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尿酸与白蛋白比值与冠心病经药物洗脱支架置入术后支架内再狭窄的关系。

Relationship between uric acid to albumin ratio and in-stent restenosis in patients with coronary artery disease undergoing drug-eluting stenting.

机构信息

Jinzhou Medical University, Jinzhou, Liaoning Province, China.

Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.

出版信息

Coron Artery Dis. 2023 Dec 1;34(8):589-594. doi: 10.1097/MCA.0000000000001300. Epub 2023 Oct 11.

Abstract

BACKGROUND

In-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI) to treat coronary artery disease (CAD) is an urgent issue in clinical practice. Recent studies have highlighted uric acid-albumin ratio (UAR) as a new marker for evaluating inflammation and oxidative stress, capable of predicting cardiovascular ailments. We aimed to examine the correlation between UAR levels and ISR in patients who underwent drug-eluting stent (DES) implantation.

METHODS

We included 503 patients with CAD who underwent initial DES implantation and angiography during the follow-up period. Based on coronary angiographic findings, the patients were categorized into ISR (n = 73) and non-ISR groups (n = 430). Before angiography, laboratory parameters were measured for all enrolled patients. To ascertain the influential factors linked to ISR, multivariate logistic regression analysis was performed. The predictive capability of UAR in determining ISR was assessed using receiver operating characteristic (ROC) curve analysis. Statistical significance was set at P  < 0.05.

RESULTS

Multivariate logistic regression analysis revealed that diabetes mellitus, stent length, UAR, albumin levels, and C-reactive protein levels independently predicted ISR. ROC curve analysis revealed that UAR had an area under the curve of 0.767 (95% CI: 0.709 - 0.826) for predicting ISR and demonstrated that UAR outperformed the individual predictive abilities of uric acid and albumin for ISR.

CONCLUSION

UAR was associated with ISR in patients with CAD undergoing PCI with DES implantation. Moreover, ROC curve analysis demonstrated that UAR exhibited superior predictive accuracy for ISR compared with evaluating uric acid and albumin levels separately.

摘要

背景

经皮冠状动脉介入治疗(PCI)治疗冠状动脉疾病(CAD)后发生的支架内再狭窄(ISR)是临床实践中的一个紧迫问题。最近的研究强调尿酸-白蛋白比值(UAR)作为评估炎症和氧化应激的新标志物,能够预测心血管疾病。我们旨在研究接受药物洗脱支架(DES)植入的患者中 UAR 水平与 ISR 之间的相关性。

方法

我们纳入了 503 例接受初始 DES 植入术和随访期间血管造影的 CAD 患者。根据冠状动脉造影结果,将患者分为 ISR 组(n=73)和非 ISR 组(n=430)。在血管造影前,测量了所有入组患者的实验室参数。为了确定与 ISR 相关的影响因素,进行了多变量 logistic 回归分析。使用受试者工作特征(ROC)曲线分析评估 UAR 预测 ISR 的能力。统计学意义设定为 P < 0.05。

结果

多变量 logistic 回归分析显示,糖尿病、支架长度、UAR、白蛋白水平和 C 反应蛋白水平独立预测 ISR。ROC 曲线分析显示,UAR 预测 ISR 的曲线下面积为 0.767(95%CI:0.709-0.826),并且 UAR 对 ISR 的预测能力优于尿酸和白蛋白的单独预测能力。

结论

UAR 与接受 DES 植入 PCI 的 CAD 患者的 ISR 相关。此外,ROC 曲线分析表明,UAR 对 ISR 的预测准确性优于单独评估尿酸和白蛋白水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1cc/10602219/bbc0ca9bbc23/cad-34-589-g001.jpg

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