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Bianco HT. Index of Systemic Immunoinflammation and Ischemia in Patients with Non-Obstructive Coronary Arteries. Arq Bras Cardiol 2024; 121:e20240081. [PMID: 38695402 PMCID: PMC11081205 DOI: 10.36660/abc.20240081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 05/12/2024] Open
Affiliation(s)
- Henrique Tria Bianco
- Universidade Federal de São PauloSão PauloSPBrasilUniversidade Federal de São Paulo (UNIFESP), São Paulo, SP – Brasil
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Budzianowski J, Faron W, Rzeźniczak J, Słomczyński M, Hiczkiewicz D, Olejniczak J, Hiczkiewicz J, Burchardt P. Predictors of Revascularization in Patients with Unstable Angina. J Clin Med 2024; 13:1096. [PMID: 38398410 PMCID: PMC10889168 DOI: 10.3390/jcm13041096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The factors that determine the necessity of coronary artery revascularization in patients with unstable angina (UA) have been supported by limited data. Therefore, this study aimed to identify the predictors of revascularization in patients with UA. METHODS The study included the recorded data of 3668 patients with UA who underwent cardiac catheterization (age 66 ± 9.2, men 70%); 2615 of them (71%) underwent revascularization (percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), or hybrid revascularization. The remaining 1053 patients (29%) had no significant coronary stenosis and were regarded as controls. Multivariable logistic regression analysis was performed to separate the predictors of revascularization. RESULTS It was found that severe angina (OR 2.7, 95%CI 1.9-3.7), male gender (OR 1.4, 95%CI 1.1-1.7), and hyperlipidemia were the predictors of revascularization. It was also noted that intraventricular conduction disorders including left and right bundle branch blocks and a history of previous revascularization and myocardial infarction were associated with lower odds of revascularization. CONCLUSION Overall, however, the predictive value of the studied factors proved to be poor and may still point to the multifactorial nature of significant coronary artery stenosis and the need for revascularization in patients with UA.
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Affiliation(s)
- Jan Budzianowski
- “Club 30”, Polish Cardiac Society, 93-338 Łódź, Poland;
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland; (D.H.); (J.H.)
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | - Wojciech Faron
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | - Janusz Rzeźniczak
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland; (J.R.); (M.S.)
| | - Marek Słomczyński
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland; (J.R.); (M.S.)
| | - Dariusz Hiczkiewicz
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland; (D.H.); (J.H.)
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | | | - Jarosław Hiczkiewicz
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Góra, 65-046 Zielona Góra, Poland; (D.H.); (J.H.)
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sól, Poland;
| | - Paweł Burchardt
- “Club 30”, Polish Cardiac Society, 93-338 Łódź, Poland;
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland; (J.R.); (M.S.)
- Department of Hypertension, Angiology, and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland
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Xiong C, Yu Q, Gao F, Liu S, Zhang J, Ma T, Liu S. Prognostic significance of IL-18 in acute coronary syndrome patients. Clin Cardiol 2024; 47:e24229. [PMID: 38402570 PMCID: PMC10823553 DOI: 10.1002/clc.24229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND After acute coronary syndrome (ACS), inflammation aids healing but may harm the heart. Interleukin (IL)-18 and IL-1β are pivotal proinflammatory cytokines released during pyroptosis, a process that initiates and sustains inflammation. This study aimed to evaluate the levels of circulating IL-18 and IL-1β during the progression of ACS and to determine their association with subsequent clinical events in ACS patients. HYPOTHESIS Circulating levels of IL-18 and IL-1β are associated with subsequent clinical events in ACS patients. METHODS Employing immunoassays, we examined plasma levels of IL-1β and IL-18 in 159 ACS patients and matched them with 159 healthy controls. The primary composite endpoint included recurrent unstable angina, myocardial infarction, heart failure exacerbation, stroke, or cardiovascular death. RESULTS ACS patients exhibited a significant increase in plasma IL-18 levels, measuring 6.36 [4.46-9.88] × 102 pg/mL, in contrast to the control group with levels at 4.04 [3.21-4.94] × 102 pg/mL (p < 0.001). Conversely, plasma levels of IL-1β remained unchanged compared to the control group. Following a 25-month follow-up, IL-18 levels exceeding the median remained an important prognostic factor for adverse clinical events in ACS patients (hazard ratio = 2.37, 95% confidence interval: 1.14-4.91, p = 0.021). Besides, IL-18 displayed a nonlinear association with adverse clinical events (p nonlinear = 0.044). Subgroup analysis revealed that the correlation between IL-18 and the risk of adverse clinical events was not significantly affected by factors such as age, sex, history of diabetes, smoking, Gensini score, or ACS type (all p interaction >0.05). CONCLUSION IL-18 appears to hold potential as a predictive marker for anticipating clinical outcomes in patients with ACS.
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Affiliation(s)
- Chenchun Xiong
- Department of Cardiology, School of Medicine, Zhongshan Hospital of Xiamen UniversityXiamen UniversityXiamenFujianChina
| | - Qiaoting Yu
- Shengli Clinical Medical CollegeFujian Medical UniversityFuzhouFujianChina
| | - Feng Gao
- Department of Cardiology, School of Medicine, Zhongshan Hospital of Xiamen UniversityXiamen UniversityXiamenFujianChina
- Shengli Clinical Medical CollegeFujian Medical UniversityFuzhouFujianChina
| | - Song Liu
- Hospital of Guizhou Medical UniversityGuiyangGuizhouChina
| | - Jianhui Zhang
- Department of Cardiology, School of Medicine, Zhongshan Hospital of Xiamen UniversityXiamen UniversityXiamenFujianChina
| | - Tianyi Ma
- Department of Cardiology, School of Medicine, Zhongshan Hospital of Xiamen UniversityXiamen UniversityXiamenFujianChina
| | - Suifeng Liu
- Department of Cardiology, School of Medicine, Zhongshan Hospital of Xiamen UniversityXiamen UniversityXiamenFujianChina
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Zou S, Mohtar SH, Othman R, Hassan RM, Liang K, Lei D, Xu B. Platelet distribution width as an useful indicator of influenza severity in children. BMC Infect Dis 2024; 24:9. [PMID: 38166827 PMCID: PMC10759456 DOI: 10.1186/s12879-023-08890-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE The present study aims to investigate the potential of platelet distribution width as an useful parameter to assess the severity of influenza in children. METHODS Baseline characteristics and laboratory results were collected and analyzed. Receiver operating characteristic (ROC) curve analysis was used to joint detection of inflammatory markers for influenza positive children, and the scatter-dot plots were used to compare the differences between severe and non-severe group. RESULTS Influenza B positive children had more bronchitis and pneumonia (P < 0.05), influenza A infected children had more other serious symptoms (P = 0.007). Neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), and platelet parameters performed differently among < 4 years and ≥ 4 years children with influenza. Combined detection of platelet parameters and other indicators could better separate healthy children from influenza infected children than single indicator detection. The levels of platelet distribution width of children with severe influenza (A and B) infection was significantly dropped, compared with non-severe group (P < 0.05). CONCLUSIONS Platelet distribution width could be a very useful and economic indicator in distinction and severity assessment for children with influenza.
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Affiliation(s)
- Seyin Zou
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, 510317, China.
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia.
| | - Siti Hasmah Mohtar
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia.
| | - Roshani Othman
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia
| | - Rodiah Mohd Hassan
- Department of Science and Biotechnology, Faculty of Engineering and Life Sciences, Universiti Selangor, Bestari Jaya Campus, Bestari Jaya, Selangor Darul Ehsan, 45600, Malaysia
| | - Kun Liang
- Guangdong Medical University, Dongguan, 523000, China
| | - Da Lei
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, 510317, China
| | - Bangming Xu
- Department of Laboratory Medicine, Guangdong Second Provincial General Hospital, Guangzhou, 510317, China
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Wang J, Liu Y, Tian P, Xing L, Huang X, Fu C, Xu X, Liu P. Exosomal circSCMH1/miR-874 ratio in serum to predict carotid and coronary plaque stability. Front Cardiovasc Med 2023; 10:1277427. [PMID: 38149265 PMCID: PMC10750349 DOI: 10.3389/fcvm.2023.1277427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023] Open
Abstract
Background To investigate the correlation between lg (circSCMH1/miR-874) and acute coronary syndrome (ACS), acute myocardial infarction (AMI), and carotid plaque stability. Methods 701 patients were divided into stable coronary artery disease (SCAD), ACS, and control groups. Furthermore, 225 patients who underwent carotid ultrasound were selected from the above 701 patients and were divided into low-risk plaque, medium-to-high risk plaque, and control (without carotid plaques) groups. We collected their baseline characteristics and measured the contents of exosomal circSCMH1 and miR-874 in peripheral blood. Then lg(circSCMH1/miR-874) was calculated and statistical analysis was performed. Results The lg (circSCMH1/miR-874) values of ACS, SCAD, and the control group decreased successively (P < 0.05). Compared with the low-risk plaque and control groups, the lg (circSCMH1/miR-874) value of medium-high risk plaque group decreased (P < 0.05). Multivariate logistic regression analysis showed that with the decrease of lg (circSCMH1/miR-874), the risk of ACS, AMI, and medium-high risk plaques increased. ROC curve analysis demonstrated that lg (circSCMH1/miR-874) has a higher diagnostic value for ACS, AMI and medium-high risk plaques than previously used predictive ratios. Conclusion Lg (circSCMH1/miR-874) is closely associated with coronary and carotid plaque stability.
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Affiliation(s)
- Jiayu Wang
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yixuan Liu
- Division of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Peiqing Tian
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
| | - Liyun Xing
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
| | - Xianwei Huang
- Department of Emergency, The First Affiliated Hospital of Xiamen University, Fujian, China
| | - Caihua Fu
- Department of Cardiology, Jinan Central Hospital Affiliated Shandong University, Shandong, China
| | - Xiangyu Xu
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
| | - Ping Liu
- Department of Cardiology, The Second Hospital of Shandong University, Shandong, China
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Zhang Y, Xing Z, Deng A. Unveiling the predictive capacity of inflammatory and platelet markers for central retinal artery occlusion. Thromb Res 2023; 232:108-112. [PMID: 37976730 DOI: 10.1016/j.thromres.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Cell counting in peripheral blood samples and their combinations have gained wide usage in clinical research due to their convenient and minimally invasive sampling method. This study aims to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR), systemic Immunoinflammatory Index (SII), and systemic Inflammatory Response Index (SIRI), and platelet distribution width (PDW) for the occurrence of non-arteritic Central retinal artery occlusion (NA-CRAO). METHODS We included 123 patients diagnosed with NA-CRAO and 120 age-, sex- and blood pressure-matched individuals in this study. All participants underwent a comprehensive ophthalmic assessment. Peripheral blood samples were retrospectively analysed to obtain patients' blood counts and platelet-related indices, and further NLR, SII and SIRI were calculated. RESULTS NLR, SII, SIRI, and PDW were all found to be elevated and significantly different in NA-CRAO patients compared to controls (p < 0.05). Notably, elevated NLR and PDW were identified as independent influences on the development of NA-CRAO, with a combined predicted AUC of 0.876. CONCLUSION The utilization of NLR and PDW in NA-CRAO prediction may prove to be more effective compared to SII and SIRI.
