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You H, Zhang D, Liu Y, Zhao Y, Xiao Y, Li X, You S, Wang T, Tian T, Xu H, Zhang R, Liu D, Li J, Yuan J, Yang W. Development and validation of a risk score nomogram model to predict the risk of 5-year all-cause mortality in diabetic patients with hypertension: A study based on NHANES data. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2024; 21:200265. [PMID: 38577011 PMCID: PMC10992723 DOI: 10.1016/j.ijcrp.2024.200265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
Background The present study aimed to develop and validate a prediction nomogram model for 5-year all-cause mortality in diabetic patients with hypertension. Methods Data were extracted from the National Health and Nutrition Examination Survey (NHANES). A total of 3291 diabetic patients with hypertension in the NHANES cycles for 1999-2014 were selected and randomly assigned at a ratio of 8:2 to the training cohort (n = 2633) and validation cohort (n = 658). Multivariable Cox regression was conducted to establish a visual nomogram model for predicting the risk of 5-year all-cause mortality. Receiver operating characteristic curves and C-indexes were used to evaluate the discriminant ability of the prediction nomogram model for all-cause mortality. Survival curves were created using the Kaplan-Meier method and compared by the log-rank test. Results The nomogram model included eight independent predictors: age, sex, education status, marital status, smoking, serum albumin, blood urea nitrogen, and previous cardiovascular disease. The C-indexes for the model in the training and validation cohorts were 0.76 (95% confidence interval: 0.73-0.79, p < 0.001) and 0.75 (95% confidence interval: 0.69-0.81, p < 0.001), respectively. The calibration curves indicated that the model had satisfactory consistency in the two cohorts. The risk of all-cause mortality gradually increased as the tertiles of the nomogram model score increased (log-rank test, p < 0.001). Conclusion The newly developed nomogram model, a readily useable and efficient tool to predict the risk of 5-year all-cause mortality in diabetic patients with hypertension, provides a novel risk stratification method for individualized intervention.
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Affiliation(s)
- Hongzhao You
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Endocrinology Centre, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dingyue Zhang
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yilu Liu
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanyan Zhao
- Medical Research and Biometrics Centre, National Centre for Cardiovascular Diseases, Beijing, China
| | - Ying Xiao
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaojue Li
- Endocrinology Centre, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shijie You
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tianjie Wang
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tao Tian
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haobo Xu
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui Zhang
- Endocrinology Centre, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dong Liu
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiansong Yuan
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weixian Yang
- Department of Cardiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, National Clinical Research Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Karatas M, Parsova KE, Keskin M, Ocal L, Doğan S, Keles N. Prognostic value of serum albumin to creatinine ratio in patients undergoing carotid artery stenting. INT ANGIOL 2024; 43:290-297. [PMID: 38577708 DOI: 10.23736/s0392-9590.24.05112-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND We aimed to investigate the prognostic value of serum albumin-to-creatinine ratio (sACR) in carotid artery stenting (CAS) patients regarding in-hospital and 5-year outcomes. METHODS This is a retrospective study. Baseline characteristics were compared between patients by admission albumin to creatinine ratio and categorized accordingly: T1, T2 and T3. 609 patients were included in the study. Serum albumin and creatinine levels at hospital admission were used to calculate the sACR. The primary endpoint was all-cause mortality. MACE consisted of stroke, transient ischemic attack (TIA), myocardial infarction (MI) and death. All follow-up data were obtained from electronic medical records or by interview. The study was terminated after 60 months of follow-up. RESULTS Serum albumin levels were found to be significantly lower in T1, while creatinine was found to be significantly higher in T1. T1 has the lowest sACR while T3 has the highest. In hospital, ipsilateral stroke, major stroke, MI and death were significantly higher in T1. In long-term outcomes, ipsilateral stroke, major stroke, and death were significantly higher in T1. CONCLUSIONS Low sACR values at hospital admission was independently associated with in-hospital and long-term mortality and major stroke in patients underwent CAS.
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Affiliation(s)
- Mesut Karatas
- Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | - Kemal E Parsova
- Department of Cardiology, Medicana Atasehir Hospital, Istanbul, Türkiye
| | - Muhammed Keskin
- Department of Cardiology, Faculty of Medicine, Bahcesehir University, Istanbul, Türkiye
| | - Lutfi Ocal
- Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
| | | | - Nursen Keles
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
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Hao P, Feng S, Suo M, Wang S, Wu X. Platelet to albumin ratio: A risk factor related to prognosis in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Int J Cardiol 2024; 395:131588. [PMID: 37989451 DOI: 10.1016/j.ijcard.2023.131588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/26/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Atherosclerotic cardiovascular disease (ASCAD) is recognized as a chronic subclinical systemic inflammatory condition. The platelet-albumin ratio (PAR) has shown promise in prognosticating various inflammation-related disorders. Our study aimed to assess the connection between PAR and major adverse cardiovascular events (MACE) in percutaneous coronary intervention (PCI)-treated patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS PAR, derived from platelet and albumin counts, categorized participants into four quartiles. The primary outcome was composite MACE, encompassing all-cause mortality, non-fatal myocardial infarction (MI), and ischemia-driven revascularization. Secondary outcomes comprised individual MACE components. Multivariate Cox regression evaluated PAR's independent impact on adverse events. The non-linear relationship between the PAR value and MACE was explored using a restricted cubic spline (RCS). Receiver operating characteristic (ROC) analysis was conducted and the area under the curve (AUC) was calculated. Subgroup analysis was used to determine the effect of PAR on MACE in different subgroups. RESULTS Enrolling 1391 NSTE-ACS patients, high PAR quartiles were correlated with elevated MACE rates (quartile 4 vs. quartile 1: 33.5% vs. 10.2%, p < 0.001). PAR was revealed to be independently related to an increased risk of MACE (quartile 4 vs. quartile 1: HR, 2.04 [95% CI, 1.34-3.08], p = 0.001). RCS indicated a positive PAR-MACE relationship. The AUC of PAR for the 3-year MACE was 0.659 (95% CI: 0.626-0.677, P<0.001). Subgroup analysis showed no significant interactions across subsets. CONCLUSION PAR independently predicted MACE risk in PCI-treated NSTE-ACS patients.
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Affiliation(s)
- Peng Hao
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Siting Feng
- Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Min Suo
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Shen Wang
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Xiaofan Wu
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
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Zhao K, Shen B, Wei H, Lu R, Liu Y, Xu C, Cai H, Huang Y, Li P, Ye X, Li Y. Diagnostic value of high sensitivity cardiac troponin T (hs-cTnT) in dialysis patients with myocardial infarction. Front Cardiovasc Med 2023; 10:1278073. [PMID: 38188256 PMCID: PMC10768174 DOI: 10.3389/fcvm.2023.1278073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Background As a sensitive diagnostic marker for myocardial infarction (MI) in people with normal renal function, elevated high sensitivity cardiac troponin T (hs-cTnT) was often found in chronic kidney disease (CKD) patients requiring dialysis. However, the accuracy of baseline hs-cTnT in the diagnosis of MI (including Type 1 MI (T1MI) and Type 2 MI (T2MI)) in dialysis patients is still controversial. The aim of this study was to retrospectively explore whether there were any clinical indices that could increase the predictive value of hs-cTnT on admission for MI occurrence in dialysis patients. Methods Here, 136 patients with uremia who underwent regular dialysis with coronary angiography in the First Affiliated Hospital of Nanjing Medical University from August 2017 to October 2021 were enrolled. According to the coronary angiography results and the presence of clinical symptoms, the patients were divided into: (1). AMI group (n = 69; angiography positive) and Control group (n = 67; angiography negative); (2). T1MI group (n = 69; angiography positive), T2MI group (n = 7; angiography negative & symptomatic), and Control group (n = 60; angiography negative & asymptomatic). Results Here, we found the mean hs-cTnT on admission in the Control group was much lower than that in the AMI group. Hs-cTnT alone had a mediocre predictive performance, with an AUROC of 0.7958 (95% CI: 0.7220, 0.8696). Moreover, the ROC curve of hs-cTnT combined with the Triglyceride (TG), Time of dialysis, and Albumin (Alb) showed a higher sensitivity area [0.9343 (95% CI: 0.8901, 0.9786)] than that of single hs-cTnT. Next, hs-cTnT combined with the TG, Time of dialysis, and Alb also presented a better performance in predicting T1MI [0.9150 (95% CI: 0.8678, 0.9621)] or T2MI (0.9167 [0.9167 (95% CI: 0.8427, 0.9906)] occurrences. Last, these combined variables could better distinguish patient between T1MI and T2MI group than hs-cTnT alone. Conclusions On admission, a combination of hs-cTnT, TG, Time of dialysis, and Alb presented a higher sensitivity than hs-cTnT alone in predicting MI occurrence in dialysis patients, suggesting a better diagnostic approach for future clinical applications.
