not HbA1c levels (7.0 ± 1.1% vs. 6.8 ± 1.3%, P = 0.27) was significantly elevated in low collateralization than in high collateralization group, and correlated inversely with Rentrop score (Spearmen's r = -0.28, P < 0.001; Spearmen's r = -0.10, P = 0.09, respectively). There was a trend towards a larger area under the curve of GA compared with that of HbA1c for detecting the presence of low collateralization (0.64 vs. 0.58, P = 0.15). In non-diabetic patients, both GA and HbA1c levels did not significantly differ regardless the status of coronary collateralization. In multivariable analysis, female gender, age > 65 years, smoke, non-hypertension, duration of diabetes > 10 years, metabolic syndrome, eGFR < 90 ml/min/1.73 m2, and GA > 18.3% were independently determinants for low collateralization in diabetic patients. CONCLUSIONS Increased GA levels in serum are associated with impaired collateral growth in type 2 diabetic patients with stable angina and chronic total occlusion.
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Affiliation(s)
- Ying Shen
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Lin Lu
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Feng Hua Ding
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Zhen Sun
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Rui Yan Zhang
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Qi Zhang
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Zheng Kun Yang
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Jian Hu
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Qiu Jing Chen
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Wei Feng Shen
- Department of Cardiology, Shanghai Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China
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Duran M, Uysal OK, Gunebakmaz O, Yilmaz Y, Vatankulu MA, Turfan M, Duran AO, Ornek E, Cetin M, Murat SN, Kaya MG. Renal impairment and coronary collaterals in patients with acute coronary syndrome. Herz 2013; 39:379-83. [PMID: 23649321 DOI: 10.1007/s00059-013-3823-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/02/2013] [Accepted: 03/24/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to elucidate the relationship between mild-to-moderate renal impairment and the development of coronary collateral vessels (CCV) in patients with acute coronary syndrome (ACS). METHODS We enrolled 461 patients with ACS who underwent coronary angiography for the first time. The development of CCV was assessed with the Rentrop score. Kidney function was classified according to the estimated glomerular filtration rate (eGFR). The Gensini score was used to show the extent of atherosclerosis. RESULTS The mean eGFR value was 89.9 ± 24.3 U/l for patients with no development of collaterals and 82.7 ± 20.5 for patients who had CCV. The mean age was 59 ± 11 years and 349 patients (75.7 %) were male. Rentrop classifications 1-2-3 (presence of CCV) were determined in 222 (48.1 %) patients. The presence of CCV was significantly associated with low levels of eGFR (p = 0.001), increased serum creatinine levels (p = 0.034), high levels of serum albumin (0.036), and the Gensini score (p < 0.001). Multivariate analysis showed that the Gensini score was an independent predictor of the presence of CCV (OR = 1.090, 95 % CI: 1.032-1.151, p = 0.002). CONCLUSION We suggest that the association between mild-to-moderate renal impairment and the presence of CCV may be explained by increased myocardial ischemia and severe CAD.
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Affiliation(s)
- M Duran
- Department of Cardiology, Ankara Research and Education Hospital, Ankara, Turkey,
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Ege MR, Yucel O, Guray U. Response to Mildly Decreased Glomerular Filtration Rate Is Associated With Poor Coronary Collateral Circulation in Patients With Coronary Artery Disease. Clin Cardiol 2012; 35:315-6; author reply 316-7. [DOI: 10.1002/clc.21007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 10/16/2011] [Indexed: 11/08/2022] Open
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Athyros VG, Karagiannis A, Katsiki N, Mikhailidis DP. Response to 'Mildly decreased glomerular filtration rate is associated with poor coronary heart disease outcome'. Clin Cardiol 2012; 35:315; author reply 316-7. [PMID: 22262111 DOI: 10.1002/clc.21002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 09/20/2011] [Indexed: 11/08/2022] Open
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