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炎症标志物对冠心病监护病房收治患者院内结局的预测能力(MORCOR-TURK INFLAME研究)

Predictive Ability of Inflammatory Markers on In-Hospital Outcomes in Patients Admitted to Coronary Care Unit (MORCOR-TURK INFLAME).

作者信息

Kümet Ömer, Özgeyik Mehmet, Topuz Şahin, Taşcanov Mustafa Beğenç, Dindaş Ferhat, Şahin İrfan, Ersoy İbrahim, Tanboğa İbrahim Halil

机构信息

Department of Cardiology, Health Sciences University, Van Educational and Research Hospital, Van, Turkey.

Department of Cardiology, Eskişehir City Hospital, Eskisehir, Turkey.

出版信息

Angiology. 2024 Aug 12:33197241273389. doi: 10.1177/00033197241273389.

DOI:10.1177/00033197241273389
PMID:39134469
Abstract

We investigated the prognostic implications of the systemic immune-inflammatory index (SII), atherogenic index of plasma (AIP), C-reactive protein/albumin ratio (CAR), neutrophil-lymphocyte ratio (NLR), prognostic nutritional index (PNI), and triglyceride/glucose index (TGI) in the MORtality predictors in the CORonary Care Units in TURKey (MORCOR-TURK) population. This is the largest registry of coronary care unit (CCU) patients in Turkey (3157 patients admitted to CCU in 50 different centers). The study population was divided into two according to in-hospital survival status; 137 patients (4.3%) died in-hospital follow-up. A significant correlation was found between death and SII, CAR, NLR, and PNI but not for AIP and TGI in logistic regression. In Model 1 (combining parameters proven to be risk predictors), the -2 log-likelihood ratio was 888.439, Nagelkerke R was 0.235, and AUC (area under curve) was 0.814 (95% CI: 0.771-0.858). All other models were constructed by adding each inflammatory marker separately to Model 1. Only Model 3 (CAR + Model 1) had a significantly greater AUC than Model 1 (DeLong = .01). Our study showed that CAR, but not other inflammatory index, is a significant predictor of in-hospital mortality in CCU patients when added to proven risk predictors.

摘要

我们在土耳其冠心病监护病房死亡率预测因素研究(MORCOR-TURK)人群中,调查了全身免疫炎症指数(SII)、血浆致动脉粥样硬化指数(AIP)、C反应蛋白/白蛋白比值(CAR)、中性粒细胞与淋巴细胞比值(NLR)、预后营养指数(PNI)以及甘油三酯/葡萄糖指数(TGI)的预后意义。这是土耳其最大的冠心病监护病房(CCU)患者登记研究(50个不同中心的3157例CCU收治患者)。根据住院生存状况将研究人群分为两组;137例患者(4.3%)在住院随访期间死亡。在逻辑回归分析中,发现死亡与SII、CAR、NLR和PNI之间存在显著相关性,但与AIP和TGI无关。在模型1(结合已被证实为风险预测因素的参数)中,-2对数似然比为888.439,Nagelkerke R为0.235,曲线下面积(AUC)为0.814(95%可信区间:0.771-0.858)。所有其他模型通过将每个炎症标志物分别添加到模型1中来构建。只有模型3(CAR + 模型1)的AUC显著大于模型1(DeLong = 0.01)。我们的研究表明,当添加到已证实的风险预测因素中时,CAR而非其他炎症指数是CCU患者住院死亡率的显著预测因素。

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