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Affiliation(s)
- Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bozhi Shen
- Department of Clinical Medicine, The First Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hongcheng Wei
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rongsheng Lu
- Jiangsu Key Laboratory for Design and Manufacture of Micro-Nano Biomedical Instruments, Southeast University, Nanjing, China
| | - Yifan Liu
- Department of Clinical Medicine, The First Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chenchen Xu
- Department of Clinical Medicine, The First Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Haoran Cai
- Department of Clinical Medicine, The First Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yanhong Huang
- Department of Clinical Medicine, The First Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peng Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiaoman Ye
- Department of Intensive Care Medicine, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yong Li
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Cardiology, The People's Hospital of Qijiang District, Qijiang, Chongqin, China
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Liu W, Ding K, Bao J, Hu Y, Gui Y, Ye L, Wang L. Relationship between uric acid to albumin ratio and in-stent restenosis in patients with coronary artery disease undergoing drug-eluting stenting. Coron Artery Dis 2023; 34:589-594. [PMID: 37855441 PMCID: PMC10602219 DOI: 10.1097/mca.0000000000001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND In-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI) to treat coronary artery disease (CAD) is an urgent issue in clinical practice. Recent studies have highlighted uric acid-albumin ratio (UAR) as a new marker for evaluating inflammation and oxidative stress, capable of predicting cardiovascular ailments. We aimed to examine the correlation between UAR levels and ISR in patients who underwent drug-eluting stent (DES) implantation. METHODS We included 503 patients with CAD who underwent initial DES implantation and angiography during the follow-up period. Based on coronary angiographic findings, the patients were categorized into ISR (n = 73) and non-ISR groups (n = 430). Before angiography, laboratory parameters were measured for all enrolled patients. To ascertain the influential factors linked to ISR, multivariate logistic regression analysis was performed. The predictive capability of UAR in determining ISR was assessed using receiver operating characteristic (ROC) curve analysis. Statistical significance was set at P < 0.05. RESULTS Multivariate logistic regression analysis revealed that diabetes mellitus, stent length, UAR, albumin levels, and C-reactive protein levels independently predicted ISR. ROC curve analysis revealed that UAR had an area under the curve of 0.767 (95% CI: 0.709 - 0.826) for predicting ISR and demonstrated that UAR outperformed the individual predictive abilities of uric acid and albumin for ISR. CONCLUSION UAR was associated with ISR in patients with CAD undergoing PCI with DES implantation. Moreover, ROC curve analysis demonstrated that UAR exhibited superior predictive accuracy for ISR compared with evaluating uric acid and albumin levels separately.
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Affiliation(s)
- Wenquan Liu
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Kun Ding
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jiaqi Bao
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yilan Hu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Gui
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Lifang Ye
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Lihong Wang
- Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Wang SF, Wu TT, Zheng YY, Hou XG, Yang HT, Yang Y, Xie X. Serum Globulin to Albumin Ratio as a Novel Predictor of Adverse Clinical Outcomes in Coronary Artery Disease Patients Who Underwent PCI. Rev Cardiovasc Med 2023; 24:278. [PMID: 39077558 PMCID: PMC11273180 DOI: 10.31083/j.rcm2410278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/03/2023] [Accepted: 04/23/2023] [Indexed: 07/31/2024] Open
Abstract
Background Coronary heart disease is one of the main causes of Mortality. Many biological indicators have been used to predict the prognosis of patients with coronary heart disease. The ratio of serum globulin to albumin (GAR) has been used to predict the prognosis of patients with various cancers. It has been proven that GAR is related to the prognosis of patients with stroke. However, GAR's role in cardiovascular disease remains unclear. Our purpose was to investigate the predictive value of GAR on clinical outcomes in post-percutaneous coronary intervention (PCI) patients with coronary artery disease (CAD). Methods From Dec. 2016 to Oct. 2021, a total of 14,994 patients undergoing PCI patients admitted to the First Affiliated Hospital of Xinjiang Medical University were divided into high GAR group (GAR ≥ 0.76, n = 4087) and low GAR group (GAR < 0.76, n = 10,907). The incidence of adverse outcomes including all-cause mortality (ACM), cardiovascular mortality (CM), major adverse cardiovascular events (MACE) and major adverse cardiovascular and cerebrovascular events (MACCE) was compared between the two groups. Multivariate Cox regression was used to adjust for the effects of confounding factors, while hazard ratios (HRs) and 95% confidence intervals (95% CI) were calculated. Median follow-up time was 24 months. Results Compared with the low GAR group, the high GAR group had significantly higher incidence of ACM (6.5% vs. 1.7%, p < 0.001); CM (4.9% vs. 1.2%, p < 0.001), MACE (10.5% vs. 6.7%, p < 0.001), and MACCE (11.3% vs. 7.5%, p < 0.001). Cox regression analysis showed the patients in the high GAR group had a 1.62-fold increased risk for ACM (HR = 2.622, 95% CI: 2.130-3.228, p < 0.01), a 1.782-fold increased risk for CM (HR = 2.782, 95% CI: 2.180-3.550, p < 0.01). There was a 37.2% increased risk for MACE (HR = 1.372, 95% CI: 1.204-1.564, p < 0.01), and 32.4% increased risk for MACCE (HR = 1.324, 95% CI: 1.169-1.500, p < 0.01), compared to the patients in the low GAR group. Conclusions The present study suggested that post-PCI CAD patients with higher GAR presented significantly increased mortality and adverse events GAR level at admission may 296 be considered as part of risk stratification when PCI is possible in patients with coronary heart disease. Clinical Trial Registration The detailed information of the PRACTICE study has been registered on http://Clinicaltrials.gov (Identifier: NCT05174143).
