Usefulness of The C‐Reactive Protein/Albumin Ratio for Predicting No‐Reflow in <scp>ST</scp>‐elevation myocardial infarction treated with primary percutaneous coronary intervention

Karabağ, Yavuz; Çağdaş, Metin; Rencüzoğulları, İbrahim; Karakoyun, Süleyman; Artaç, İnanç; İliş, Doğan; Yesi̇n, Mahmut; Çağdaş, Öznur Sadioğlu; Altıntaş, Bernas; Burak, Cengiz; Tanboğa, Halil İbrahim

doi:10.1111/eci.12928

Cited by 73 publications

(65 citation statements)

References 33 publications

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“…In group A, (no-reflow) CRP was significantly higher reflecting ongoing inflammation associated with thrombosis. This is comparative to the data reported by Karabag et al in 2018 [20]. Our data showed a lower Albumin level in patients who had no-reflow.…”

Section: Discussionsupporting

confidence: 71%

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Othman¹

2019

CCR

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Background Primary Percutaneous coronary intervention (PPCI) is an established mainstay in treatment of patients presenting with acute ST elevation myocardial infarction (STEMI). However, successful revascularization of the culprit coronary vessel does not always mean ideal myocardial reperfusion in a portion of patients, mainly because of the noreflow phenomenon. Myocardial no-reflow is associated with worse contractile dysfunction and higher incidence of complications and is an independent predictor of death and myocardial infarction after PPCI. Objective: To study the relationship between admissions CRP, Albumin, CRP/Albumin ratio, Monocyte, HDL, and Monocyte/HDL ratio, in patients presenting with acute STEMI and angiographic no-reflow after PPCI. Material and Methods: From October 2018 to February 2019, of the 1500 patients who presented with STEMI for PPCI to any of the Ain Shams University Hospitals' cath labs, we enrolled 150 consecutive patients who had post revascularization angiographic no-reflow. They were allocated to group A. we allocated 150 age, gender, and baseline characteristics matched STEMI patients who had TIMI III flow post revascularization to group B. this was set as the control group. Results: The study population was divided into 2 groups: no-reflow "A" (n = 150) and reflow "B" (n = 150) groups. CRP and Monocytes were significantly higher in the no-reflow group; Albumin and HDL were significantly lower in the no-reflow group. The novel indices, CRP/Albumin ratio (CAR) and Monocytes/HDL ratio (MHR) were both significantly higher in the no-reflow group (p value = 0.000) for both. The tow indices were found to be independent predictors of no-reflow development. Conclusion: Our results suggested that CAR and MHR on admission before PPCI though cheap, and easily measurable laboratory tools, have a significant predictive value with an odds ratio of 0.182 with a p value = 0.000 and 0.321 with a p value = 0.002 respectively. They could help to risk stratify STEMI patients who might suffer from no-reflow phenomenon after PPCI.

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Section: Discussionsupporting

confidence: 71%

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Othman¹

2019

CCR

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“…Previous studies showed that MI is usually accompanied by hypoxia, myocardial cell apoptosis, and death [4,5]. Oxidative stress, inflammation, and fibrosis are significantly involved in the progression of MI [6–10].…”

Section: Introductionmentioning

confidence: 99%

Hypoxia-Inducible Factor 1 alpha (HIF-1α)/Vascular Endothelial Growth Factor (VEGF) Pathway Participates in Angiogenesis of Myocardial Infarction in Muscone-Treated Mice: Preliminary Study

et al. 2018

Med Sci Monit

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BackgroundAngiogenesis plays a crucial role in myocardial infarction (MI) treatment by ameliorating myocardial remodeling, thus improving cardiac function and preventing heart failure. Muscone has been reported to have beneficial effects on cardiac remodeling in MI mice. However, the effects of muscone on angiogenesis in MI mice and its underlying mechanisms remain unknown.Material/MethodsMice were randomly divided into sham, MI, and MI+muscone groups. The MI mouse model was established by ligating the left anterior descending coronary artery. Mice in the sham group received the same procedure except for ligation. Mice were administered muscone or an equivalent volume of saline for 4 consecutive weeks. Cardiac function was evaluated by echocardiograph after MI for 2 and 4 weeks. Four weeks later, all mice were sacrificed and Masson’s trichrome staining was used to assess myocardial fibrosis. Isolectin B4 staining was applied to evaluate the angiogenesis in mouse hearts. Immunohistochemistry, Western blot analysis, and quantitative real-time polymerase chain reaction (qPCR) were performed to analyze expression levels of HIF-1α and its downstream genes.ResultsCompared with the MI group, muscone treatment significantly improved cardiac function and reduced myocardial fibrosis. Moreover, muscone enhanced angiogenesis in the peri-infarct region and p-VEGFR2 expression in the vascular endothelial cells. Western blot analysis and qPCR showed that muscone upregulated expression levels of HIF-1α and VEGFA.ConclusionsMuscone improved cardiac function in MI mice through augmented angiogenesis. The potential mechanism of muscone treatment in regulating angiogenesis of MI mice was upregulating expression levels of HIF-1α and VEGFA.

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“…Karabağ et al revealed that increase in CAR levels is related to reperfusion injury and it is an independent predictor of angiographic NR development. In addition, increase in in-hospital mortality rate was correlated with the increase in CAR levels in their study [32]. Low serum albumin and increased CRP levels might be associated with NR in patients with STEMI [33].…”

Section: Correlation Between Nr and Car In Patients With Stemimentioning

confidence: 74%

Prognostic value of C-reactive protein/albumin ratio in ST-segment elevation myocardial infarction

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Tıbıllı

et al. 2020

IMAS

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Serum C-reactive protein (CRP)/albumin ratio (CAR) is demonstrated as a more precise marker in determining the prognosis of critical diseases than albumin and CRP levels, separately. Recently, inflammatory biomarkers are increasingly used for both screening and prognosis of coronary artery disease (CAD). As an ischemia-dependent risk index, CAR is an independent marker of in-hospital and long-term all-cause mortality in ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention. The results indicate that CAR is a more effective prognostic marker than either CRP or albumin.

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Usefulness of The C‐Reactive Protein/Albumin Ratio for Predicting No‐Reflow in ST‐elevation myocardial infarction treated with primary percutaneous coronary intervention

Abstract: No-reflow can be predicted by systemic inflammation markers including WBC count, NLR and CAR measured from the blood sample obtained on admission. CAR has a higher clinical value than CRP, albumin level, WBC count and NLR in NR prediction.

Cited by 73 publications

References 33 publications

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Hypoxia-Inducible Factor 1 alpha (HIF-1α)/Vascular Endothelial Growth Factor (VEGF) Pathway Participates in Angiogenesis of Myocardial Infarction in Muscone-Treated Mice: Preliminary Study

Prognostic value of C-reactive protein/albumin ratio in ST-segment elevation myocardial infarction

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