ST段抬高型心肌梗死患者尿酸-白蛋白比值与自发再灌注之间的关联
Association between uric acid-albumin ratio and spontaneous reperfusion in ST-segment elevation myocardial infarction patients.
作者信息
Nan Jing, Meng Shuai, Jia Ruo-Fei, Chen Wei, Yang Xing-Sheng, Hu Hong-Yu, Jin Ze-Ning
机构信息
Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
J Geriatr Cardiol. 2025 Feb 28;22(2):229-236. doi: 10.26599/1671-5411.2025.02.006.
BACKGROUND
The association between uric acid-albumin ratio (UAR) with different diseases has been evaluated before. However, the association between UAR with spontaneous reperfusion (SR) in patients with ST-segment elevation myocardial infarction (STEMI) has not been explored.
METHODS
STEMI patients admitted to our department and underwent primary coronary angiography between 1 November 2018 and 31 December 2020 were retrospectively enrolled. The patients were divided into the SR group and the non-SR group according to the index coronary angiography results. The association between UAR and SR was evaluated by uni-variable and multi-variable logistic analysis. Receiver operating characteristic curve analysis was used to determine the optimum cut-off level of UAR in predicting SR.
RESULTS
Three hundred and fifty-seven patients were finally enrolled in our study, 55 patients were divided into the SR group and 302 patients were divided into the non-SR group. In uni-variable analysis, patients with SR were older ( = 0.032), with higher red blood cell distribution width ( < 0.001) and red blood cell distribution width-to-platelet ratio ( < 0.001), higher level of C-reactive protein ( = 0.046), higher level of uric acid ( < 0.001) compared with patients without SR. Patients with SR had a lower level of platelets ( = 0.008), lower level of on-admission B-type natriuretic peptide ( < 0.001). As for the level of UAR, STEMI patients with SR had significantly higher levels of UAR compared with STEMI patients without SR [11.1 (8.9-13.4) 8.3 (6.6-10.0), < 0.001]. Further multi-variable logistic analysis reveals that UAR was the independent risk factor of SR in different models after adjusting different variables. Receiver operating characteristic analysis showed that UAR had good predictive value in SR (AUC = 0.75, 95% CI: 0.702-0.794, < 0.01).
CONCLUSIONS
Our study shows that UAR is an independent risk factor for predicting SR in STEMI patients.
背景
此前已评估尿酸-白蛋白比值（UAR）与不同疾病之间的关联。然而，尚未探讨UAR与ST段抬高型心肌梗死（STEMI）患者自发再灌注（SR）之间的关联。
方法
回顾性纳入2018年11月1日至2020年12月31日期间入住我科并接受冠状动脉造影的STEMI患者。根据冠状动脉造影结果将患者分为SR组和非SR组。采用单变量和多变量逻辑回归分析评估UAR与SR之间的关联。采用受试者工作特征曲线分析确定UAR预测SR的最佳截断水平。
结果
最终357例患者纳入本研究，55例患者分为SR组，302例患者分为非SR组。单变量分析显示，与无SR的患者相比，SR患者年龄更大（P = 0.032），红细胞分布宽度更高（P < 0.001）、红细胞分布宽度与血小板比值更高（P < 0.001），C反应蛋白水平更高（P = 0.046），尿酸水平更高（P < 0.001）。SR患者血小板水平更低（P = 0.008），入院时B型利钠肽水平更低（P < 0.001）。至于UAR水平，与无SR的STEMI患者相比，有SR的STEMI患者UAR水平显著更高[11.1（8.9 - 13.4）对8.3（6.6 - 10.0），P < 0.001]。进一步的多变量逻辑回归分析显示，在调整不同变量后，UAR在不同模型中均为SR的独立危险因素。受试者工作特征分析显示，UAR对SR具有良好的预测价值（AUC = 0.75，95%CI：0.702 - 0.794，P < 0.01）。
结论
我们的研究表明，UAR是预测STEMI患者SR的独立危险因素。
Zotero 插件