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Affiliation(s)
- Si-Fan Wang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
| | - Ting-Ting Wu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
| | - Ying-Ying Zheng
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
| | - Xian-Geng Hou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
| | - Hai-Tao Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
| | - Yi Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
| | - Xiang Xie
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical
University, 830054 Urumqi, Xinjiang, China
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Ozkan E, Elcik D, Barutcu S, Kelesoglu S, Alp ME, Ozan R, Capar G, Turkmen O, Cinier G, Polat V, Inanc MT, Kepez A, Akgun T. Inflammatory Markers as Predictors of Atrial Fibrillation Recurrence: Exploring the C-Reactive Protein to Albumin Ratio in Cryoablation Patients. J Clin Med 2023; 12:6313. [PMID: 37834958 PMCID: PMC10573371 DOI: 10.3390/jcm12196313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 09/17/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is a common cardiac rhythm disorder associated with hemodynamic disruptions and thromboembolic events. While antiarrhythmic drugs are often recommended as the initial treatment, catheter ablation has emerged as a viable alternative. However, the recurrence of AF following ablation remains a challenge, and there is growing interest in exploring inflammatory markers as predictors of recurrence. METHODS This retrospective, cross-sectional analysis included 249 patients who underwent cryoablation for paroxysmal AF. The relationship between the 'C-reactive protein (CRP) to albumin ratio (CAR)' and AF recurrence was examined. RESULTS Two hundred and forty-nine patients with paroxysmal non-valvular atrial fibrillation were included. They were divided into two groups: those without recurrence (Group 1) and those with recurrence (Group 2). Significant differences were observed in age (57.2 ± 9.9 vs. 62.5 ± 8.4, p = 0.001) and left atrial size (4.0 ± 0.5 vs. 4.2 ± 0.7, p = 0.001) between the two groups. In blood parameters, significant differences were found in CRP (5.2 ± 1.3 vs. 9.4 ± 2.8, p < 0.001) and neutrophil counts (5.1 ± 2.2 vs. 6.7 ± 3.6, p = 0.001). In univariate regression analysis, age (OR: 1.058, CI: 1.024-1.093, p = 0.001), WBC count (OR: 1.201, CI: 1.092-1.322, p < 0.001), neutrophil count (OR: 1.239, CI: 1.114-1.378, p = 0.001), CAR (OR: 1.409, CI: 1.183-1.678, p < 0.001), and left atrial diameter (OR: 0.968, CI: 0.948-0.989, p = 0.002) showed significant associations with AF recurrence. CONCLUSIONS Inflammation plays a crucial role in the initiation and progression of AF. This study demonstrated that along with age, the CAR can serve as an independent predictor of AF recurrence following cryoablation.
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Affiliation(s)
- Eyup Ozkan
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Deniz Elcik
- Faculty of Medicine, Erciyes University, 38280 Kayseri, Turkey; (D.E.); (S.K.); (R.O.); (M.T.I.)
| | - Suleyman Barutcu
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Saban Kelesoglu
- Faculty of Medicine, Erciyes University, 38280 Kayseri, Turkey; (D.E.); (S.K.); (R.O.); (M.T.I.)
| | - Murat Erdem Alp
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Ramazan Ozan
- Faculty of Medicine, Erciyes University, 38280 Kayseri, Turkey; (D.E.); (S.K.); (R.O.); (M.T.I.)
| | - Gazi Capar
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Omer Turkmen
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Goksel Cinier
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Veli Polat
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
| | - Mehmet Tugrul Inanc
- Faculty of Medicine, Erciyes University, 38280 Kayseri, Turkey; (D.E.); (S.K.); (R.O.); (M.T.I.)
| | - Alper Kepez
- Department of Cardiology, School of Medicine, Marmara University, 34722 Istanbul, Turkey;
| | - Taylan Akgun
- Basaksehir Cam ve Sakura City Hospital, 34480 Istanbul, Turkey; (S.B.); (M.E.A.); (G.C.); (O.T.); (G.C.); (V.P.); (T.A.)
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Chang WT, Sun CK, Wu JY, Yu CH, Chang YJ, Lin MC, Lan KM, Chen IW, Hung KC. Association of prognostic nutritional index with long-term mortality in patients receiving percutaneous coronary intervention for acute coronary syndrome: a meta-analysis. Sci Rep 2023; 13:13102. [PMID: 37567925 PMCID: PMC10421894 DOI: 10.1038/s41598-023-40312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023] Open
Abstract
The predictive value of the prognostic nutritional index (PNI) for the long-term prognosis of patients with acute coronary syndrome (ACS) remains uncertain. Medline, Embase, Cochrane Library, and Google Scholar were searched from inception until January 2023 to study the relationship between all-cause mortality risk and PNI in patients receiving percutaneous coronary intervention for ACS (i.e., primary outcome). Thirteen observational studies were included in this meta-analysis. Analysis of seven studies using PNI as a categorical variable showed a pooled hazard ratio (HR) of all-cause mortality of 2.97 (95% CI 1.65 to 5.34, p = 0.0003, I2 = 89%, n = 11,245) for patients with a low PNI. The meta-analysis also showed a higher risk of major adverse cardiovascular events (MACEs) in patients with a low PNI (HR 2.04; 95% CI 1.59 to 2.61; p < 0.00001; I2 = 21%; n = 8534). Moreover, advanced age, diabetes mellitus, and high Global Registry of Acute Coronary Events risk scores were associated with a high risk of all-cause mortality, whereas a high body mass index was associated with a low risk of all-cause mortality. The results showed an association between a low PNI and an increased risk of long-term mortality in patients undergoing coronary interventions for ACS. Further randomized controlled trials are necessary to confirm these findings.
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Affiliation(s)
- Wei-Ting Chang
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan City, Taiwan
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan City, Taiwan
- School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung City, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
| | - Chia-Hung Yu
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan
| | - Ying-Jen Chang
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan
| | - Ming-Chung Lin
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan
| | - Kuo-Mao Lan
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan City, 71004, Taiwan.
- School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung City, Taiwan.
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9
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Huang X, Liu Y, Zhong C, Lin Z, Zheng B. Association between serum albumin-to-creatinine ratio and clinical outcomes among patients with ST-elevation myocardial infarction after percutaneous coronary intervention: a secondary analysis based on Dryad databases. Front Cardiovasc Med 2023; 10:1191167. [PMID: 37456814 PMCID: PMC10339211 DOI: 10.3389/fcvm.2023.1191167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Background The prognostic value of the serum albumin-to-creatinine ratio (sACR) in patients with ST-elevation myocardial infarction (STEMI) remains unclear. This study aims to investigate the impact of the sACR on incident major adverse cardiovascular events (MACEs) among revascularized patients with STEMI at long-term follow-up. Methods A total of 461 patients with STEMI who underwent successful primary percutaneous coronary intervention (PCI) were enrolled to explore the association between the sACR and MACE during a 30-month follow-up. The Cox regression proportional hazard model was used to evaluate the prognostic value of the sACR. Heterogeneity among specific groups was investigated by subgroup analysis. Results A total of 118 patients developed MACE during the follow-up. A negative association between the sACR and MACE was found after adjusting for other MACE-related risk factors. In subgroup analyses, the sACR was inversely associated with MACE in patients aged ≥ 60 years [hazard ratio (HR), 0.478; 95% confidence interval (CI), 0.292-0.784], male (HR, 0.528; 95% CI, 0.327-0.851), with hypertension history (HR, 0.470; 95% CI, 0.271-0.816), and with anterior wall myocardial infarction (HR, 0.418; 95% CI, 0.239-0.730). Meanwhile, the negative association between the sACR and MACE remained significant in a sensitivity analysis that excluded patients with low serum albumin levels (HR, 0.553; 95% CI, 0.356-0.860). Conclusions Patients with STEMI who underwent successful PCI with a low sACR had a higher risk of developing MACE, indicating that the sACR could be used to identify patients with STEMI who are at high risk of developing MACE.