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Affiliation(s)
- Yupeng Zhang
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, 261000 Weifang, Shandong, China
| | - Zhen Xing
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, 261000 Weifang, Shandong, China
| | - Aijun Deng
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, 261000 Weifang, Shandong, China.
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Demir G, Karaca G, Ekmekci A, Safaei S, Kimiaei A, Emre A. White Blood Cell/Mean Platelet Volume Ratio as a Predictor of Long-Term Outcomes but Not Coronary Artery Disease Severity in Non-ST Elevation Myocardial Infarction Patients. Cureus 2023; 15:e51423. [PMID: 38299134 PMCID: PMC10828626 DOI: 10.7759/cureus.51423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/02/2024] Open
Abstract
Background White blood cell count (WBC) and mean platelet volume (MPV) have been shown to be hematologic parameters of prognostic significance in acute coronary syndrome. We sought to determine the relationship between the WBC/MPV ratio (WMR), coronary artery disease (CAD) complexity, and long-term clinical outcomes in patients with non-ST elevation myocardial infarction (NSTEMI). Hypothesis WMR has a relationship with the complexity of CAD and long-term clinical outcomes in NSTEMI patients. Methods A total of 289 NSTEMI patients who underwent coronary angiography were divided into two groups according to the median WMR (>970 or ≤970). CAD complexity was assessed with the SYNTAX score. Results The WMR was not associated with the synergy between percutaneous coronary intervention (PCI) with Taxus and cardiac surgery (SYNTAX) score on multivariate linear regression analysis (ß=0.08, 95% CI = -0.76-2.21, p = 0.14). However, it was of prognostic significance on Kaplan-Meier survival analysis in overall patients (log-rank p = 0.03) and in patients with a SYNTAX Score <22 (log-rank p = 0.01). Follow-up data showed that major adverse cardiac events (MACE) (p = 0.02), death (p < 0.001), non-fatal MI (p = 0.03), ischemia-driven revascularization (p = 0.03), and heart failure (p = 0.04) were more frequent in the high WMR group. After adjustment for age, sex, eGFR, troponin levels, and the Global Registry of Acute Coronary Events (GRACE) score in Cox regression models, the association of high WMR with the cumulative incidence of MACE was preserved (overall patients (HR=1.85, 95% CI 1.1-3.12, p=0.02) and patients with a SYNTAX score <22 (HR=2.06, 95% CI 1.15-3.67, p=0.01). Conclusion The WMR was not related to CAD complexity, but it was associated with long-term clinical outcomes in patients with NSTEMI who underwent coronary angiography.
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Affiliation(s)
- Gizem Demir
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Educational Research Hospital, Istanbul, TUR
| | - Gürkan Karaca
- Department of Cardiology, Bahçeşehir University, Istanbul, TUR
- Department of Cardiology, VM Medical Park Maltepe Hospital, Istanbul, TUR
| | - Ahmet Ekmekci
- Department of Cardiology, Bahçeşehir University, Istanbul, TUR
- Department of Cardiology, Medical Park Pendik Hospital, Istanbul, TUR
| | | | - Ali Kimiaei
- Department of Cardiology, Bahçeşehir University, Istanbul, TUR
| | - Ayşe Emre
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Educational Research Hospital, Istanbul, TUR
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Hu Y, Shen W, Pan Y. The prognostic value of red blood cell distribution width for pulmonary infection in elderly patients received abdominal surgery with tracheal intubation and general anesthesia. J Natl Med Assoc 2023; 115:519-527. [PMID: 37852881 DOI: 10.1016/j.jnma.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/16/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Red blood cell distribution width (RDW) has been shown to be an important predictor of the occurrence of various inflammatory and infectious diseases. However, the predictive value of RDW for pulmonary infection in elderly patients undergoing abdominal surgery under general anesthesia with endotracheal intubation remains unclear. METHODS A total of 200 eligible elderly patients who underwent abdominal surgery with endotracheal intubation and general anesthesia in our hospital from January 2019 to January 2022 were included in this study. During hospitalization, there were 64 cases with different degrees of pulmonary infection, and 136 cases without pulmonary infection. Participants' RDW levels were analyzed on admission. Serum levels of inflammatory factors in infected patients were analyzed during hospitalization. Multivariate logistic analysis was performed to evaluate clinical factors for pulmonary infection during hospitalization following-up abdominal surgery with endotracheal intubation and general anesthesia in elderly patients. Youden's J statistic was used to define the correlation. RESULTS RDW at admission was independently associated with the risk of pulmonary infection in elderly patients undergoing general anesthesia with endotracheal intubation for abdominal surgery ([OR 1.952, 95% confidence interval 1.604 to 2.279, p=0.006]). RDW at admission was statistically positively correlated with inflammatory factors, including procalcitonin (p<0.001), C-reactive protein (p<0.001), and tumor necrosis factor-α (p<0.001), in elderly patients with postoperative pneumonia who underwent abdominal surgery. CONCLUSION RDW at admission had predictive value for pulmonary infection in elderly patients undergoing abdominal surgery under general anesthesia with endotracheal intubation.
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Affiliation(s)
- Yifeng Hu
- Department of Anesthesiology, Wuxi No.2 People's Hospital, Jiangnan University Medical Center, JUMC, No. 68 Zhongshan Road, Wuxi 214000, Jiangsu, China
| | - Weihong Shen
- Department of Anesthesiology, Wuxi No.2 People's Hospital, Jiangnan University Medical Center, JUMC, No. 68 Zhongshan Road, Wuxi 214000, Jiangsu, China
| | - Yunsong Pan
- Department of Anesthesiology, Wuxi No.2 People's Hospital, Jiangnan University Medical Center, JUMC, No. 68 Zhongshan Road, Wuxi 214000, Jiangsu, China.
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Tudurachi BS, Anghel L, Tudurachi A, Sascău RA, Stătescu C. Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL-Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients. Int J Mol Sci 2023; 24:14378. [PMID: 37762680 PMCID: PMC10531986 DOI: 10.3390/ijms241814378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular disease, particularly coronary artery disease (CAD), remains a predominant cause of mortality globally. Factors such as atherosclerosis and inflammation play significant roles in the pathogenesis of CAD. The nexus between inflammation and CAD is underscored by the role of immune cells, such as neutrophils, lymphocytes, monocytes, and macrophages. These cells orchestrate the inflammatory process, a core component in the initiation and progression of atherosclerosis. The activation of these pathways and the subsequent lipid, fibrous element, and calcification accumulation can result in vessel narrowing. Hematological parameters derived from routine blood tests offer insights into the underlying inflammatory state. Recent studies have highlighted the potential of inflammatory hematological ratios, such as the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio and lymphocyte/monocyte ratio. These parameters are not only accessible and cost-effective but also mirror the degree of systemic inflammation. Several studies have indicated a correlation between these markers and the severity, prognosis, and presence of CAD. Despite the burgeoning interest in the relationship between inflammatory markers and CAD, there remains a paucity of data exploring these parameters in young patients with acute myocardial infarction. Such data could offer valuable insights into the unique pathophysiology of early-onset CAD and improve risk assessment and predictive strategies.
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Affiliation(s)
- Bogdan-Sorin Tudurachi
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania; (B.-S.T.); (R.A.S.); (C.S.)
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania;
| | - Larisa Anghel
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania; (B.-S.T.); (R.A.S.); (C.S.)
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania;
| | - Andreea Tudurachi
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania;
| | - Radu Andy Sascău
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania; (B.-S.T.); (R.A.S.); (C.S.)
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania;
| | - Cristian Stătescu
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania; (B.-S.T.); (R.A.S.); (C.S.)
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania;
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Kaltsas A, Markou E, Zachariou A, Dimitriadis F, Symeonidis EN, Zikopoulos A, Mamoulakis C, Tien DMB, Takenaka A, Sofikitis N. Evaluating the Predictive Value of Diagnostic Testicular Biopsy for Sperm Retrieval Outcomes in Men with Non-Obstructive Azoospermia. J Pers Med 2023; 13:1362. [PMID: 37763130 PMCID: PMC10532560 DOI: 10.3390/jpm13091362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Non-obstructive azoospermia (NOA) presents a challenge in male infertility management. This study aimed to assess the efficacy of diagnostic testicular biopsy (DTB) in predicting sperm retrieval success via therapeutic testicular biopsy (TTB) and to understand the role of systemic inflammation in microdissection testicular sperm extraction (mTESE) outcomes. METHODS A retrospective analysis was conducted on 50 NOA males who underwent mTESE at the University of Ioannina's Department of Urology from January 2017 to December 2019. All participants underwent thorough medical evaluations, including semen analyses and endocrinological assessments. RESULTS DTB did not detect spermatozoa in half of the patients who later showed positive sperm findings in TTB. Preoperative variables, such as age, plasma levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), prolactin (PRL), estradiol (E2), and inflammation biomarkers (neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-eosinophil ratio (MER)), were not consistently predictive of sperm retrieval success. Notably, TTB-negative patients had elevated NLR and PLR values, suggesting a possible link between systemic inflammation and reduced sperm retrieval during mTESE. CONCLUSIONS The findings question the necessity of an initial DTB, which might provide misleading results. A negative DTB should not deter further TTB or intracytoplasmic sperm injection (ICSI) attempts. The study emphasizes the need for further research to refine diagnostic approaches and deepen the understanding of factors influencing sperm retrieval in NOA patients, ultimately enhancing their prospects of biological parenthood.
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Affiliation(s)
- Aris Kaltsas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.)
| | - Eleftheria Markou
- Department of Microbiology, University Hospital of Ioannina, 45500 Ioannina, Greece;
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (F.D.); (E.N.S.)
| | - Evangelos N. Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (F.D.); (E.N.S.)
| | - Athanasios Zikopoulos
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.)
| | - Charalampos Mamoulakis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Crete, 70013 Heraklion, Greece;
| | - Dung Mai Ba Tien
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City 70000, Vietnam;
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan;
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.)
