Kalkan Sedat, Cagan Efe Süleyman, Karagöz Ali, Zeren Gönül, Yılmaz Mehmet Fatih, Şimşek Barış, Batgerel Ulaankhuu, Özkalaycı Flora, Tanboğa İbrahim Halil, Oduncu Vecih, Karabay Can Yücel, Kırma Cevat
Department of Cardiology, Ringgold:111350Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Research and Training Hospital, Istanbul, Turkey.
Angiology. 2022 May;73(5):461-469. doi: 10.1177/00033197211066362. Epub 2022 Jan 6.
Several studies have shown that high uric acid (UA) and low serum albumin (SA) values increase the risk of cardiovascular disease and mortality in ST-elevation myocardial infarction (STEMI). We determined whether the uric acid/albumin ratio (UAR) is a predictor of mortality in STEMI patients. All patients who presented at our center with a diagnosis of STEMI and underwent percutaneous intervention from 2015 to 2020 were screened consecutively; 4599 patients were included. A Cox proportional hazards model was used to evaluate UAR, and adjusted predictors obtained from laboratory findings and clinical characteristics contributed to mortality. Also, a regression model was presented with a directed acyclic graph (DAG). The median age of the patients was 58 years (IQR [interquartile range]: 50-67); 3581 patients (77.9%) were male. The incidence of mortality in the entire patient group was 11.9%. Median follow-up duration of all groups was 42 months. Multivariate Cox proportional regression (model-1) analysis showed age (increase 50 to 67 years; HR [hazard ratio]: 1.34, 95% CI 1.18-1.52) and UAR (increase 1.15-1.73; HR: 1.33, 95% CI 1.16-1.52) were associated with mortality. UAR may be a prognostic factor for mortality in STEMI patients and an easily accessible parameter to identify high-risk patients.
多项研究表明，高尿酸（UA）和低血清白蛋白（SA）值会增加ST段抬高型心肌梗死（STEMI）患者发生心血管疾病和死亡的风险。我们确定尿酸/白蛋白比值（UAR）是否为STEMI患者死亡的预测指标。对2015年至2020年期间在我们中心诊断为STEMI并接受经皮介入治疗的所有患者进行了连续筛查；共纳入4599例患者。采用Cox比例风险模型评估UAR，并将从实验室检查结果和临床特征中获得的校正预测指标用于分析死亡率。此外，还使用有向无环图（DAG）呈现了一个回归模型。患者的中位年龄为58岁（四分位间距[IQR]：50 - 67岁）；3581例患者（77.9%）为男性。整个患者组的死亡率为11.9%。所有组的中位随访时间为42个月。多变量Cox比例回归（模型1）分析显示，年龄（从50岁增至67岁；风险比[HR]：1.34，95%置信区间[CI] 1.18 - 1.52）和UAR（从1.15增至1.73；HR：1.33，95% CI 1.16 - 1.52）与死亡率相关。UAR可能是STEMI患者死亡的一个预后因素，也是识别高危患者的一个易于获取的参数。