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Affiliation(s)
- Xiaoye Huang
- Intensive Care Unit, Jieyang People’s Hospital, Jieyang, China
| | - Yuchun Liu
- Intensive Care Unit, Jieyang People’s Hospital, Jieyang, China
| | - Chuyang Zhong
- Intensive Care Unit, Jieyang People’s Hospital, Jieyang, China
| | - Zengrui Lin
- Intensive Care Unit, Jieyang People’s Hospital, Jieyang, China
| | - Binyun Zheng
- Emergency Department, Jieyang People’s Hospital, Jieyang, China
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10
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Jian L, Zhang Z, Zhou Q, Duan X, Xu H, Ge L. Association between albumin corrected anion gap and 30-day all-cause mortality of critically ill patients with acute myocardial infarction: a retrospective analysis based on the MIMIC-IV database. BMC Cardiovasc Disord 2023; 23:211. [PMID: 37118662 PMCID: PMC10148465 DOI: 10.1186/s12872-023-03200-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/22/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The anion gap (AG) has been linked to the prognosis of many cardiovascular disorders. However, the correlation between albumin-corrected anion gap (ACAG) and 30 d all-cause mortality of intensive care patients with acute myocardial infarction (AMI) is unclear. Furthermore, owing to the lack of studies, it is also unknown whether ACAG is more accurate than AG in predicting the mortality of AMI. METHODS The Medical Information Mart for Intensive Care IV (MIMIC IV) dataset was used to provide patient data in this retrospective cohort study. ACAG is computed using the formulae: [4.4-{albumin (g/dl)}] × 2.5 + AG. The primary outcome was 30 d all-cause mortality intensive care patients with AMI. To explore the prognostic worthiness of ACAG, the receiver operating characteristic curve, smooth curve fitting, Cox regression model, and Kaplan survival analysis was performed. RESULTS We enrolled 2,160 patients in this study. ACAG had a better predictive value for 30 d all-cause mortality than AG, with an area under the curve of 0.66. The association between ACAG levels and overall mortality was nonlinear. In our model, after correcting for confounding factors, the ACAG was the independent predictor for 30 d all-cause mortality (HR 1.75, 95%CI 1.24, 2.47). ACAG K-M estimator curve analyses revealed that the group with ACAG ≥ 21.75 mmol/l had poor survival rate than the other group. CONCLUSIONS High serum ACAG levels were a significant risk factor for 30 d all-cause mortality in critically ill patients with AMI. ACAG concentration and 30 d all-cause mortality had a nonlinear relationship. ACAG had better predictive value in identifying 30 d all-cause mortality of patients with AMI in ICU than the AG.
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Affiliation(s)
- Linhao Jian
- Department of the First Clinical College, Jinan University, 601 Huangpu Avenue West, Guangzhou, 510632, China
- Department of Cardiology, The First People's Hospital of Changde, 818 Renmin Avenue, Changde City, 415003, China
| | - Zhixiang Zhang
- Department of Cardiology, The First People's Hospital of Changde, 818 Renmin Avenue, Changde City, 415003, China
| | - Quan Zhou
- Department of Science and Education, The First People's Hospital of Changde, 818 Renmin Avenue, Changde City, 415003, China
| | - Xiangjie Duan
- Department of Infectious Diseases, The First People's Hospital of Changde, 818 Renmin Avenue, Changde City, 415003, China
| | - Haiqin Xu
- Department of Cardiac Electrophysiology, The First People's Hospital of Changde, 818 Renmin Avenue, Changde City, 415003, China
| | - Liangqing Ge
- Department of Cardiology, The First People's Hospital of Changde, 818 Renmin Avenue, Changde City, 415003, China.
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11
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Schupp T, Behnes M, Rusnak J, Ruka M, Dudda J, Forner J, Egner-Walter S, Barre M, Abumayyaleh M, Bertsch T, Müller J, Akin I. Does Albumin Predict the Risk of Mortality in Patients with Cardiogenic Shock? Int J Mol Sci 2023; 24:ijms24087375. [PMID: 37108536 PMCID: PMC10138505 DOI: 10.3390/ijms24087375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/02/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
This study investigates the prognostic impact of albumin levels in patients with cardiogenic shock (CS). Intensive care unit (ICU) related mortality in CS patients remains unacceptably high despite improvement concerning the treatment of CS patients. Limited data regarding the prognostic value of albumin in patients with CS is available. All consecutive patients with CS from 2019 to 2021 were included at one institution. Laboratory values were retrieved from the day of disease onset (day 1) and days 2, 3, 4, and 8 thereafter. The prognostic impact of albumin was tested for 30-day all-cause mortality. Moreover, the prognostic performance of albumin decline during ICU treatment was examined. Statistical analyses included univariable t-test, Spearman's correlation, Kaplan-Meier analyses, multivariable mixed analysis of variance (ANOVA), C-Statistics, and Cox proportional regression analyses. In total, 230 CS patients were included, with an overall all-cause mortality at 30 days of 54%. The median albumin on day 1 was 30.0 g/L. Albumin on day 1 was able to discriminate between 30-day survivors and non-survivors (area under the curve (AUC) 0.607; 0.535-0.680; p = 0.005). CS patients with albumin < 30.0 g/L were associated with an increased risk of 30-day all-cause mortality (63% vs. 46%; log-rank p = 0.016; HR = 1.517; 95% CI 1.063-2.164; p = 0.021), which was demonstrated even after multivariable adjustment. Moreover, a decrease of albumin levels by ≥20% from day 1 to day 3 was accompanied by a higher risk of 30-days all-cause mortality (56% vs. 39%; log-rank p = 0.036; HR = 1.645; 95% CI 1.014-2.669; p = 0.044). Especially when combined with lactate, creatinine, and cardiac troponin I, reliable discrimination of 30-day all-cause mortality was observed, including albumin in CS risk stratification models (AUC = 0.745; 95% CI 0.677-0.814; p = 0.001). In conclusion, low baseline albumin levels as well as a decay of albumin levels during the course of ICU treatment, deteriorate prognostic outcomes in CS patients. The additional assessment of albumin levels may further improve risk stratification in CS patients.
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Affiliation(s)
- Tobias Schupp
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Michael Behnes
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Jonas Rusnak
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Marinela Ruka
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Jonas Dudda
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Jan Forner
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Sascha Egner-Walter
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Max Barre
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Mohammad Abumayyaleh
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Nuremberg General Hospital, Paracelsus Medical University, 90419 Nuremberg, Germany
| | - Julian Müller
- Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, 97616 Bad Neustadt a. d. Saale, Germany
- Department of Cardiology and Angiology, Philipps-University Marburg, 35037 Marburg, Germany
| | - Ibrahim Akin
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, 69117 Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, 68167 Mannheim, Germany
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12
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Dönmez E, Özcan S, Mert B, Özkaynak B, Tuğrul S, Şahin İ, Okuyan E. A Retrospective Study to Evaluate the Association Between the Glasgow Prognostic Score and Atrial Fibrillation, Stroke, and Mortality at 30 Days and at 1 Year After Coronary Artery Bypass Graft Surgery. Med Sci Monit 2023; 29:e939283. [PMID: 36718108 PMCID: PMC9898998 DOI: 10.12659/msm.939283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The Glasgow prognostic score (GPS) consists of a combination of serum C-reactive protein and albumin levels as indicators of systematic inflammatory response and nutritional status, respectively. The present retrospective study aimed to evaluate the association between the GPS and atrial fibrillation, stroke, and mortality at 30 days and 1 year after coronary artery bypass graft (CABG) surgery. MATERIAL AND METHODS Patients with chronic coronary syndromes who underwent CABG surgery between 2012 and 2019 in a single center were included. Preoperative GPS was calculated. Then, patients were grouped according to postoperative atrial fibrillation (POAF) development. Further, groups were formed to evaluate the relationship between GPS and 30-day and 1-year cardiovascular mortality as well as stroke development. RESULTS Patients who developed POAF had higher GPS, higher European System for Cardiac Operative Risk Evaluation (EuroSCORE II) score, advanced age, lower angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) use, lower left ventricular ejection fraction, and were more likely to be female and to have a history of carotid artery disease (P<0.05, for all). Additionally, GPS, EuroSCORE II, advanced age, and lower left ventricular ejection fraction were detected as independent risk factors for POAF development. When adverse outcomes were assessed, cardiovascular mortality at 30 days or 1 year, and stroke development at 1 year, were more frequent in patients with POAF. Moreover, POAF development was found to be an independent risk factor for adverse outcomes. Also, GPS was established as an independent risk factor both for 30-day and 1-year cardiovascular mortality (P<0.0001 and P=0.001, respectively). CONCLUSIONS GPS is an easy-to-calculate score that has reasonable diagnostic accuracy in determining the risk of POAF and stroke as well as 30-day and 1-year cardiovascular mortality.