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Khan UH, Pala MR, Hafeez I, Shabir A, Dhar A, Rather HA. Prognostic value of hematological parameters in older adult patients with acute coronary syndrome undergoing coronary intervention: a single centre prospective study. J Geriatr Cardiol 2023; 20:596-601. [PMID: 37675260 PMCID: PMC10477583 DOI: 10.26599/1671-5411.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Cardiovascular disease is a significant contributor to the disease burden in geriatric patients. Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis. The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome (ACS). METHODS This was a prospective observational study of 601 older adult patients (age > 60 years) with ACS who underwent percutaneous coronary intervention over two years (2017-2019). The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up. Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters. RESULTS The mean age of presentation was 77 ± 17 years. The mean neutrophil-lymphocyte ratio (NLR) value was 5.07 ± 4.90 and the mean platelet-lymphocyte ratio (PLR) value was 108.65 ± 85.82. On univariate analysis, total leucocyte count [odds ratio (OR) = 0.85, P = 0.021], hematocrit (OR = 0.91, P = 0.018), NLR (OR = 1.10, P = 0.001) and PLR (OR = 1.05, P = 0.001) were associated with mortality. On receiver operating characteristic curve analysis, NLR predicted mortality with 68.1% and PLR with 65.7% accuracy. On multivariate analysis, NLR (OR = 1.096, 95% CI: 1.006-1.15, P = 0.035) was an independent predictor of 30-day mortality. CONCLUSIONS For the risk classification of all elderly ACS patients, we highly advise using NLR rather than the total white blood cell count.
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Affiliation(s)
- Umar Hafiz Khan
- Geriatric Medicine, Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Murtaza Rashid Pala
- Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Imran Hafeez
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Afshan Shabir
- Geriatric Medicine, Department of Internal Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Amrit Dhar
- Department of Internal and Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Hilal Ahmad Rather
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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Qin G, Lin T, You Y, Shang M, He W, Pazo EE. Blood inflammatory biomarkers in participants with idiopathic epiretinal membrane: A retrospective case series study. Medicine (Baltimore) 2023; 102:e34225. [PMID: 37390242 PMCID: PMC10313294 DOI: 10.1097/md.0000000000034225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023] Open
Abstract
The objective was to evaluate the levels of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with idiopathic epiretinal membrane (iERM). This retrospective case series study comprised of participants with iERM and participants with cataract. The values of MLR, NLR, PLR and from participants' peripheral blood were assessed among groups. The best cutoff value of MLR, NLR, and PLR in iERM was found by performing a receiver operating characteristic curve analysis and determining the optimum cutoff value for each variable. In total, 95 participants with iERM were included in the study group, and 61 participants with senile cataract were included as controls. The lymphocyte count in the iERM group was significantly lower than the control group (1.69 ± 0.63 vs. 1.95 ± 0.53, P = .003). The monocyte count in the iERM group was significantly higher than the control group (0.39 ± 0.11 vs. 0.31 ± 0.10, P < .001). The area under the curve of MLR, NLR, and PLR in differentiating patients with IERM and controls was 0.782, 0.645, and 0.657, respectively, according to receiver operating characteristic. The best cutoff value of MLR was > 0.18, with sensitivity and specificity of 74.7% and 75.4%, respectively. The NLR was > 2.06, with a sensitivity and specificity of 50.5% and 83.6%, respectively. The PLR was > 95.89, with a sensitivity and specificity of 86.3% and 41.0%, respectively. The findings of this study suggest that systemic inflammation may be associated with iERM. IERM patients may be prone to have high MLR, NLR, and PLR values.
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Affiliation(s)
| | - Tiezhu Lin
- He Eye Specialist Hospital, Shenyang, China
| | - Yue You
- Sinqi Eye Hospital, Shenyang, China
| | | | - Wei He
- He Eye Specialist Hospital, Shenyang, China
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Tang HH, Wang YJ, Wang Z, Yan GL, Qiao Y, Li X, Wang D, Tang CC. Predicting cerebral white matter lesions based on the platelet-to-white blood cell ratio in hypertensive patients. Brain Res 2023; 1808:148340. [PMID: 36966958 DOI: 10.1016/j.brainres.2023.148340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
Hypertension is a common chronic disease affecting many people. White matter lesions (WMLs) are one of the imaging features of cerebrovascular disease. Predicting the possibility of developing syncretic WMLs in patients with hypertension may contribute to the early identification of serious clinical conditions. This study aims to build a model to identify patients who suffered from moderate-to-severe WMLs by using recognized WMLs risk factors including age and history of diabetes and a new factor named platelet-to-white blood cell ratio (PWR). A total of 237 patients were included in this study. The Affiliated ZhongDa Hospital of Southeast University Research Ethics Committee approved this study (Ethics No. 2019ZDSYLL189-P01). We developed a nomogram to predict the risk of syncretic WMLs in patients with hypertension using the above factors. Higher total scores on the nomogram indicated a higher risk of syncretic WMLs. This means older age, smaller PWR, and patients suffering from diabetes contributed to a greater chance for the patient to suffer from syncretic WMLs. We used a decision analysis curve(DCA) to determine the net benefit of the prediction model. The DCA we constructed showed that using our model to decide whether patients suffered from syncretic WMLs or not was better than assuming they all suffered from syncretic WMLs or all WMLs-free. As a result, the area under the curve of our model was 0.787. By integrating PWR, history of diabetes, and age, we could estimate integrated WMLs in hypertensive patients. This study provides a potential tool to identify cerebrovascular disease in patients with hypertension.
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Affiliation(s)
- Hui-Hong Tang
- Department of Cardiology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China
| | - Yan-Juan Wang
- Department of Neurology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China
| | - Zan Wang
- Department of Neurology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China
| | - Gao-Liang Yan
- Department of Cardiology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China
| | - Yong Qiao
- Department of Cardiology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China
| | | | - Dong Wang
- Department of Cardiology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China.
| | - Cheng-Chun Tang
- Department of Cardiology, Zhongda Hospital, Southeast University, P.R. China; Southeast University, P.R. China.
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Chen Y, Chen S, Han Y, Xu Q, Zhao X. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Important Indicators for Predicting in-Hospital Death in Elderly AMI Patients. J Inflamm Res 2023; 16:2051-2061. [PMID: 37215380 PMCID: PMC10198281 DOI: 10.2147/jir.s411086] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/06/2023] [Indexed: 05/24/2023] Open
Abstract
Aim To investigate the role of neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte(PLR) in predicting the risk of in-hospital mortality in elderly acute myocardial infarction(AMI) patients. Methods This study was a single-center, retrospective and observational study. From December 2015 to December 2021, a total of 1550 elderly patients (age ≥ 60 years) with AMI with complete clinical history data were enrolled in the Second Hospital of Dalian Medical University. Routine blood tests were performed on admission, and NLR and PLR were calculated based on neutrophil, platelet, and lymphocyte counts. Outcome was defined as all-cause mortality during hospitalization. Cox regression and restricted spline cubic(RCS) models were used to evaluate the association of NLR and in-hospital mortality risk and the association of PLR with in-hospital mortality risk, respectively. Results (1) A total of 132 (8.5%) patients died during hospitalization. From the results of blood routine, the white blood cell, neutrophil, NLR and PLR in the death group were higher than those in the non-death group, while the lymphocyte was lower than that in the non-death group, and the difference was statistically significant (P < 0.05). (2) The results of receiver operating characteristic(ROC) curves analysis showed that the predictive ability of NLR (AUC = 0.790) for in-hospital death was better than that of PLR (AUC = 0.637). (3) Multivariate Cox proportional regression hazard models showed that high NLR was associated with the risk of in-hospital mortality in elderly AMI patients (HR = 3.091, 95% CI 2.097-4.557, P < 0.001), while high PLR was not. (4) RCS models showed a nonlinear dose-response relationship between NLR and in-hospital death (P for nonlinear = 0.0007). Conclusion High NLR (> 6.69) is associated with the risk of in-hospital mortality in elderly patients with AMI and can be an independent predictor of poor short-term prognosis in elderly patients with AMI.
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Affiliation(s)
- Yan Chen
- Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Shengyue Chen
- Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Yuanyuan Han
- Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Qing Xu
- Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
| | - Xin Zhao
- Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian, People’s Republic of China
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Yang Y, Wang Q, Gao L, Liu S, Zhao J, Liu G, Zhang S. Promising applications of red cell distribution width in diagnosis and prognosis of diseases with or without disordered iron metabolism. Cell Biol Int 2023. [PMID: 37092585 DOI: 10.1002/cbin.12029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/02/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
Many indicators, including red cell distribution width (RDW) and iron metabolism, are sensitive to a variety of risk factors, and are associated with the pathological alterations and disease onset. RDW reflects the degree of heterogeneous volumes of peripheral red blood cells (RBCs). It has been well-known that increased RDW indicates iron deficiency anemia, hemolytic anemia, ineffective erythropoiesis, and shorten lifespan of RBCs. Increased RDW is also prevalent in various non-anemic pathological conditions and diseases. We here review the factors affecting RDW, particularly disordered iron metabolism, chronic inflammation, and oxidative stress, and recapitulate the interplays among these factors. Furthermore, we review the application of increased RDW together with disordered iron homeostasis and the deregulations of hepcidin expression and ferritin levels in the diagnoses and prognosis of anemic and nonanemic diseases. RDW is inexpensive and readily available and may be valuable in adding to the diagnosis and monitoring of many pathological conditions. RDW combined with other indicators, for example, hepcidin and ferritin levels, should be utilized more frequently in clinical practice.
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Affiliation(s)
- Yashuang Yang
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
| | - Quanshu Wang
- Biomedical Sciences College & Shandong Medicinal Biotechnology Centre, Shandong First Medical University, Jinan, Shandong, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Ling Gao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
| | - Sijin Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
| | - Guoliang Liu
- Department of Pulmonary and Critical Care Medicine, Centre for Respiratory Diseases, National Center for Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Shuping Zhang
- Biomedical Sciences College & Shandong Medicinal Biotechnology Centre, Shandong First Medical University, Jinan, Shandong, China
- Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
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Yao H, Lian L, Zheng R, Chen C. Red blood cell distribution width/platelet ratio on admission as a predictor for in-hospital mortality in patients with acute myocardial infarction: a retrospective analysis from MIMIC-IV Database. BMC Anesthesiol 2023; 23:113. [PMID: 37016294 PMCID: PMC10071654 DOI: 10.1186/s12871-023-02071-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) to platelet ratio (RPR) is a novel inflammatory indicator. It integrates the risk prediction of RDW and platelet, which is associated with adverse outcomes. However, the predictive power of RPR in mortality for patients with acute myocardial infarction (AMI) remains uncertain. Thus, we aimed to explore the association between RPR and 180-day in-hospital mortality in patients with AMI. METHODS Data on patients with AMI were extracted from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients were divided into two groups according to the optimal RPR cut-off value. The survival curve between high and low RPR groups was plotted via the Kaplan-Meier (KM) method. Univariate and multivariate Cox regression analyses were performed to determine the association between RPR on admission and 180-day in-hospital mortality. RESULTS A total of 1266 patients were enrolled, of which 83 (6.8%) died within 180 days during the hospitalization. Compared with the survivor group, the non-survivor group had higher RPR on admission (0.11 ± 0.07 vs. 0.08 ± 0.06, P < 0.001). The KM curve indicated that the survival probability of low RPR group was higher than that of high RPR group. Multivariate Cox regression analysis demonstrated that higher RPR on admission was an independent and effective predictor of 180-day mortality in patients with AMI (hazard ratio [HR]: 2.677, 95% confidence interval [CI]: 1.159-6.188, P = 0.021). CONCLUSION Higher RPR was associated with higher in-hospital 180-day mortality in patients with AMI.
