ST-segment yükselmesiz miyokard enfarktüslü hastalarda serum ürik asit/albümin oranı ile tamamen tıkalı enfarkt ilişkili arter arasındaki ilişki

Abstract

Aim: Infarct-related artery (IRA) patency before primary percutaneous coronary intervention (pPCI) is linked to improved clinical outcomes and lower mortality in patients with acute coronary syndrome. The purpose of this research was to examine the association between serum uric acid/albumin ratio (UAR) and IRA patency in patients with non-ST-segment elevation myocardial infarction (NSTEMI).Material and Method: We evaluated 430 consecutive patients with NSTEMI in total retrospectively. The study population was divided into 2 groups according to the IRA patency as assessed by the degree of Thrombolysis in Myocardial Infarction (TIMI) flow before pPCI. As a result, completely occluded IRA was defined as TIMI grade 0-1, while patent IRA was defined as TIMI grade 2-3.Results: IRA was found to be occluded in 110 (25.5%) patients prior to the procedure. UAR level (p=<0.001) was found to be higher among the patients with IRA occlusion when compared to the patent group. Regression analysis revealed that UAR (OR:3.125; 95% CI:1.186-8.232, p<0.001), left ventricular ejection fraction (OR:0.917, 95% CI:0.885-0.951, p<0.001) and culprit artery diameter (OR:0.917, 95% CI:0.885-0.951, p<0.001) were independent predictors for an occluded IRA. An UAR cut-off value of >1.40 was detected to prognosticate the occluded IRA with 62.7% sensitivity and 63.8% specificity (AUC: 0.722, 95% CI: 0.671-0.773, p<0.001).Conclusion: UAR is an independent predictor of preprocedural IRA patency in patients with NSTEMI. Thus, UAR may be an easily accessible parameter to diagnose high-risk NSTEMI patients who would benefit from an immediate invasive strategy (<2 hours).