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Affiliation(s)
- Esra Dönmez
- Department of Cardiology, Bagcilar Training and Research Hospital, İstanbul, Turkey
| | - Sevgi Özcan
- Department of Cardiology, Bagcilar Training and Research Hospital, İstanbul, Turkey
| | - Bülent Mert
- Department of Cardiovascular Surgery, Bagcilar Training and Research Hospital, İstanbul, Turkey
| | - Berk Özkaynak
- Department of Cardiovascular Surgery, Bagcilar Training and Research Hospital, İstanbul, Turkey
| | - Sevil Tuğrul
- Department of Cardiology, Bagcilar Training and Research Hospital, İstanbul, Turkey
| | - İrfan Şahin
- Department of Cardiology, Bagcilar Training and Research Hospital, İstanbul, Turkey
| | - Ertuğrul Okuyan
- Department of Cardiology, Bagcilar Training and Research Hospital, İstanbul, Turkey
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13
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Jian L, Zhang Z, Zhou Q, Duan X, Ge L. Red Cell Distribution Width/Albumin Ratio: A Predictor of In-Hospital All-Cause Mortality in Patients with Acute Myocardial Infarction in the ICU. Int J Gen Med 2023; 16:745-756. [PMID: 36872940 PMCID: PMC9983434 DOI: 10.2147/ijgm.s393393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
Purpose Red cell distribution width (RDW) and albumin level are linked to adverse outcomes in patients with acute myocardial infarction (AMI). Nonetheless, it remains unknown whether the RDW/albumin ratio (RAR) is associated with the short-term prognosis of AMI. Using a large cohort, we aimed to explore the association between RAR and in-hospital all-cause mortality in intensive care unit (ICU) patients with AMI. Patients and Methods The patients' data analyzed in this retrospective cohort investigation were obtained from the eICU Collaborative Research Data Resource. RAR was calculated based on the serum albumin level and RDW. The primary outcome was in-hospital all-cause mortality. Receiver operating characteristic curve, multiple logistic regression model, and Kaplan-Meier survival analysis were performed to explore the prognostic value of RAR. Results We enrolled 2594 patients in this study. After correcting for confounding factors, the RAR was an independent predictor for in-hospital mortality in our model (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.12, 1.43). A similar relationship was observed with mechanical ventilation use. RAR showed a better predictive value with an area under the curve (AUC) of 0.738 (cutoff, 4.776) for in-hospital all-cause mortality compared to RDW or albumin alone. Kaplan-Meier estimator curve analyses for RAR demonstrated that the group with RAR ≥4.776%/g/dL had poorer survival than the group with RAR <4.776%/g/dL (p< 0.0001). The subgroup analysis revealed no significant interaction between RAR and in-hospital all-cause mortality in all strata. Conclusion RAR was an independent risk factor for in-hospital all-cause mortality in ICU patients with AMI. Higher RAR values corresponded to higher mortality rates. RAR is a more accurate predictor of in-hospital all-cause mortality in patients with AMI in the ICU than albumin or RDW. Thus, RAR may be a potential biomarker of AMI.
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Affiliation(s)
- Linhao Jian
- Department of the First Clinical College, Jinan University, Guangzhou, 510632, People's Republic of China.,Department of Cardiology, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Zhixiang Zhang
- Department of Cardiology, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Quan Zhou
- Department of Science and Education, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Xiangjie Duan
- Department of Infectious Diseases, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
| | - Liangqing Ge
- Department of Cardiology, The First People's Hospital of Changde, Changde City, 415003, People's Republic of China
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14
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Inoue M, Takeuchi J, Sakuma M, Nakamura T, Morimoto T. Low Serum Total Protein at Admission Predicts in-Hospital Mortality Among General Inpatients: Historical Cohort Study. Int J Gen Med 2022; 15:7941-7949. [PMID: 36317096 PMCID: PMC9617561 DOI: 10.2147/ijgm.s385798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Low total protein (TP) is associated with mortality among patients with specific diseases, but its association was uncertain among general patients. We evaluated the effects of low TP on in-hospital mortality among general inpatients. Patients and Methods We used data from the Japan Adverse Drug Events study series. We enrolled adult inpatients (≥ 16 years) admitted to a tertiary care hospital between September 1 and November 30, 2013. We excluded patients with multiple myeloma, pregnant women, and bone marrow graft donors. Patient data were extracted from electronic medical records. All patients were stratified into those with and without malignancy and divided into the low and normal TP groups. Low TP was defined as < 6.5 g/dL. We compared the in-hospital mortality of the low and normal TP groups stratified by the presence of malignancy. Results Among the 2235 enrolled patients (mean age, 67.8 years), the TP value was lower in 516 patients with malignancy than in 1719 patients without malignancy (6.6 g/dL vs 6.8 g/dL, P = 0.0002). Among patients without or with malignancy, 27% (462/1719) and 35% (183/516) were in the low TP group, respectively. Mortality was higher in the low TP group among patients without malignancy (23.2% vs 10.2%, P < 0.0001). Likewise, among patients with malignancy, mortality was higher in the low TP group (34.7% vs 11.3%, P = 0.0029). The adjusted hazard ratio of the low TP group was 1.75 (95% confidence interval, 1.04–2.96) in patients without malignancy and 2.45 (95% confidence interval, 1.12–5.37) in patients with malignancy, but the interaction was not significant (P = 0.23). Conclusion Low TP values were associated with higher in-hospital mortality among general inpatients, and this association was observed among patients with and those without malignancy. Routinely measured TP should be utilized to risk stratification on admission.
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Affiliation(s)
- Miharu Inoue
- Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Jiro Takeuchi
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
| | - Mio Sakuma
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan
| | - Tsukasa Nakamura
- Department of Infectious Diseases, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo Medical University, Nishinomiya, Japan,Correspondence: Takeshi Morimoto, Department of Clinical Epidemiology, Hyogo Medical University, 1-1 Mukogawa, Nishinomiya, Hyogo, 663-8501, Japan, Tel +81-798-45-6879, Fax +81-798-45-6920, Email
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15
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Chen X, Xiong S, Chen Y, Cheng L, Chen Q, Yang S, Qi L, Liu H, Cai L. The Predictive Value of Different Nutritional Indices Combined with the GRACE Score in Predicting the Risk of Long-Term Death in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. J Cardiovasc Dev Dis 2022; 9:jcdd9100358. [PMID: 36286310 PMCID: PMC9604676 DOI: 10.3390/jcdd9100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Nutritional status is associated with prognosis in acute coronary syndrome (ACS) patients. Although the Global Registry of Acute Coronary Events (GRACE) risk score is regarded as a relevant risk predictor for the prognosis of ACS patients, nutritional variables are not included in the GRACE score. This study aimed to compare the prognostic ability of the Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) in predicting long-term all-cause death in ACS patients undergoing percutaneous coronary intervention (PCI) and to determine whether the GNRI or PNI could improve the predictive value of the GRACE score. A total of 799 patients with ACS who underwent PCI from May 2018 to December 2019 were included and regularly followed up. The performance of the PNI in predicting all-cause death was better than that of the GNRI [C-index, 0.677 vs. 0.638, p = 0.038]. The addition of the PNI significantly improved the predictive value of the GRACE score for all-cause death [increase in C-index from 0.722 to 0.740; IDI 0.006; NRI 0.095; p < 0.05]. The PNI was superior to the GNRI in predicting long-term all-cause death in ACS patients undergoing PCI. The addition of the PNI to the GRACE score could significantly improve the prediction of long-term all-cause death.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lin Cai
- Correspondence: (H.L.); (L.C.)