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Affiliation(s)
- Hongxia Yao
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liyou Lian
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Rujie Zheng
- Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen Chen
- Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Çelik MC, Karayiğit O, Ozkan C, Dolu AK, Kalçık M. Relationship Between Systemic Inflammation Index and No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2023; 74:387-394. [PMID: 35857618 DOI: 10.1177/00033197221115562] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This study aimed to evaluate the relationship between no-reflow phenomenon and systemic inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI). A total of 785 patients were included. The thrombolysis in myocardial infarction (TIMI) flow degree has been used to describe the no-reflow phenomenon. The study population was divided into two groups regarding the presence of no-reflow phenomenon including 110 patients with no-reflow (TIMI frame count 0-2) and 675 patients without no-reflow (TIMI frame count 3). The NLR [6.6 (4.6-11.6) vs 3.2 (2.0-5.3); P < .001], PLR [175 (121.3-220) vs 102.6 (76.1-150.1); P < .001] and SII [1921(1225-2906) vs 738.5 (450.5-1293); P < .001] were significantly higher in the no-reflow group. High NLR (OR: 1.078, 95%CI: 1.027-1.397; P = .021), PLR (OR: 1.009, 95%CI: 1.003-1.021; P = .041) and SII (OR: 1.216, 95%CI: 1.106-1.942; P = .004) were found to be independently associated with no-reflow phenomenon. The comparison of the receiver-operating characteristic curves showed that area under the curve of SII was greater than that of NLR (.789 vs .766, P = .007) and PLR (.789 vs .759, P = .048). SII levels may predict no-reflow phenomenon better than NLR and PLR.
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Affiliation(s)
- Muhammet Cihat Çelik
- Department of Cardiology, 485536Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey
| | - Orhan Karayiğit
- Department of Cardiology, 233009Yozgat City Hospital, Yozgat, Turkey
| | - Can Ozkan
- Department of Cardiology, Muş State Hospital, Muş, Turkey
| | - Abdullah Kadir Dolu
- Department of Cardiology, 64103Izmir Katip Çelebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Macit Kalçık
- Department of Cardiology, 485536Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey
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Dolu AK, Karayiğit O, Ozkan C, Çelik MC, Kalçık M. Relationship between intracoronary thrombus burden and systemic immune-inflammation index in patients with ST-segment elevation myocardial infarction. Acta Cardiol 2023; 78:72-79. [PMID: 35105281 DOI: 10.1080/00015385.2022.2035082] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIM This study aimed to evaluate the relationship between intracoronary thrombus burden and systemic immune-inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI). PATIENT & METHODS A total of 425 patients were included in the study. The clinical, laboratory, and demographic characteristics of the patients were recorded. The thrombus classification "Thrombolysis in myocardial infarction (TIMI)" was used to assess the intracoronary thrombus burden. According to the TIMI thrombus classification, 229 (54%) patients with low thrombus burden (grade 0-3) and 196 (46%) patients with high thrombus burden (grade 4 and 5) were compared. SII was calculated as platelet × neutrophil/lymphocyte counts. RESULTS High NLR (OR: 1.068, 95% CI:1.023-1.404; p = 0.031), PLR(OR: 1.012, 95% CI:1.002-1.018; p = 0.043), SII(OR: 1.325, 95% CI: 1.156-1.879; p = 0.015) and low left ventricle ejection fraction (LVEF) (OR: 0.957, 95% CI:0.924-0.990; p = 0.012) were found to be independent predictors of high thrombus burden. SII values above 812 predicted a high thrombus burden with a sensitivity of 82% and specificity of 73% (AUC: 0.836; 95% CI:0.795-0.877; p < 0.001). This predictiveness of SII was stronger as compared to NLR (0.836 vs. 0.818, p = 0.043) and PLR (0.836 vs. 0.780, p < 0.001). CONCLUSION SII is an independent predictor of high thrombus burden in patients with STEMI. In addition, SII is superior to NLR and PLR in this regard.
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Affiliation(s)
- Abdullah Kadir Dolu
- Department of Cardiology, Izmir Katip Çelebi University Ataturk Education and Research Hospital, Izmir, Turkey
| | - Orhan Karayiğit
- Department of Cardiology, Yozgat City Hospital, Yozgat, Turkey
| | - Can Ozkan
- Department of Cardiology, Muş State Hospital, Muş, Turkey
| | - Muhammet Cihat Çelik
- Department of Cardiology, Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey
| | - Macit Kalçık
- Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey
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Zhai R, Chen X, Wang G, Xu J, Yang Y. Predictive Value of Red Cell Distribution Width in the Diagnosis of Peripherally Inserted Central Catheter (PICC)-Related Thrombosis Among Cancer Patients. Int J Gen Med 2023; 16:359-365. [PMID: 36747971 PMCID: PMC9899010 DOI: 10.2147/ijgm.s395745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023] Open
Abstract
Purpose This study aimed to investigate the predictive value of red cell distribution width (RDW) in patients with peripherally inserted central catheter (PICC)-related thrombosis. Patients and methods This was a case‒control study. A total of 98 cancer patients undergoing PICC placement from January 2017 to December 2019 at the ICU Venous Access Center of Peking University Cancer Hospital were retrospectively analyzed. These included 47 cases in the thrombosis group and 51 cases in the nonthrombosis group according to the occurrence of PICC-related thrombosis within 90 days after the PICC procedure. Results a) RDW was significantly higher in the thrombosis group (15.98±1.93) than in the nonthrombosis group (13.98±1.09). Additionally, the number of smoking histories in the thrombosis group (18, 38.30%) was significantly higher than that in the nonthrombosis group (5, 9.80%). b) Logistic regression analysis indicated that RDW and smoking history were independent risk factors for PICC-related thrombosis (OR: 3.028, P<0.001; OR: 5.640, P=0.023). c) The area under the receiver operating characteristic (ROC) curve of the combination of RDW and smoking history was 86.8%, and the sensitivity and specificity for predicting thrombosis after PICC were 85.1% and 80%, respectively. d) Cox regression analysis revealed that RDW and smoking history were independent risk factors for PICC-related thrombosis (p<0.001). e) Results from Kaplan‒Meier analysis showed that incidence of PICC-related thrombosis in patients with RDW less than 14.75% is significantly lower than those with RDW 14.75% and above (p<0.001). e) Baseline RDW was not different between the two groups (P>0.05), ΔRDW was significantly different between the two groups (p<0.001). Conclusion The combined use of RDW and smoking history has early evaluation and predictive value in the diagnosis of PICC-related thrombosis.
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Affiliation(s)
- Rui Zhai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Xiaojie Chen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Guodong Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Jiaxuan Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China
| | - Yong Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Critical Care Medicine, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China,Correspondence: Yong Yang, Peking University Cancer Hospital & Institute, No. 52 of Fucheng Road, Haidian District, Beijing, 100142, People’s Republic of China, Tel +86-10-88197798, Email
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Preoperative Neutrophil Lymphocyte Ratio in Prediction of Adnexal Mass Torsion. Obstet Gynecol Int 2023; 2023:3585189. [PMID: 36880062 PMCID: PMC9985499 DOI: 10.1155/2023/3585189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/02/2022] [Accepted: 02/13/2023] [Indexed: 02/27/2023] Open
Abstract
Aims Adnexal torsion commonly affects reproductive age group females. Prompt diagnosis and early management help in the preservation of fertility. However, its diagnosis is challenging. Preoperative diagnosis can be suspected in only 23-66% of the cases and half of the patients operated for adnexal torsion have different diagnosis. This article thus aims to identify the diagnostic value of preoperative neutrophil lymphocyte ratio in adnexal torsion in comparison with other untwisted unruptured ovarian cysts. Methods This was a retrospective study conducted in the duration of five years from 1st January 2016 to 1st January 2020. The data about demographic parameters, hematological parameters, operative approach, operative technique, and histopathological reports were derived from an electronic database and documented on proforma. SPSS was used for statistical analysis. Logistic regression analysis and influence of each factor on preoperative diagnosis of Adnexal torsion was evaluated. Results A total of 125 patients were included in the article (adnexal torsion group n = 25, untwisted unruptured ovarian cyst group n = 100). There was no statistically significant difference in comparison to age, parity, and abortion between both groups. Most patients had undergone laparoscopic surgery which was based on surgeon's skill and preference. Nineteen (78%) patients in the adnexal torsion group underwent oophorectomy while infarcted ovary was seen in only 4 cases. Among the blood parameters, only neutrophil-lymphocyte ratio (NLR) >3 was found to be statistically significant under logistic regression analysis. Most common adnexal pathology to undergo torsion was serous cyst. Conclusion Preoperative neutrophil-lymphocyte ratio can be a predictive marker for diagnosis of adnexal torsion and can differentiate it from untwisted unruptured ovarian cysts.
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Mohanty V, Sharma S, Goswami S, Kaushik A, Choudhary R, Yadav D, Deora S, Singh K. Association of Novel Hematological Indices with Severity of Coronary Artery Disease using SYNTAX Score in Patients with Acute Coronary Syndrome. Cardiovasc Hematol Disord Drug Targets 2023; 23:202-211. [PMID: 37953615 DOI: 10.2174/011871529x269740231102045028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Recent evidence suggests that systemic inflammation not only plays an important role in the pathogenesis of Acute Coronary Syndrome but also correlates with disease severity. Monocyte-to-high-density lipoprotein cholesterol ratio (MHR), Neutrophil-Lymphocyte Ratio (NLR), and Monocyte-Lymphocyte Ratio (MLR) are novel systemic inflammation markers used for predicting the burden of coronary artery disease (CAD) based on SYNTAX Score. This single-center, cross-sectional, observational study compared the association of these novel hematological indices with CAD severity using the SYNTAX Score in ACS patients and aimed to determine the best predictor of the severity of CAD. METHODS A total of 403 consecutive patients with ACS who underwent coronary angiography were enrolled. On the basis of the SYNTAX Score, patients were divided into three groups: Low: <22, Moderate 22 - 32 and High ≥ 32. MHR, MLR, and NLR were calculated and correlated with SYNTAX Score. RESULTS All three indices: MHR (r=0.511; p <0.001), MLR (r=0.373; p <0.001), and NLR (r=0.292; p =0.001) showed significant correlation with SYNTAX Score. The MHR ROC was significantly higher than that of MLR (difference between area: 0.158; 95% CI: 0.079-0.259) and NLR (difference between area: 0.279; 95% CI: 0.172-0.419) for the SYNTAX Score. Analysis showed a strong correlation between these indices with SYNTAX Score >22 compared to low scores <22 and that these also related to the LAD as an infarct artery. Multiple regression analysis showed that diabetes mellitus, eGFR, Infarct-related artery left anterior descending (IRALAD), MHR, MLR, and NLR were predictors of the severity of CAD in ACS patients based on SYNTAX Score. CONCLUSION In ACS patients MHR, MLR, and NLR showed significant correlation with SYNTAX score >22 which may be indicative of severity of disease. MHR is a better predictor of the severity of CAD than MLR and NLR in ACS patients.
