The blood glucose level at admission indicates (with some limitations) poor prognosis and thrombus burden in patients with the acute coronary syndrome (ACS). Our study aimed to measure the predictive value of the stress hyperglycemia ratio (SHR), an indicator of stress hyperglycemia, showing increased thrombus burden in patients with ACS. Patients (n = 1222) with ACS were enrolled in this cross-sectional study. Coronary thrombus burden was classified as high and low. SHR was calculated by dividing the admission serum glucose by the estimated average glucose derived from HbA1c. Low thrombus burden was detected in 771 patients, while high thrombus burden (HTB) was detected in 451 patients. SHR was found to be significantly higher in patients with HTB (1.1 ± .3 vs 1.06 ± .4; P = .002). SHR was determined as a predictor of HTB (odds ratio (OR) 1.547 95% CI (1.139–2.100), P < .001) as a result of univariate analysis. According to multivariate analysis, SHR was determined as an independent risk factor for HTB (OR 1.328 CI (1.082–1.752), P = .001). We found that SHR predicted thrombus burden with higher sensitivity than admission glucose level in patients with ACS.
Obesity is one of today’s pandemics. The link between obesity and inflammation is well established and contributes to atherogenesis. We aimed to determine the relationship between carotid intima-media thickness (cIMT) and inflammation in healthy obese patients (n = 289). The patients were referred to the outpatient clinic due to obesity but had no chronic diseases. Subclinical atherosclerosis was defined as present in participants with cIMT values greater than those expected according to their age group. In patients with subclinical atherosclerosis, the neutrophil–lymphocyte ratio (1.86 ± .65 vs 1.57 ± .45, P < .01), platelet–lymphocyte ratio (120.0 ± 41.2 vs 106.8 ± 30.5, P ≤ .01), and systemic immune-inflammatory index (SII) (550.0 ± 232.8 vs 430.4 ± 135.0, P ≤ .01) were found to be higher. SII was the only independent risk factor for developing subclinical atherosclerosis (odds ratio (OR): 1.995, odds ratio (95% confidence interval): 1.692–4.099), P = .004). The area under the curve (AUC) was .664 (95% CI: .605–.729, P ≤ .001), and the optimal cut-off value was 436.7 (69.3% sensitivity and 61.6% specificity). In conclusion, SII may indicate subclinical atherosclerosis in healthy obese patients, thus leading to early initiation of treatment to reduce cardiovascular morbidity and mortality.
Background: We investigated the ability of the platelet-to-hemoglobin ratio (PHR) to predict mortality and disease severity in patients with acute pulmonary embolism (APE). Materials & methods: The... Plain language summary Acute pulmonary embolism is an important cause of death and disability. It is essential to diagnose this disease early, determine its severity and give appropriate treatments...
1 January 2024 in Revista da Associação Médica Brasileira
Nowadays, the frequency of complications is also increasing following the increasing frequency of coronary angiography and percutaneous coronary intervention. Contrast-induced nephropathy is one of the most common of these complications. This study aimed to investigate the relationship between the Osaka prognostic score, which has previously been shown to have prognostic importance in gastrointestinal malignancies, and the development of contrast-induced nephropathy.
Dyslipidemia is an important risk factor for cardiovascular morbidity and mortality. Although low-density lipoprotein (LDL) is primarily responsible, the importance of triglyceride (TG) and high-density lipoprotein (HDL) has also been recognized. The present study investigated the effect of the atherogenic index of plasma (AIP), in which atherogenic and protective lipoproteins were evaluated together, on the initial flow in patients with ST elevation myocardial infarction. AIP was calculated as log(TG/HDL-cholesterol). Patients included in the study (n = 1535) were divided into Thrombolysis in Myocardial Infarction (TIMI) flow grade 0 and >0. AIP was found to be significantly different between 2 groups (.55 ± .23 vs .67 ± .21; P < .001). AIP was an independent predictor for pre-intervention TIMI flow (Odds Ratio: 2.778). A moderate correlation was found between TIMI frame count measurements, calculated in patients with TIMI 2–3, and AIP (Pearson correlation coefficient: .63, P < .001). In the receiver operating characteristic analysis, AIP showed the highest area under curve (AUC) compared with other lipid parameters for predicting vascular patency. The AUC of AIP was .634, the cut-off value was .59, and the sensitivity and specificity were 67.6% and 68.4%, respectively ( P < .001). In conclusion, AIP was found to be an important marker affecting pre-percutaneous coronary intervention TIMI flow.
Contrast-induced nephropathy (CIN) is one of the most common complications associated with coronary angiography and percutaneous coronary intervention (PCI). This study evaluated the relationship between the H 2 FPEF (obesity (H), hypertension(H), atrial fibrillation (F), pulmonary hypertension (P), an age >60 years (E), and E/e’ > 9 (F)) score which is used to diagnose heart failure with preserved ejection fraction and CIN. Patients (n = 1346) who underwent PCI for acute coronary syndrome (ACS) between December 2018 and January 2021 were retrospectively included. Contrast-induced nephropathy patients had significantly higher H 2 FPEF scores (4.10 ± 1.92 vs 2.28 ± 1.56, P < .001). In addition, the H 2 FPEF score was found to be an independent risk factor for the development of CIN (Odd Ratio 1.633 95% CI (1.473-1.811), P < .001) together with age, diabetes mellitus, systolic pulmonary arterial pressure, and left anterior descending as an infarct-related artery. According to point biserial correlation analysis, CIN and H 2 FPEF score have a strong correlation (r pb = .376, P < .001). The receiver operating characteristic curve showed the optimal cutoff value of the H 2 FPEF score to predict the development of CIN was 2.5, with 79.8% sensitivity and 64.1% specificity. In conclusion, the H 2 FPEF score may predict the development of CIN in patients presenting with ACS and undergoing PCI.