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非ST段抬高型心肌梗死患者纤维蛋白原与白蛋白比值和SYNTAX评分的关系

Relationship Between the Fibrinogen-to-Albumin Ratio and SYNTAX Score in Patients with Non-St-Elevation Myocardial Infarction.

作者信息

Erdoğan Güney, Arslan Uğur, Yenercağ Mustafa, Durmuş Gündüz, Tuğrul Sevil, Şahin İrfan

机构信息

University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun, Turkey.

Sultangazi Haseki Training and Research Hospital, Cardiology Clinic, Istanbul, Turkey.

出版信息

Rev Invest Clin. 2021 Feb 3;73(3):182-189. doi: 10.24875/RIC.20000534.

Abstract

BACKGROUND

Despite the association of fibrinogen-to-albumin ratio (FAR) with the extent, severity, and complexity of coronary artery disease (CAD) in patients with ST-elevation myocardial infarction (STEMI) and stable CAD, no studies to date have specifically addressed this issue in patients with non-STEMI (NSTEMI).

OBJECTIVES

This study aimed to evaluate whether a relationship exists between FAR and the SYNergy between Percutaneous Coronary Intervention with TAXus (SYNTAX) score in patients with NSTEMI.

METHODS

In this prospective cross-sectional study, 330 patients with NSTEMI who had undergone coronary angiography in an academic medical center were divided into two groups: those with an intermediate/high (≥23) SYNTAX score (241 patients) and those with a low SYNTAX score < 23 (89 patients). SYNTAX score was computed by two highly experienced cardiologists (who were blinded to the study data) using an online SYNTAX calculator. Fibrinogen and albumin levels were measured in all patients, and FAR was calculated.

RESULTS

Multivariate logistic regression analysis showed that FAR (odds ratio [OR]: 1.478, 95% confidence interval [CI]: 1.089-2.133, p = 0.002), low-density lipoprotein (OR: 1.058, 95% CI: 1.008-1.134, p = 0.026), and troponin I (OR: 1.219, 95% CI: 1.015-1.486, p = 0.031) were independent predictors of the SYNTAX score. In a receiver operating characteristics analysis, a cutoff FAR value of 95.3 had an 83% sensitivity and an 86% specificity (area under the curve [AUC]: 0.84, p < 0.001) for the prediction of SYNTAX scores ≥23 in NSTEMI patients.

CONCLUSION

These results indicate that FAR is a useful tool to predict intermediate-high SYNTAX scores in NSTEMI patients.

摘要

背景

尽管纤维蛋白原与白蛋白比值(FAR)与ST段抬高型心肌梗死(STEMI)和稳定性冠心病患者的冠状动脉疾病(CAD)的范围、严重程度及复杂性相关,但迄今为止尚无研究专门针对非ST段抬高型心肌梗死(NSTEMI)患者的这一问题进行探讨。

目的

本研究旨在评估NSTEMI患者中FAR与紫杉醇药物涂层支架冠状动脉介入治疗协同(SYNTAX)评分之间是否存在关联。

方法

在这项前瞻性横断面研究中,330例在一所学术医疗中心接受冠状动脉造影的NSTEMI患者被分为两组:中/高(≥23)SYNTAX评分组(241例患者)和低SYNTAX评分组(<23,89例患者)。SYNTAX评分由两位经验丰富的心脏病专家(对研究数据不知情)使用在线SYNTAX计算器计算得出。对所有患者测量纤维蛋白原和白蛋白水平,并计算FAR。

结果

多因素逻辑回归分析显示,FAR(比值比[OR]:1.478,95%置信区间[CI]:1.089 - 2.133,p = 0.002)、低密度脂蛋白(OR:1.058,95% CI:1.008 - 1.134,p = 0.026)及肌钙蛋白I(OR:1.219,95% CI:1.015 - 1.486,p = 0.031)是SYNTAX评分的独立预测因素。在受试者工作特征分析中,FAR临界值为95.3时,预测NSTEMI患者SYNTAX评分≥23的敏感度为83%,特异度为86%(曲线下面积[AUC]:0.84,p < 0.001)。

结论

这些结果表明,FAR是预测NSTEMI患者中/高SYNTAX评分的有用工具。

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