Department of Cardiology, Health Sciences University, Sultan II, Abdülhamid Han Training and Research Hospital, Istanbul, Turkey.
Health Sciences University, Van Training and Research Hospital, Van, Turkey.
Rev Invest Clin. 2022 May 2;74(3):156-164. doi: 10.24875/RIC.22000072.
There is a lack of studies supporting the association between the uric acid/albumin ratio (UAR) and the development of new-onset atrial fibrillation (NOAF) in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI).
The objective of the study was to assess the efficacy of the UAR for predicting the occurrence of NOAF in STEMI patients undergoing pPCI.
We recruited 1484 consecutive STEMI patients in this retrospective and cross-sectional investigation. The population sample was classified based on the development of NOAF during hospitalization. NOAF was defined as an atrial fibrillation (AF) observed during hospitalization in patients without a history of AF or atrial flutter. The UAR was computed by dividing the serum uric acid (UA) level by serum albumin level.
After pPCI, 119 STEMI patients (8%) were diagnosed with NOAF. NOAF patients had higher serum UAR levels than individuals who did not have NOAF. According to the multivariable logistic regression model, the UAR was an independent predictor for NOAF in STEMI patients (OR: 6.951, 95% CI: 2.978-16.28, p < 0.001). The area under curve (AUC) value of the UAR in a receiver operating characteristics (ROC) evaluation was 0.758, which was greater than those of its components (albumin [AUC: 0.633] and UA [AUC: 0.647]) and C-reactive protein (AUC: 0.714). The optimal UAR value in predicting NOAF in STEMI patients was greater than 1.39, with a sensitivity of 69% and a specificity of 74.5%.
To the best of our knowledge, this is the first study indicating that the UAR was an independent predictor of NOAF development in STEMI patients.
目前缺乏研究支持原发性经皮冠状动脉介入治疗（pPCI）治疗的 ST 段抬高型心肌梗死（STEMI）患者血尿酸/白蛋白比值（UAR）与新发心房颤动（NOAF）之间的关系。
本研究旨在评估 UAR 预测 STEMI 患者接受 pPCI 后发生 NOAF 的效果。
本回顾性、横断面研究纳入了 1484 例连续 STEMI 患者。根据住院期间是否发生 NOAF 将人群样本进行分类。NOAF 定义为住院期间无房颤或房扑病史的患者出现房颤。UAR 通过血清尿酸（UA）水平除以血清白蛋白水平计算得出。
pPCI 后，119 例（8%）STEMI 患者被诊断为 NOAF。NOAF 患者的血清 UAR 水平高于未发生 NOAF 的患者。多变量逻辑回归模型显示，UAR 是 STEMI 患者发生 NOAF 的独立预测因子（OR：6.951，95%CI：2.978-16.28，p＜0.001）。ROC 评价中 UAR 的曲线下面积（AUC）值为 0.758，大于其组成部分（白蛋白[AUC：0.633]和 UA[AUC：0.647]）和 C 反应蛋白（AUC：0.714）。预测 STEMI 患者发生 NOAF 的最佳 UAR 值大于 1.39，其灵敏度为 69%，特异性为 74.5%。
据我们所知，这是第一项表明 UAR 是 STEMI 患者发生 NOAF 的独立预测因子的研究。