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16
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Mir SR, Lakshmi VSB. High-Sensitivity C-Reactive Protein-to-Albumin Ratio in Predicting the Major Adverse Cardiovascular Event in Acute Coronary Syndrome at Presentation. INDIAN JOURNAL OF CARDIOVASCULAR DISEASE IN WOMEN 2022. [DOI: 10.25259/mm_ijcdw_441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective:
Our study aimed to determine the association between high sensitivity-c reactive protein to albumin ratio (CAR) and in-hospital major adverse cardiovascular event (MACE) in patients with acute coronary syndrome and also to assess whether hs-CAR is a better marker than hsCRP or albumin alone in predicting MACE.
Materials and Methods:
We enrolled 110 cases who were hospitalized and major adverse cardiovascular event was defined as cardiogenic shock, acute heart failure, reinfarction and death. Blood sample for Serum albumin and hs-crp was taken at the time when patients were admitted.
Results:
The incidence of MACE was more in patients with high CAR (≥1.8 group) as compared to those with low CAR (<1.8 group).
Conclusion:
The CAR is an independent predictor of MACE in patients who present with ACS.
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Affiliation(s)
- Sajad Rashid Mir
- Department of Cardiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India,
| | - V. S. Bharathi Lakshmi
- Department of Cardiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India,
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17
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Manolis AA, Manolis TA, Melita H, Mikhailidis DP, Manolis AS. Low serum albumin: A neglected predictor in patients with cardiovascular disease. Eur J Intern Med 2022; 102:24-39. [PMID: 35537999 DOI: 10.1016/j.ejim.2022.05.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 01/02/2023]
Abstract
Albumin, the most abundant circulating protein in blood, is an essential protein which binds and transports various drugs and substances, maintains the oncotic pressure of blood and influences the physiological function of the circulatory system. Albumin also has anti-inflammatory, antioxidant, and antithrombotic properties. Evidence supports albumin's role as a strong predictor of cardiovascular (CV) risk in several patient groups. Its protective role extends to those with coronary artery disease, heart failure, hypertension, atrial fibrillation, peripheral artery disease or ischemic stroke, as well as those undergoing revascularization procedures or with aortic stenosis undergoing transcatheter aortic valve replacement, and patients with congenital heart disease and/or endocarditis. Hypoalbuminemia is a strong prognosticator of increased all-cause and CV mortality according to several cohort studies and meta-analyses in hospitalized and non-hospitalized patients with or without comorbidities. Normalization of albumin levels before discharge lowers mortality risk, compared with hypoalbuminemia before discharge. Modified forms of albumin, such as ischemia modified albumin, also has prognostic value in patients with coronary or peripheral artery disease. When albumin is combined with other risk factors, such as uric acid or C-reactive protein, the prognostic value is enhanced. Although albumin supplementation may be a plausible approach, its efficacy has not been established and in patients with hypoalbuminemia, priority is focused on diagnosing and managing the underlying condition. The CV effects of hypoalbuminemia and relevant issues are considered in this review. Large cohort studies and meta-analyses are tabulated and the physiologic effects of albumin and the deleterious effects of low albumin are pictorially illustrated.
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Affiliation(s)
| | - Theodora A Manolis
- Aiginiteio University Hospital, Athens University School of Medicine, Athens, Greece
| | - Helen Melita
- Central Laboratories, Onassis Cardiac Surgery Center, Athens, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Hospital Campus, University College London Medical School, London, UK
| | - Antonis S Manolis
- First Department of Cardiology, Athens University School of Medicine, Athens, Greece.
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18
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Turkyilmaz E, Ozkalayci F, Birdal O, Karagoz A, Tanboga IH, Tanalp AC, Oduncu V. Serum Albumin to Creatinine Ratio and Short-Term Clinical Outcomes in Patients With ST-Elevation Myocardial Infarction. Angiology 2022; 73:809-817. [PMID: 35451336 DOI: 10.1177/00033197221089423] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
There is a lack of evidence regarding the short-term predictive value of serum albumin to creatinine ratio (sACR) in patients with ST-segment elevation myocardial infarction (STEMI). This study aims to investigate the relationship between sACR and short-term outcomes in these patients. We retrospectively enrolled 3057 patients with STEMI who underwent primary percutaneous coronary interventions (PCI) (median age was 58 years, and 74.3% were male). In-hospital mortality occurred in 114 (3.7%) patients. Contrast-induced nephropathy (CIN) was reported in 381 (12.4%) patients. During a 30-day follow-up, stent thrombosis (ST) occurred in 28 (.9%) patients and 30-day death in 147 (4.8%) patients. Multivariable logistic regression analysis reported that sACR was inversely associated with 30-day mortality (adjusted odds ratio (aOR): .51, 95% confidence interval (CI) .31-.82, P < .001). The sACR was also inversely associated with in-hospital mortality (aOR: .71, 95% CI .56-.90, P = .009), CIN (aOR: .60, 95% CI .52-.68, P < .001), congestive heart failure (CHF) (aOR: .64, 95% CI .47-.87, P = .007), and ST (aOR .61, 95% CI .41-.92, P = .001) at 30 days. Our findings suggest that sACR is inversely associated with short-term clinical outcomes in patients with STEMI after PCI.
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Affiliation(s)
| | - Flora Ozkalayci
- 599103Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Oğuzhan Birdal
- Medical School, Cardiology, Ataturk University, Erzurum, Turkey
| | - Ali Karagoz
- Cardiology, Kosuyolu Heart, Research and Training Hospital, Istanbul, Turkey
| | - Ibrahim H Tanboga
- 385796Medical School, Cardiology and Biostatistics, Nisantasi University, Istanbul, Turkey
| | | | - Vecih Oduncu
- 472597Medical School, Cardiology, Bahcesehir University, Istanbul, Turkey
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19
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Lin Y, Lin Y, Yue J, Zou Q. The neutrophil percentage-to-albumin ratio is associated with all-cause mortality in critically ill patients with acute myocardial infarction. BMC Cardiovasc Disord 2022; 22:115. [PMID: 35300600 PMCID: PMC8932161 DOI: 10.1186/s12872-022-02559-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/09/2022] [Indexed: 12/02/2022] Open
Abstract
Aim In this study, we evaluated the utility of neutrophil percentage-to-albumin ratio (NPAR) in predicting in critically ill patients with acute myocardial infarction (AMI).
Methods The information of patients were collected from Medical Information Mart for Intensive Care III database. Admission NPAR was calculated as neutrophil percentage divided by serum albumin. The endpoints of this study were 30-day, 90-day, 180-day, and 365-day all-cause mortality. Cox proportional hazards models and subgroup analyses were used to determine the relationship between admission NPAR and these endpoints.