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Affiliation(s)
- Vivek Mohanty
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shubham Sharma
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Sourabh Goswami
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Atul Kaushik
- Associate Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rahul Choudhary
- Associate Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Dharamveer Yadav
- Additional Professor of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Surender Deora
- Additional Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Kuldeep Singh
- Professor of Paediatrics and Genetic Medicine, All India Institute of Medical Sciences, Jodhpur, India
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22
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Tok D, Ekizler FA, Tak BT. The relation between apical thrombus formation and systemic immune-inflammation index in patients with acute anterior myocardial infarction. Medicine (Baltimore) 2022; 101:e32215. [PMID: 36550886 PMCID: PMC9771313 DOI: 10.1097/md.0000000000032215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Left ventricular (LV) apical thrombus formation is a well described and clinically important complication of acute myocardial infarction (MI) with a substantial risk of thromboembolism. Alterations in the inflammatory status may contribute to this complication. The aim of this study was to evaluate the predictive role of the systemic immune-inflammation index (SII) in identifying high risk patients who will develop an apical thrombus formation during the acute phase of anterior transmural infarction. Consecutive 1753 patients (mean age: 61.5 ± 9.6 years; male: 63.8 %) with first acute anterior MI who underwent primary percutaneous coronary intervention were assessed. Patients were divided into 2 groups according to the presence of apical thrombus. SII was calculated using the following equation: neutrophil (N) × platelet (P) ÷ lymphocyte (L). LV apical thrombus was detected on transthoracic echocardiogram in 99 patients (5.6%). Patients with an apical thrombus had lower LV ejection fraction, prolonged time from symptoms to treatment, higher rate of post-percutaneous coronary intervention thrombolysis in myocardial infarction flow ≤1 and significantly higher mean high-sensitivity C-reactive protein, and SII values and lower lymphocyte than those without an apical thrombus. Admission SII level was found to be a significant predictor for early LV apical thrombus formation complicating a first-ever anterior MI. This simple calculated tool may be used to identify high-risk patients for LV thrombus and individualization of targeted therapy.
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Affiliation(s)
- Derya Tok
- Department of Cardiology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
- * Correspondence: Derya Tok, Sağlik Bilimleri Üniversitesi, Ankara Şehir Hastanesi, Kardiyoloji Klinigi, Ankara 06100, Turkey (e-mail: )
| | | | - Bahar Tekin Tak
- Department of Cardiology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
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23
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Li X, Yan F, Liu X, Li M, Li J, Chen Y, Li C. Acute coronary syndrome screening in patients presenting with arteriosclerosis in health check-ups: a case-control study. BMJ Open 2022; 12:e062596. [PMID: 36418121 PMCID: PMC9685184 DOI: 10.1136/bmjopen-2022-062596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This research aimed to develop a simple and effective acute coronary syndrome (ACS) screening model in order to intervene early and focus on prevention in patients presenting with arteriosclerosis. DESIGN A case-control study. SETTING The study used a cross-sectional survey to collect data from 2243 patients who completed anonymous electronic medical record (EMR) data and coronary angiography was gathered at a hospital in Shandong Province between December 2013 and April 2016. PARTICIPANTS Adults 18 years old and above diagnosed as ACS or non-ACS according to the records in hospital EMR database, and with completed basic information (age and sex). PREDICTORS 54 laboratory biomarkers and demographic factors (age and sex). STATISTICAL ANALYSIS A dataset without missing data of all patients' laboratory indicators and demographic factors was divided into training set and validation set after being balanced. After the training set balanced, area under the curve of random forest (AUCRF) and least absolute shrinkage and selection operator (LASSO) regression were used for feature extraction. Then two set random forest models were established with the different feature sets, and the process of comparison and analysis was made to evaluate models for the optimal model including sensitivity, accuracy and AUC receiver operating characteristic curves with the internal validation set. MAIN OUTCOME MEASURES To establish an ACS screening model. RESULTS An RF model with 31 features selected by LASSO with an AUC of 0.616 (95% CI 0.650 to 0.772), a sensitivity of 0.832 and an accuracy of 0.714 in the validation set. The other RF model with 27 features selected by AUCRF with an AUC of 0.621 (95% CI 0.664 to 0.785), a sensitivity of 0.849 and an accuracy of 0.728 in the validation set. CONCLUSIONS The established ACS screening model with 27 clinical features provides a better performance for practical solution in predicting ACS.
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Affiliation(s)
- Xiaoxing Li
- Department of Geriatrics, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Fangkun Yan
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xinhui Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Mingzhuo Li
- Center for Big Data Research in Health and Medicine, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jiangbing Li
- Department of Cardiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuguo Chen
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Chuanbao Li
- Department of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, Shandong, China
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24
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Diao S, Li J, Zhao J, Wang D, Wang H, Xu X, Zhou J. Risk factors and new inflammatory indicators of deep vein thrombosis after adult patella fractures. Front Surg 2022; 9:1028542. [PMID: 36406364 PMCID: PMC9666767 DOI: 10.3389/fsurg.2022.1028542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/03/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the association between new inflammatory indicators at admission and the occurrence of preoperative deep vein thrombosis (DVT) in patients with patella fractures. METHODS A retrospective analysis of the medical records of patients aged 18 years or older who underwent surgical treatment for unilateral closed patella fractures at our hospital between August 2016 and August 2020. The incidence of preoperative DVT was detected by Duplex ultrasound (DUS). Partial blood routine and biochemical indexes were collected at admission, and the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) of inflammatory indexes were also calculated. ROC was used to analyze the cut-off value NLR, MLR, and PLR for predicting preoperative DVT, and univariate and multivariate analyses of the risk factors for preoperative DVT of patella fractures, and to verify whether other risk factors affecting the relationship between validation indexes and preoperative DVT. RESULTS A total of 500 patients were included, of which 39 patients (7.8%) developed preoperative DVT. After univariate and multivariate analysis, preoperative time (in each day delay), male (vs. female), D-dimer > 0.6 mg/L, total cholesterol (TC) > 5.6 mmol/L, and PLR > 189.8 were the risk factors for preoperative DVT in patients with patella fracture. Inflammation index PLR combined with the other four risk factors significantly improved the predictive efficacy of preoperative DVT compared with PLR (P = 0.009). CONCLUSION Inflammatory index PLR is a risk factor for preoperative DVT in patients with patella fracture, and the efficacy of PLR in predicting DVT can be significantly improved when other risk factors (male, D-dimer > 0.6 mg/L, TC > 5.6 mmol/L, and PLR > 189.8 of preoperative time in each day delay) are combined. These data are useful for the clinical identification of patients at high risk of preoperative DVT in patella fractures.
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Affiliation(s)
- Shuo Diao
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jingqiao Li
- Department of Orthopedic Surgery, Hebei Jing-Xing Xian Hospital, Shijiazhuang, China
| | - Jianyong Zhao
- Department of Hand Surgery, Cangzhou Hospital of Integrated Traditional and Western Medicine of Hebei Province, Cangzhou, China
| | - Dong Wang
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hanzhou Wang
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaopei Xu
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Junlin Zhou
- Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China,Correspondence: Junlin Zhou
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25
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Identification of Monocyte-Associated Genes Related to the Instability of Atherosclerosis Plaque. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3972272. [PMID: 36187340 PMCID: PMC9519342 DOI: 10.1155/2022/3972272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022]
Abstract
Background. Atherosclerotic plaque instability is a common cause of stroke and ischemic infarction, and identification of monocyte-associated genes has become a prominent feature in cardiovascular research as a contributing/predictive marker. Methods. Whole genome sequencing data were downloaded from GSE159677, GSE41571, GSE120521, and GSE118481. Single-cell sequencing data analysis was conducted to cluster molecular subtypes of atherosclerotic plaques and identify specific genes. Differentially expressed genes (DEGs) between normal subjects and patients with unstable atheromatous plaques were screened. Weighted gene coexpression network analysis (WGCNA) was performed to find key module genes. In addition, GO and KEGG enrichment analyses explored potential biological signaling pathways to generate protein interaction (PPI) networks. GSEA and GSVA demonstrated activations in plaque instability subtypes. Results. 239 monocyte-associated genes were identified based on bulk and single-cell RNA-sequencing, followed by the recognition of 1221 atherosclerotic plaque-associated DEGs from the pooled matrix. GO and KEGG analyses suggested that DEGs might be related to inflammation response and the PI3K-Akt signaling pathway. Eight no-grey modules were obtained through WGCNA analysis, and the turquoise module has the highest correlation with unstable plaque (
), which contained 1323 module genes. After fetching the intersecting genes, CXCL3, FPR1, GK, and LST1 were obtained that were significantly associated with plaque instability, which had an intense specific interaction. Monocyte-associated genes associated with atherosclerotic plaque instability have certain diagnostic significance and are generally overexpressed in this patient population. In addition, 11 overlapping coexpressed genes (CEG) might also activated multiple pathways regulating inflammatory responses, platelet activation, and hypoxia-inducible factors. GSVA showed that the corresponding pathways were significantly activated in high expression samples. Conclusions. Overexpression of CXCL3, GK, FPR1, and LST1 was advanced recognition and intervention factors for unstable plaques, which might become targets for atherosclerosis rupture prevention. We also analyzed the potential mechanisms of CEG from inflammatory and oxidative stress pathways.
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26
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Xie X, Yan D, Liu X, Wang Y, Deng Y, Yao R, Li N. High platelet distribution width is an independent risk factor of postoperative pneumonia in patients with type A acute aortic dissection. Front Cardiovasc Med 2022; 9:984693. [PMID: 36186998 PMCID: PMC9521668 DOI: 10.3389/fcvm.2022.984693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Platelet distribution width (PDW), as a widely applied and reliable marker of platelet activation, was associated with adverse outcomes in cardiovascular diseases. However, there is little literature on the relationship between PDW and postoperative pneumonia in patients with type A acute aortic dissection (AAAD). Methods In this retrospective cohort study, we collected consecutive patients who underwent emergency surgery for AAAD at Xiangya Hospital of Central South University from January 1, 2014 and June 30, 2020. Patients were divided into three tertiles on the basis of the PDW. The independent effect of the PDW on postoperative pneumonia was evaluated using multivariate logistic regression analysis, and smooth curve fitting was performed to visualize the linear relationship between PDW and the risk of postoperative pneumonia in patients with AAAD. Results A total of 210 patients with AAAD were enrolled and the overall incidence of postoperative pneumonia was 25.24% (n = 53). Multivariate logistic regression revealed that PDW was positively associated with the risk of postoperative pneumonia (OR: 1.07, 95% CI: 1.02–1.13, P < 0.05) after adjusting the confounders. Compared with the lowest PDW tertile, the risk of postoperative pneumonia increased by 1.21-fold in the medium PDW tertile (OR: 2.21, 95% CI: 0.73–6.72) and by 3.16-fold in the highest PDW tertile (OR: 4.16, 95% CI: 1.40–12.33). A straight-line relationship was observed between PDW and postoperative pneumonia risk in smoothing spline fitting. Conclusion Our findings indicate that high PDW is an independent risk factor of postoperative pneumonia in patients with AAAD. Preoperative PDW may serve as an available indicator of pneumonia, which helps identify AAAD patients with a high risk of postoperative pneumonia.
