Department of Cardiology, Tokat State Hospital, Tokat, Turkey.
Public Health Department, Tokat Provincial Health Directorate, Tokat, Turkey.
Angiology. 2023 Jan;74(1):55-61. doi: 10.1177/00033197221098277. Epub 2022 May 2.
Many hypotheses have been proposed to explain no-reflow (NR). Some of these hypotheses, state that NR may be caused by damage to the vascular endothelium and an inflammatory process. In a recent study that did not include patients with coronary artery bypass graft (CABG), the ratio of C-reactive protein (CRP) to albumin (CAR) was found to be associated with NR. Our study aims to evaluate the relationship between CAR and NR in patients who underwent percutaneous coronary intervention (PCI) for saphenous vein graft (SVG). In this retrospective study, among the patients with CABG who underwent primary or elective coronary angiography, 242 patients who underwent PCI to the SVG were selected. The incidence of NR was 19.8% (n = 48). Diabetes mellitus, left ventricular ejection fraction (LVEF), stent length, and CAR were found as independent predictors of NR in multivariate logistic regression analysis (P < .05). Using a cut-off level of .930, the CAR predicted NR with a sensitivity of 75% and a specificity of 73% (AUC: .814, 95% CI: .749-.879, P < .001). The CAR was a better predictor than both stent length and LVEF. CAR was found to be the strongest predictor of NR in our study.
许多假说被提出以解释无复流（NR）现象。其中一些假说认为，NR 可能是由血管内皮损伤和炎症过程引起的。在一项最近的研究中，该研究未包括冠状动脉旁路移植术（CABG）患者，发现 C 反应蛋白（CRP）与白蛋白（ALB）的比值（CAR）与 NR 相关。我们的研究旨在评估经皮冠状动脉介入治疗（PCI）治疗大隐静脉桥（SVG）患者中 CAR 与 NR 之间的关系。在这项回顾性研究中，在接受 CABG 行初次或选择性冠状动脉造影的患者中，选择了 242 例行 PCI 至 SVG 的患者。NR 的发生率为 19.8%（n=48）。多变量逻辑回归分析发现，糖尿病、左心室射血分数（LVEF）、支架长度和 CAR 是 NR 的独立预测因子（P<.05）。使用.930 的截断水平，CAR 预测 NR 的敏感度为 75%，特异度为 73%（AUC：.814，95%CI：.749-.879，P<.001）。CAR 比支架长度和 LVEF 更能预测 NR。在我们的研究中，CAR 被发现是预测 NR 的最强预测因子。