Results 798 critically ill patients with AMI were enrolled in. After adjustments for age, race and gender, higher admission NPAR was associated with increased risk of 30-day, 90-day, 180-day, and 365-day all-cause mortality in critically ill patients with AMI. And after adjusting for possible confounding variables, two different trends have emerged. Stratified by tertiles, high admission NPAR was independently associated with 180-day and 365-day all-cause mortality in critically ill patients with AMI (tertile 3 vs. tertile 1: adjusted HR, 95% CI 1.71, 1.10–2.66, p < 0.05; 1.66, 1.10–2.51, p < 0.05). In other hand, stratified by quartiles, highest admission NPAR levels were independently associated with 90-day, 180-day and 365-day all-cause mortality (quartile 4 vs. quartile 1: adjusted HR, 95% CI 2.36, 1.32–4.23, p < 0.05; 2.58, 1.49–4.47, p < 0.05; 2.61, 1.56–4.37, p < 0.05). ROC test showed that admission NPAR had a moderate ability to predict all-cause mortality of critically ill patients with AMI. No obvious interaction was found by subgroup analysis in most subgroups. Conclusions Admission NPAR was an independent predictor for 180-day and 365-day all-cause mortality in critically ill patients with AMI.
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Affiliation(s)
- Ya Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Yanhan Lin
- Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Juanqing Yue
- Department of Pathology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China.
| | - Qianqian Zou
- Obstetrics and Gynecology Ultrasonic Department, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
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20
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Duan Z, Luo C, Fu B, Han D. Association between fibrinogen-to-albumin ratio and the presence and severity of coronary artery disease in patients with acute coronary syndrome. BMC Cardiovasc Disord 2021; 21:588. [PMID: 34876026 PMCID: PMC8650388 DOI: 10.1186/s12872-021-02400-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
Objective Although the levels of plasma fibrinogen and albumin have been proven to be in relation to coronary heart disease (CHD), the association between fibrinogen-to-albumin ratio (FAR) and acute coronary syndrome (ACS) has not been adequately investigated. The aim of this study is to investigate the relationship between FAR and the presence and severity of CHD in patients with ACS. Methods and results A total of 1575 individuals who received coronary angiography (CAG) were enrolled. Patients were divided into the ACS group and the control group. The severity of ACS was determined by Gensini score, number of diseased coronary artery and the presence of myocardial infarction (MI). Data showed that the level of FAR in ACS group was higher than in the control group (81.20 ± 35.45 vs. 72.89 ± 20.24, P < 0.001). The results from subgroup analysis indicated that the values of FAR in the high Gensini score group, MI group and multiple-vessel stenosis group were higher than the matched subgroups. After adjustment for confounders, FAR was still independently related to the presence and severity of ACS (MI OR 2.097, 95%CI 1.430–3.076; High GS: OR 2.335, 95%CI 1.567–3.479; multiple-vessel disease: OR 2.088, 95%CI 1.439–3.030; P < 0.05). Conclusion The levels of FAR are independently associated with the presence and the severity of coronary artery disease in patients with ACS. Furthermore, FAR, as a more convenient and rapid biological indicator, may provide a new idea for predicting the presence and severity of ACS. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02400-z.
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Affiliation(s)
- Zhenzhen Duan
- Department of Peripheral Vascular Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Chaodi Luo
- Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Bowen Fu
- Department of Peripheral Vascular Diseases, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Dan Han
- Department of Cardiovascular Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China.
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21
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Feng DY, Ren Y, Zhou M, Zou XL, Wu WB, Yang HL, Zhou YQ, Zhang TT. Deep Learning-Based Available and Common Clinical-Related Feature Variables Robustly Predict Survival in Community-Acquired Pneumonia. Risk Manag Healthc Policy 2021; 14:3701-3709. [PMID: 34512057 PMCID: PMC8427836 DOI: 10.2147/rmhp.s317735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/14/2021] [Indexed: 01/16/2023] Open
Abstract
Background Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. Although there are many predictors of death for CAP, there are still some limitations. This study aimed to build a simple and accurate model based on available and common clinical-related feature variables for predicting CAP mortality by adopting machine learning techniques. Methods This was a single-center retrospective study. The data used in this study were collected from all patients (≥18 years) with CAP admitted to research hospitals between January 2012 and April 2020. Each patient had 62 clinical-related features, including clinical diagnostic and treatment features. Patients were divided into two endpoints, and by using Tensorflow2.4.1 as the modeling framework, a three-layer fully connected neural network (FCNN) was built as a base model for classification. For a comprehensive comparison, seven classical machine learning methods and their integrated stacking patterns were introduced to model and compare the same training and test data. Results A total of 3997 patients with CAP were included; 205 (5.12%) died in the hospital. After performing deep learning methods, this study established an ensemble FCNN model based on 12 FCNNs. By comparing with seven classical machine learning methods, the area under the curve of the ensemble FCNN was 0.975 when using deep learning algorithms to classify poor from good prognosis based on available and common clinical-related feature variables. The predicted outcome was poor prognosis if the ControlNet's poor prognosis score was greater than the cutoff value of 0.50. To confirm the scientificity of the ensemble FCNN model, this study analyzed the weight of random forest features and found that mainstream prognostic features still held weight, although the model is perfect after integrating other factors considered less important by previous studies. Conclusion This study used deep learning algorithms to classify prognosis based on available and common clinical-related feature variables in patients with CAP with high accuracy and good generalizability. Every clinical-related feature is important to the model.
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Affiliation(s)
- Ding-Yun Feng
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yong Ren
- Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, People's Republic of China
| | - Mi Zhou
- Department of Surgery Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiao-Ling Zou
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Wen-Bin Wu
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Hai-Ling Yang
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yu-Qi Zhou
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Tian-Tuo Zhang
- Department of Pulmonary and Critical Care Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Institute of Respiratory Diseases of Sun Yat-Sen University, Guangzhou, People's Republic of China
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22
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Wang Y, Du P, Xiao Q, Li J, Liu X, Tan J, Zhang X. Relationship Between Serum Albumin and Risk of Atrial Fibrillation: A Dose-Response Meta-Analysis. Front Nutr 2021; 8:728353. [PMID: 34490334 PMCID: PMC8418186 DOI: 10.3389/fnut.2021.728353] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/23/2021] [Indexed: 02/01/2023] Open
Abstract
Background: The dose-response association between serum albumin and atrial fibrillation is not well known. This study aims to assess the relationship between albumin and atrial fibrillation and the potential dose-response effect. Methods: Studies reported that the serum albumin and AF were identified by searching the EMBASE, PubMed, and Cochrane Library databases. The potential dose-response effect was performed by using a stage robust error meta-regression. Results: Nine studies were included with a total of 32,130 individuals. Patients with high albumin level were associated with a decreased risk of atrial fibrillation compared with patients with low serum albumin (OR[odds ratio]: 0.62, 95% CI [0.44, 0.89]; I 2 = 76%; P = 0.009). In the dose-response analysis, for each 10 g/L increase in serum albumin level, the risk of atrial fibrillation decreased by 36% (95% CI: 0.51-0.81, I 2 = 87%, P < 0.001). Furthermore, a significant negative linear relationship between serum albumin and the risk of atrial fibrillation (P nonlinearity = 0.33) was found. Conclusion: Our dose-response meta-analysis suggests that low serum albumin level is associated with an increased risk of atrial fibrillation. Further studies are needed to explore the effect of induction of elevated serum albumin levels on the prevention of atrial fibrillation.