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Affiliation(s)
- Xi Xie
- Department of Blood Transfusion, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, China
| | - Danyang Yan
- Department of Blood Transfusion, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, China
| | - Xin Liu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Yanjie Wang
- Department of Blood Transfusion, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, China
| | - Ying Deng
- Ningxiang People's Hospital Affiliated to Hunan University of Traditional Chinese Medicine, Ningxiang, China
| | - Run Yao
- Department of Blood Transfusion, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, China
- *Correspondence: Run Yao
| | - Ning Li
- Department of Blood Transfusion, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Clinical Transfusion Research Center, Central South University, Changsha, China
- Ning Li
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27
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Parsa SA, Nourian S, Safi M, Namazi MH, Saadat H, Vakili H, Eslami V, Salehi A, Kiaee FH, Sohrabifar N, Khaheshi I. The Association Between Hematologic Indices With TIMI Flow In STEMI Patients Who Undergo primary percutaneous coronary intervention. Cardiovasc Hematol Disord Drug Targets 2022; 22:CHDDT-EPUB-126290. [PMID: 36100995 DOI: 10.2174/1871529x22666220913122046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/26/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Primary Percutaneous Coronary Intervention (PPCI) is the preferred therapeutic strategy for patients who experienced ST-Elevation Myocardial Infarction (STEMI). OBJECTIVE We aimed to evaluate the association of hematological indices, including hemoglobin level, platelets, White Blood Cells (WBCs) count, and MPV before PPCI with the TIMI grade flow after PPCI. METHODS STEMI patients who experienced PPCI were included in the present retrospective crosssectional study. Then participants were divided into three groups based on their post-procedural TIMI flow grades. Demographic data and hematologic indices of patients before PPCI were collected and their association with the TIMI grade flow after PPCI was evaluated. To compare the quantitative and qualitative variables, chi-square and t-tests were performed, respectively. RESULTS We found that elevated levels of hemoglobin and decreased levels of MPV had a significant association with an advanced grade of TIMI flow. Interestingly, in the normal range, there was a significant association between higher platelet count and TIMI-flow grade 1. Besides, TIMI flow grades 2 and 3 had a significant association with low and moderate platelets count, respectively. CONCLUSION In conclusion, evaluating MPV, platelets, and hemoglobin levels before PPCI as easy and accessible parameters may be able to identify high-risk STEMI patients undergoing PPCI.
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Affiliation(s)
- Saeed Alipour Parsa
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Nourian
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Safi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hasan Namazi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habib Saadat
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Vakili
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Eslami
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ayoub Salehi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Nasim Sohrabifar
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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28
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Firani NK, Hartanti KD, Purnamasari P. Hematological Parameter as Predictor Mortality in Acute Myocardial Infarction Patients. Int J Gen Med 2022; 15:6757-6763. [PMID: 36039309 PMCID: PMC9419809 DOI: 10.2147/ijgm.s380659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Acute myocardial infarction (AMI) is one of the leading causes of death in the world. Several hematological parameters are involved in AMI conditions and can be explored for their ability to predict in-hospital mortality. We evaluated hematological parameter value as predictors of in-hospital mortality in AMI patients. Patients and Methods Analytical observational study on AMI patients that admitted to Dr. Saiful Anwar Hospital, June-August 2021. Complete blood count was taken at the beginning of hospital admission. Patients with sepsis were excluded from the study. The research subjects were divided into two groups, survivor group and non-survivor group (in-hospital mortality). Hematological parameters as predictors of mortality were analyzed using the ROC curve and odds ratio. Results Among 44 study subjects, 19 (43.18%) patients were in the non-survivor group and 25 (56.82%) patients were in the survivor group. Hematological parameters that can be predictors of mortality include leukocytes (AUC = 0.744; p = 0.006), neutrophils (AUC = 0.729; p = 0.010), eosinophils (AUC = 0.696; p = 0.028), and eosinophils/leukocytes ratio (AUC = 0.772; p = 0.012). The cut-off value for leukocytes was 13,725/μL (OR: 9), neutrophils was 12,008/μL (OR: 8.14), eosinophils was 58.3/μL (OR: 4.06), and eosinophil/leukocyte ratio was 0.0025 (OR: 4.41) with sensitivity 63.25%, 52.6%, 78.9%, and 63.2%, respectively, and specificity 84%, 88%, 52%, and 72%, respectively. Conclusion Leukocyte, neutrophils, eosinophils count and eosinophil/leukocyte ratio can help predict in-hospital mortality of AMI patients.
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Affiliation(s)
- Novi Khila Firani
- Clinical Pathology Department, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Khoirunisah Dwi Hartanti
- Clinical Pathology Resident, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.,Central Laboratory Dr. Saiful Anwar Hospital, Malang, Indonesia
| | - Putri Purnamasari
- Clinical Pathology Resident, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.,Central Laboratory Dr. Saiful Anwar Hospital, Malang, Indonesia
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29
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From Classic to Modern Prognostic Biomarkers in Patients with Acute Myocardial Infarction. Int J Mol Sci 2022; 23:ijms23169168. [PMID: 36012430 PMCID: PMC9409468 DOI: 10.3390/ijms23169168] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Despite all the important advances in its diagnosis and treatment, acute myocardial infarction (AMI) is still one of the most prominent causes of morbidity and mortality worldwide. Early identification of patients at high risk of poor outcomes through the measurement of various biomarker concentrations might contribute to more accurate risk stratification and help to guide more individualized therapeutic strategies, thus improving prognoses. The aim of this article is to provide an overview of the role and applications of cardiac biomarkers in risk stratification and prognostic assessment for patients with myocardial infarction. Although there is no ideal biomarker that can provide prognostic information for risk assessment in patients with AMI, the results obtained in recent years are promising. Several novel biomarkers related to the pathophysiological processes found in patients with myocardial infarction, such as inflammation, neurohormonal activation, myocardial stress, myocardial necrosis, cardiac remodeling and vasoactive processes, have been identified; they may bring additional value for AMI prognosis when included in multi-biomarker strategies. Furthermore, the use of artificial intelligence algorithms for risk stratification and prognostic assessment in these patients may have an extremely important role in improving outcomes.
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30
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He J, Bian X, Song C, Zhang R, Yuan S, Yin D, Dou K. High neutrophil to lymphocyte ratio with type 2 diabetes mellitus predicts poor prognosis in patients undergoing percutaneous coronary intervention: a large-scale cohort study. Cardiovasc Diabetol 2022; 21:156. [PMID: 35964050 PMCID: PMC9375260 DOI: 10.1186/s12933-022-01583-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inflammation plays a crucial role in the pathogenesis and progression of coronary artery disease (CAD). The neutrophil to lymphocyte ratio (NLR) is a novel inflammatory biomarker and its association with clinical outcomes in CAD patients with different glycemic metabolism after percutaneous coronary intervention (PCI) remains undetermined. Therefore, this study aimed to investigate the effect of NLR on the prognosis of patients undergoing PCI with or without type 2 diabetes mellitus (T2DM). METHODS We consecutively enrolled 8,835 patients with CAD hospitalized for PCI at Fuwai hospital. NLR was calculated using the following formula: neutrophil (*109/L)/lymphocyte (*109/L). According to optimal cut-off value, study patients were categorized as higher level of NLR (NLR-H) and lower level of NLR (NLR-L) and were further stratified as NLR-H with T2DM and non-T2DM, and NLR-L with T2DM and non-T2DM. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs), defined as all-cause mortality, myocardial infarction (MI), stroke and target vessel revascularization. RESULTS A total of 674 (7.6%) MACCEs were recorded during a median follow-up of 2.4 years. The optimal cut-off value of NLR was 2.85 determined by the surv_cutpoint function. Compared to those in the NLR-H/T2DM groups, patients in the NLR-L/non-T2DM, NLR-H/non-T2DM and NLR-L/T2DM groups were at significantly lower risk of 2-year MACCEs [adjusted hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.52 to 0.87, P = 0.003; adjusted HR: 0.62, 95%CI: 0.45 to 0.85, P = 0.003; adjusted HR: 0.77, 95%CI: 0.61 to 0.97, P = 0.025; respectively]. Remarkably, patients in the NLR-L/non-T2DM group also had significantly lower risk of a composite of all-cause mortality and MI than those in the NLR-H/T2DM group (adjusted HR: 0.57, 95%CI: 0.35 to 0.93, P = 0.024). Multivariable Cox proportional hazards model also indicated the highest risk of MACCEs in diabetic patients with higher level of NLR than others (P for trend = 0.009). Additionally, subgroup analysis indicated consistent impact of NLR on MACCEs across different subgroups. CONCLUSIONS Presence of T2DM with elevated NLR is associated with worse clinical outcomes in CAD patients undergoing PCI. Categorization of patients with elevated NLR and T2DM could provide valuable information for risk stratification of CAD patients.
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Affiliation(s)
- Jining He
- State Key Laboratory of Cardiovascular Disease, Beijing, China.,Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Xiaohui Bian
- State Key Laboratory of Cardiovascular Disease, Beijing, China.,Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Chenxi Song
- State Key Laboratory of Cardiovascular Disease, Beijing, China.,Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Rui Zhang
- State Key Laboratory of Cardiovascular Disease, Beijing, China.,Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Sheng Yuan
- State Key Laboratory of Cardiovascular Disease, Beijing, China.,Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Dong Yin
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kefei Dou
- State Key Laboratory of Cardiovascular Disease, Beijing, China. .,Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China.