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Affiliation(s)
- Yali Wang
- Department of Pathology, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Peng Du
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qi Xiao
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianfeng Li
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiao Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jinfeng Tan
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xingjian Zhang
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
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23
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Effects of preoperative and postoperative albumin levels on postoperative arrhythmias after open heart surgeries with cardiopulmonary bypass. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.887312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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24
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Arques S. Serum albumin and cardiovascular disease: State-of-the-art review. Ann Cardiol Angeiol (Paris) 2020; 69:192-200. [PMID: 32797938 DOI: 10.1016/j.ancard.2020.07.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
Cardiovascular disease is the leading cause of death worldwide. Conceptually, endothelial dysfunction, inflammatory conditions and oxidative stress are at the forefront of the onset and development of most cardiovascular diseases, particularly coronary artery disease and heart failure. Serum albumin has many physiological properties, including in particular antioxidant, anti-inflammatory, anticoagulant and anti-platelet aggregation activity. It also plays an essential role in the exchange of fluids across the capillary membrane. Hypoalbuminemia is a powerful prognostic marker in the general population as well as in many disease states. In the more specific context of cardiovascular disease, low serum albumin is independently associated with the development of various deleterious conditions such as coronary artery disease, heart failure, atrial fibrillation, stroke and venous thromboembolism. Low serum albumin has also emerged as a potent prognostic parameter in patients with cardiovascular disease regardless of usual prognostic markers. Remarkably, its potent prognostic value persists after adjusting for causative confounders such as malnutrition and inflammation. This prognostic value probably refers primarily to the syndrome of malnutrition-inflammation and the severity of comorbidities. Nevertheless, several recent meta-analyses strongly support the hypothesis that hypoalbuminemia may act as an unrecognized, potentially modifiable risk factor contributing to the emergence and progression of cardiovascular disease, primarily by exacerbating oxidative stress, inflammation and platelet aggregation, and by favouring peripheral congestion and pulmonary edema. Currently, it is unknown whether prevention and correction of low serum albumin offers a benefit to patients with or at risk for cardiovascular disease, and further studies are critically needed in this setting.
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Affiliation(s)
- S Arques
- Service de Cardiologie, Centre hospitalier Edmond Garcin, Avenue des Soeurs Gastine, 13400 Aubagne, France.
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25
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Liu H, Zhang J, Yu J, Li D, Jia Y, Cheng Y, Zhang Q, Liao X, Liu Y, Wu J, Zeng Z, Cao Y, Zeng R, Wan Z, Gao Y. Prognostic value of serum albumin-to-creatinine ratio in patients with acute myocardial infarction: Results from the retrospective evaluation of acute chest pain study. Medicine (Baltimore) 2020; 99:e22049. [PMID: 32871964 PMCID: PMC7458165 DOI: 10.1097/md.0000000000022049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The long-term association between serum albumin-to-creatinine ratio (sACR) and poor patient outcomes in acute myocardial infarction (AMI) remains unclear. This study aimed to determine whether sACR was a predictor of poor long-term survival in patients with AMI.This was a study of patients with AMI in the emergency department (ED) from the retrospective multicenter study for early evaluation of acute chest pain (REACP) study. The patients were categorized into tertiles (T1, T2, and T3) based on the admission sACR (0.445 and 0.584 g/μmol). Baseline sACR at admission to the ED was predictive of adverse outcomes. The primary outcome was all-cause mortality within the follow-up period. Cox proportional hazards models were performed to investigate the association between sACR and all-cause mortality in patients with AMI.A total of 2250 patients with AMI were enrolled, of whom 229 (10.2%) died within the median follow-up period of 10.7 (7.2-14.6) months. Patients with a lower sACR had higher all-cause mortality and adverse outcomes rates than patients with a higher sACR. Kaplan-Meier survival analysis showed that patients with a higher sACR had a higher cumulative survival rate (P < .001). Cox regression analysis showed that a decreased sACR was an independent predictor of all-cause mortality [T2 vs T1: hazard ratio (HR); 0.550, 95% confidence interval (95% CI), 0.348-0.867; P = .010 and T3 vs T1: HR, 0.305; 95% CI, 0.165-0.561; P < .001] and cardiac mortality (T2 vs T1: HR, 0.536; 95% CI, 0.332-0.866; P = .011 and T3 vs T1: HR, 0.309; 95% CI, 0.164-0.582, P < .001).The sACR at admission to ED was independently associated with adverse outcomes, indicating that baseline sACR was a useful biomarker to identify high-risk patients with AMI at an early phase in ED.
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Affiliation(s)
- Hong Liu
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Jianna Zhang
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Jing Yu
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Dongze Li
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Yu Jia
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Yisong Cheng
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Qin Zhang
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Xiaoyang Liao
- Department of General Practice, International Hospital of Sichuan Province, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Yanmei Liu
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiang Wu
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Zhi Zeng
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Yu Cao
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Rui Zeng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Wan
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
| | - Yongli Gao
- Department of Emergency Medicine, Laboratory of Emergency Medicine, Deep Underground Space Medical Center, West China School of Nursing, West China Hospital, and Disaster Medical Center, Sichuan University, Chengdu, China
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26
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Fagbohun OF, Olawoye B, Ademakinwa AN, Jolayemi KA, Msagati TAM. Metabolome modulatory effects of Kigelia africana (Lam.) Benth. fruit extracts on oxidative stress, hyperlipidaemic biomarkers in STZ-induced diabetic rats and antidiabetic effects in 3T3 L1 adipocytes. J Pharm Pharmacol 2020; 72:1798-1811. [PMID: 32812253 DOI: 10.1111/jphp.13362] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/25/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The management of diabetes is considered a global problem, and a cure is yet to be discovered. This study investigated the modulatory effect of Kigelia africana fruit on oxidative stress and hyperlipidaemic biomarkers in STZ-induced diabetic rats, profiled phytoconstituents using GC-TOF-MS and evaluated antidiabetic effects on 3T3 L1 adipocytes. METHODS Thirty male Wistar rats (120-150 g) were divided into six groups (n = 5). Diabetes was induced by a single intraperitoneal injection of STZ (60 mg/kg) and treated with 100, 200 and 400 of hexane fraction of KA for 28 days. Immunohistochemical evaluation was carried out using avidin-biotin immunoperoxidase (ABI) method. Catalase and SOD activities as well as the levels of total protein, albumin, bilirubin, triglyceride, cholesterol, and high-density lipoprotein were measured. KEY FINDINGS The expressions of oxidative stress and hyperlipidaemic biomarkers alongside fasting blood glucose concentrations were remarkedly decreased in KA-treated diabetic rats. Moreover, there was a significant increase in endocrine cell distribution, area covered with increase in β-cell mass, composition and morphology of KA-treated animals. Additionally, there was constant up-regulation in 3T3 L1 adipocytes due to the presence of phytoconstituents. CONCLUSION Kigelia africana fruit can act as a modulatory agent due to its ameliorative effects against oxidative stress.
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Affiliation(s)
- Oladapo F Fagbohun
- Department of Biomedical Engineering, First Technical University, Ibadan, Nigeria
| | - Babatunde Olawoye
- Department of Food Science and Technology, First Technical University, Ibadan, Nigeria
| | - Adedeji N Ademakinwa
- Department of Physical and Chemical Sciences, Elizade University, Ilara-Mokin, Nigeria
| | - Kehinde A Jolayemi
- Department of Anatomy and Cell Biology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Titus A M Msagati
- Nanotechnology and Water Sustainability Research Unit, College of Science Engineering and Technology, University of South Africa (UNISA), Johannesburg, South Africa
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