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ÇAKMAK KARAASLAN Ö, BAŞYIĞIT F. Aort Kapak Sklerozunun Öngörülmesinde Yeni Hematolojik İnflamatuar Parametrelerin Önemi. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2022. [DOI: 10.25000/acem.1107825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: Inflammatory process plays a critical role in the progression of aortic valve sclerosis (AVS). This study aims to evaluate the haematological and biochemical inflammatory markers in AVS patients.Methods: A retrospective observational study was included consecutive 557 patients who underwent an echocardiogram between June 2021 and September 2021. The study population was divided into two groups according to the presence of AVS. The groups were compared in terms of C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-HDL cholesterol ratio (MHR).Results: The mean age was 63 ± 10 years. C-reactive protein (CRP), NLR, PLR and MHR were significantly higher in patients with AVS. The best cut-off values of the NLR were 1.4 (a sensitivity of 84%, a specificity of 74%), PLR was 116 (a sensitivity of 75%, a specificity of 54%), and MHR was 9.5 (a sensitivity of 78%, a specificity of 75%). CRP (OR: 1.246, 95% CI: 1.117 – 1.389; p < 0.001), NLR (OR: 2.10, 95% CI: 1.456 – 3.032; p < 0.001), and MHR (OR: 1.227, 95% CI: 1.125 – 1.339; p < 0.001) were independent predictors of the AVS when NLR and MHR analysed as a continuous variable. Using a cut off level of NLR > 1.4 (OR: 4.825, 95% CI: 2.430 – 9.583; p < 0.001) and MHR > 9.5 (OR: 13.937, 95% CI: 7.464 – 26.023; p < 0.001) were independent predictors of the AVS.Conclusion: Increased CRP levels, NLR and MHR were found to be independent predictors for AVS. Hematological inflammatory biomarkers are cost effective and helpful approach for prediction of AVS presence.
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Affiliation(s)
- Özge ÇAKMAK KARAASLAN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI
| | - Funda BAŞYIĞIT
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI
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Sanchez-Autet M, Arranz B, Sierra P, Safont G, Garcia-Blanco A, de la Fuente L, Garriga M, Marín L, García-Portilla MP. Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein levels and metabolic status in patients with a bipolar disorder. World J Biol Psychiatry 2022; 23:464-474. [PMID: 34856870 DOI: 10.1080/15622975.2021.2013089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-Reactive Protein (CRP) are markers of inflammation that are elevated in bipolar disorder (BD) and are also related to a higher risk of metabolic syndrome (MetS). This study aimed at investigating for the first time the association between NLR, PLR, and CRP and the metabolic status in BD. METHODS We assessed the association between biomarkers and the metabolic status: number of metabolic risk factors, presence of MetS, insulin sensitivity (Quantitative Insulin Sensitivity Check Index, QUICKI) and insulin resistance (Homeostatic Model Assessment for Insulin Resistance, HOMA-IR index), in a sample of 219 outpatients with BD. RESULTS 25.9% of the sample met the criteria for MetS. High levels of CRP were found in 12% of the sample. Older age, low PLR, high NLR, and high CRP levels significantly predicted a higher number of MetS risk factors (p < 0.001). Older age and low PLR were associated with a greater likelihood of developing MetS (p = 0.007). CONCLUSIONS Although further studies are needed to replicate and validate these findings, inflammatory biomarkers as CRP, PLR and NLR could be useful tools to identify patients with a BD at risk for a metabolic adverse outcome.
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Affiliation(s)
| | - Belén Arranz
- Parc Sanitari Sant Joan de Deu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Pilar Sierra
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Gemma Safont
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Ana Garcia-Blanco
- Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain
| | - Lorena de la Fuente
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Marina Garriga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lorena Marín
- Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Maria Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
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Clinical Features of Acute Coronary Syndrome in Patients with Coronary Heart Disease and Its Correlation with Tumour Necrosis Factor in Cardiology. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3439768. [PMID: 35813433 PMCID: PMC9262531 DOI: 10.1155/2022/3439768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022]
Abstract
Tumour necrosis factor (TNF) levels are higher in patients who have experienced an acute ischemic stroke. Greater levels of TNF may not be linked to an increased risk of recurrent coronary events in the stable phase after myocardial ischemia (MI). Coronary atheroma is connected to endothelial and smooth muscle cells, as well as macrophages that emit the multifunctional cytokine tumour necrosis factor (TNF). Transplanted tumours become more vulnerable when TNF-α was first recognized to have a function in hemorrhagic necrosis. TNF-α has been demonstrated to induce heart failure, pulmonary edoema, and cardiomyopathy in people with advanced heart failure when it is elevated in the bloodstream. It has been postulated that prolonged overexpression of TNF-α after ischemia may contribute to poor cardiac outcomes by increasing TNF-α when the myocardium undergoes both temporary ischemia and reperfusion. A rise in TNF levels has been seen after a myocardial infarction, but it is unclear if these higher levels, found months after the initial event, are associated with an increased risk of subsequent heart attacks. We looked at TNF levels in the blood of 270 patients with coronary heart disease in the Chinese Hypertension League's Cholesterol and Recurrent Events (CARE) experiment to see if this notion held true. Recurrent coronary syndrome and coronary mortality were monitored prospectively in the participants. The min max imbalance normalization can be used to assess a patient's baseline characteristics, including hormone and cholesterol test results. Type 2 stimulant connection to aggregate the TNF-signaling qualities and fuzzy techniques was applied. There may now be enough preliminary evidence from the crucial bundle neural network analysis to identify the risk of coronary heart disease associated with TNF pregeneration studies. The tests were assessed using a variety of methods and performance metrics in a Matlab environment.
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Liu Z, Perry LA, Penny-Dimri JC, Handscombe M, Overmars I, Plummer M, Segal R, Smith JA. Elevated Cardiac Troponin to Detect Acute Cellular Rejection After Cardiac Transplantation: A Systematic Review and Meta-Analysis. TRANSPLANT INTERNATIONAL : OFFICIAL JOURNAL OF THE EUROPEAN SOCIETY FOR ORGAN TRANSPLANTATION 2022; 35:10362. [PMID: 35755856 PMCID: PMC9215116 DOI: 10.3389/ti.2022.10362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022]
Abstract
Cardiac troponin is well known as a highly specific marker of cardiomyocyte damage, and has significant diagnostic accuracy in many cardiac conditions. However, the value of elevated recipient troponin in diagnosing adverse outcomes in heart transplant recipients is uncertain. We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from inception until December 2020. We generated summary sensitivity, specificity, and Bayesian areas under the curve (BAUC) using bivariate Bayesian modelling, and standardised mean differences (SMDs) to quantify the diagnostic relationship of recipient troponin and adverse outcomes following cardiac transplant. We included 27 studies with 1,684 cardiac transplant recipients. Patients with acute rejection had a statistically significant late elevation in standardised troponin measurements taken at least 1 month postoperatively (SMD 0.98, 95% CI 0.33–1.64). However, pooled diagnostic accuracy was poor (sensitivity 0.414, 95% CrI 0.174–0.696; specificity 0.785, 95% CrI 0.567–0.912; BAUC 0.607, 95% CrI 0.469–0.723). In summary, late troponin elevation in heart transplant recipients is associated with acute cellular rejection in adults, but its stand-alone diagnostic accuracy is poor. Further research is needed to assess its performance in predictive modelling of adverse outcomes following cardiac transplant. Systematic Review Registration: identifier CRD42021227861
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Affiliation(s)
- Zhengyang Liu
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Luke A Perry
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Jahan C Penny-Dimri
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Michael Handscombe
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Isabella Overmars
- Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Mark Plummer
- Department of Intensive Care Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Medicine, University of Melbourne, Parkville, VIC, Australia
| | - Reny Segal
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Medicine, University of Melbourne, Parkville, VIC, Australia
| | - Julian A Smith
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
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Gur DO, Efe MM, Alpsoy S, Akyüz A, Uslu N, Çelikkol A, Gur O. Índice Imunoinflamatório Sistêmico como Determinante de Carga Aterosclerótica e Pacientes de Alto Risco com Síndromes Coronarianas Agudas. Arq Bras Cardiol 2022; 119:382-390. [PMID: 35766615 PMCID: PMC9438541 DOI: 10.36660/abc.20210416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 01/26/2022] [Indexed: 11/18/2022] Open
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Feng J, Lu X, Li H, Wang S. High neutrophil-to-lymphocyte ratio is a significant predictor of depressive symptoms in maintenance hemodialysis patients: a cross-sectional study. BMC Psychiatry 2022; 22:313. [PMID: 35505395 PMCID: PMC9063198 DOI: 10.1186/s12888-022-03963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is one of the most important psychiatric disorders in chronic kidney disease patients who undergo maintenance hemodialysis (MHD). Previous studies have shown that low-grade inflammation is involved in the progression of depressive symptoms. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker that is inexpensive and easy to measure. However, the association between NLR and depression symptoms in MHD patients has not been examined. METHODS In this single-center, cross-sectional study, we included 160 patients undergoing MHD. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. NLR was calculated as the ratio of neutrophils to lymphocytes. Multinomial logistic regression and multivariate linear regression analyses were used to examine the association between NLR and depressive symptoms in MHD patients. RESULTS Depressive symptoms were detected in 36.7% of the 160 MHD patients. Multinomial logistic regression showed that NLR was a significant predictor of mild (odds ratio [OR]: 1.383, 95% confidence interval [CI]: 1.015-1.884, p = 0.04) and moderate/moderately severe depressive symptoms (OR: 1.441, 95% CI: 1.017-2.042, p = 0.04) in MHD patients, adjusted for age, sex, Kt/V, dialysis duration, history of kidney transplantation, history of hypertension, and Charlson comorbidity index score. In addition, multivariate linear regression analysis showed that NLR was an independent influencing factor for PHQ-9 score in MHD patients, after adjusting for confounding factors. CONCLUSIONS These findings suggest that NLR can be used as a biomarker for predicting depressive symptoms in MHD patients.
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Affiliation(s)
- Jianan Feng
- grid.411607.5Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
| | - Xiangxue Lu
- grid.411607.5Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
| | - Han Li
- Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020, China.
| | - Shixiang Wang
- grid.411607.5Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
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Li Q, Ma X, Shao Q, Yang Z, Wang Y, Gao F, Zhou Y, Yang L, Wang Z. Prognostic Impact of Multiple Lymphocyte-Based Inflammatory Indices in Acute Coronary Syndrome Patients. Front Cardiovasc Med 2022; 9:811790. [PMID: 35592392 PMCID: PMC9110784 DOI: 10.3389/fcvm.2022.811790] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study was to evaluate the prognostic values of five lymphocyte-based inflammatory indices (platelet-lymphocyte ratio [PLR], neutrophil-lymphocyte ratio [NLR], monocyte-lymphocyte ratio [MLR], systemic immune inflammation index [SII], and system inflammation response index [SIRI]) in patients with acute coronary syndrome (ACS). Methods A total of 1,701 ACS patients who underwent percutaneous coronary intervention (PCI) were included in this study and followed up for major adverse cardiovascular events (MACE) including all-cause death, non-fatal ischemic stroke, and non-fatal myocardial infarction. The five indices were stratified by the optimal cutoff value for comparison. The association between each of the lymphocyte-based inflammatory indices and MACE was assessed by the Cox proportional hazards regression analysis. Results During the median follow-up of 30 months, 107 (6.3%) MACE were identified. The multivariate COX analysis showed that all five indices were independent predictors of MACE, and SIRI seemingly performed best (Hazard ratio [HR]: 3.847; 95% confidence interval [CI]: [2.623–5.641]; p < 0.001; C-statistic: 0.794 [0.731–0.856]). The addition of NLR, MLR, SII, or SIRI to the Global Registry of Acute Coronary Events (GRACE) risk score, especially SIRI (C-statistic: 0.699 [0.646–0.753], p < 0.001; net reclassification improvement [NRI]: 0.311 [0.209–0.407], p < 0.001; integrated discrimination improvement [IDI]: 0.024 [0.010–0.046], p < 0.001), outperformed the GRACE risk score alone in the risk predictive performance. Conclusion Lymphocyte-based inflammatory indices were significantly and independently associated with MACE in ACS patients who underwent PCI. SIRI seemed to be better than the other four indices in predicting MACE, and the combination of SIRI with the GRACE risk score could predict MACE more accurately.
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38
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Demir M, Özbek M. A novel predictor in patients with coronary chronic total occlusion: systemic immune-inflammation index: a single-center cross-sectional study. Rev Assoc Med Bras (1992) 2022; 68:579-585. [DOI: 10.1590/1806-9282.20211097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/11/2022] [Indexed: 11/22/2022] Open
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Raza H, Noor T, Umer S, Fatima M, Imran A, Malik N. Relationship Between High-Density Lipoprotein-Cholesterol and Red Cell Distribution Width in Patients With Coronary Artery Disease. Cureus 2022; 14:e23132. [PMID: 35425675 PMCID: PMC9005557 DOI: 10.7759/cureus.23132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background A high red cell distribution width (RDW), which indicates ongoing inflammation, and low levels of high-density lipoprotein-cholesterol (HDL-C) are associated with increased mortality and morbidity in patients with coronary artery disease (CAD). Recent studies have suggested that HDL-C possesses anti-inflammatory and antioxidant effects, which may explain its anti-atherogenic properties. This study aims to determine the relationship between HDL-C levels and RDW in patients with CAD. Materials and methods This cross-sectional study was performed on 120 patients with CAD from July 2020 to June 2021 in the Hematology Department of Chughtai Lab Lahore. Patients were graded according to the degree of coronary artery stenosis as follows: Grade 1,30%-50%; Grade 2, 51%-70%; and Grade 3,>70%. The HDL-C level was measured from venous blood samples by a fully automated Abbot Alinity analyzer. The RDW was measured by Sysmex XN-5000. The sample size was calculated using the Select Statistics calculator. The mean RDW and HDL-C of the patients were calculated, and correlation analyses were performed using the Pearson correlation coefficient. Results The HDL-C level was inversely related to the RDW. Of the 120 patients, 38, 44, and 38 had Grade 1, Grade 2, and Grade 3 stenosis, respectively. The mean HDL-C level and RDW were 30.58 ±3.77 mg/dL and 16.04% ±1.66%, respectively. The value of r was −0.8622 (strongly negative). Data were stratified based on the degree of stenosis. The values of r in Grades 1, 2, and 3 were −0.43 (moderately negative), −0.604 (moderately negative), and −0.27 (weakly negative), respectively. Conclusion The RDW can be used as an additional marker to determine the disease status in CAD patients.
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Topuz MF, Ture N, Akdag G, Arik O, Gulhan PY. The importance of systemic immune-inflammation index in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2022; 279:5033-5038. [DOI: 10.1007/s00405-021-07227-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/17/2021] [Indexed: 11/28/2022]
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Raygan F, Etminan A, Mohammadi H, Akbari H, Nikoueinejad H. Serum Levels of Growth Differentiation Factor-15 as an Inflammatory Marker in Patients with Unstable Angina Pectoris. J Tehran Heart Cent 2022; 16:15-19. [PMID: 35082862 PMCID: PMC8728865 DOI: 10.18502/jthc.v16i1.6595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/19/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Growth differentiation factor-15 (GDF-15), a member of transforming growth factors, is a stress-responsive marker whose levels may significantly increase in response to pathological stresses associated with inflammatory tissue injuries such as unstable angina pectoris (USAP). This study evaluated the diagnostic value of GDF-15 in patients with USAP. Methods: The present cross-sectional study recruited 39 patients with USAP criteria and 30 patients with stable angina pectoris (SAP), referred to Shahid Beheshti Hospital, Kashan, Iran. All the patients with USAP had at least 1 coronary artery stenosis (>50%) in angiography. The control group comprised 42 healthy individuals. The serum levels of GDF-15 were measured in all the participants by ELISA. Also analyzed were the relationship between GDF-15 levels and thrombolysis in myocardial infarction (TIMI) and the Global Registry of Acute Coronary Events (GRACE) risk scores in the patients with USAP to determine the severity of the disease. Result: The study population consisted of 111 subjects, 62 women and 49 men, divided into 3 groups of USAP (n=39, mean age=60.07±14.10 y), SAP (n=30, mean age=67.56±9.88 y), and control (n=42, mean age=61.21±7.76 y). The mean serum level of GDF-15 in the USAP group was significantly different from the other 2 groups (P<0.001), while no significant difference was observed in this regard between the SAP and control groups (P=0.797). No correlation was found between the mean GDF-15 serum level and the GRACE (P=0.816) and TIMI (P=0.359) risk scores in the USAP group. Conclusion: The mean serum level of GDF-15 exhibited a rise in our patients with USAP. GDF-15 may be a diagnostic biomarker of USAP and its severity.
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Affiliation(s)
- Fariba Raygan
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Aniseh Etminan
- Students' Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Hanieh Mohammadi
- Students' Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Akbari
- School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Hassan Nikoueinejad
- Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Systemic Immune-Inflammation Index: A Novel Predictor of Coronary Thrombus Burden in Patients with Non-ST Acute Coronary Syndrome. Medicina (B Aires) 2022; 58:medicina58020143. [PMID: 35208466 PMCID: PMC8875451 DOI: 10.3390/medicina58020143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objectives: Excessive coronary thrombus burden is known to cause an increase in mortality and major adverse cardiac events (MACEs) in NSTE-ACS (non-ST acute coronary syndrome) patients. We investigated the association between the systemic immune-inflammation index (SII) and coronary thrombus burden in patients with non-ST segment elevation myocardial infarction (NSTEMI) who underwent coronary angiography and percutaneous coronary intervention (PCI). Materials and Methods: A total of 389 patients with the diagnosis of NSTEMI participated in our study. Coronary thrombus burden was classified in the TIMI (thrombolysis in myocardial infarction) thrombus grade scale and patients were divided into two groups: a TIMI thrombus grade 0–1 group (n = 209, 157 males) and a TIMI thrombus grade 2–6 group (n = 180, 118 males). Demographics, angiographic lesion images, coronary thrombus burden, clinical risk factors, laboratory parameters, and SII score were compared between the two groups. Results: The high thrombus burden patient group had a higher neutrophil count, WBC count, platelet count, and systemic immune-inflammation index (SII) (p < 0.001). The receiver operating characteristic (ROC) curve analysis showed that at a cutoff of 1103, the value of SII manifested 74.4% sensitivity and 74.6% specificity for detecting a high coronary thrombus burden. Conclusions: Our study showed that the SII levels at hospital admission were independently associated with high coronary thrombus with NSTEMI.
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Yilmaz M, Sahin Y, Hacibey I, Ozkuvanci U, Suzan S, Muslumanoglu AY. Should haematological inflammatory markers be included as an adjuvant in the differential diagnosis of acute scrotal pathologies? Andrologia 2022; 54:e14374. [PMID: 35043470 DOI: 10.1111/and.14374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to determine discriminative role of haematological inflammatories between acute scrotal pathologies and malignancies. In addition, it was aimed to search for a predictive marker of testicular survival in the TT group. Medical data of 141 patients with acute scrotal pathology and 63 TTm patients who presented to our clinic between January 2015 and July 2019 were retrospectively reviewed and compared in terms of haematological values and demographic parameters following the inclusion of 92 healthy controls. In the TTm group, NLR was the discriminative parameter with a median of 2.42 (0.25-8.42), whereas discriminative median values of MCV for TT and CRP for EO were 83.65 (56.9-98.16) and 59.5 (2.9-337) respectively. NLR, PLR, MER and RDW values were statistically lower in the control group compared to the patients groups. In TT subgroup analysis, monocyte count, MER and CRP were found to be statistically higher in the orchiectomy group, while multivariate logistic regression analysis performed for testicular viability revealed monocyte count to be the only significant variable (Odds Ratio [95% Confidence Interval] = 0.046 (0.006-0.366), p<0.004). While our study demonstrated both diagnostic and discriminative values of haematological parameters, it also showed that monocyte count could predict testicular salvage in TT patients. However, further prospective studies are required.
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Affiliation(s)
- Mehmet Yilmaz
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Yusuf Sahin
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim Hacibey
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Unsal Ozkuvanci
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Serhat Suzan
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Yaser Muslumanoglu
- Department of Urology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey
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Liu Z, Perry LA, Penny-Dimri JC, Handscombe M, Overmars I, Plummer M, Segal R, Smith JA. Donor Cardiac Troponin for Prognosis of Adverse Outcomes in Cardiac Transplantation Recipients: a Systematic Review and Meta-analysis. Transplant Direct 2022; 8:e1261. [PMID: 34912948 PMCID: PMC8670586 DOI: 10.1097/txd.0000000000001261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/05/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Cardiac troponin is a highly specific and widely available marker of myocardial injury, and elevations in cardiac transplant donors may influence donor selection. We aimed to investigate whether elevated donor troponin has a role as a prognostic biomarker in cardiac transplantation. METHODS In a systematic review and meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library, without language restriction, from inception to December 2020. We included studies reporting the association of elevated donor troponin with recipient outcome after cardiac transplant. We generated summary odds ratios and hazard ratios for the association of elevated donor troponin with short- and long-term adverse outcomes. Methodological quality was monitored using the Quality In Prognosis Studies tool, and interstudy heterogeneity was assessed using a series of sensitivity and subgroup analyses. RESULTS We included 17 studies involving 15 443 patients undergoing cardiac transplantation. Elevated donor troponin was associated with increased odds of graft rejection at 1 y (odds ratio, 2.54; 95% confidence interval, 1.22-5.28). No significant prognostic relationship was found between donor troponin and primary graft failure, short- to long-term mortality, cardiac allograft vasculopathy, and pediatric graft loss. CONCLUSIONS Elevated donor troponin is not associated with an increased short- or long-term mortality postcardiac transplant despite increasing the risk of graft rejection at 1 y. Accordingly, an elevated donor troponin in isolation should not exclude donation.
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Affiliation(s)
- Zhengyang Liu
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
| | - Luke A. Perry
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
| | - Jahan C. Penny-Dimri
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Michael Handscombe
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
| | - Isabella Overmars
- Infection and Immunity Theme, Murdoch Children’s Research Institute, Parkville, Australia
| | - Mark Plummer
- Department of Intensive Care Medicine, Royal Melbourne Hospital, Parkville, Australia
- Department of Critical Care, University of Melbourne, Parkville, Australia
| | - Reny Segal
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
- Department of Critical Care, University of Melbourne, Parkville, Australia
| | - Julian A. Smith
- Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
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Shumakov OV, Dovhan ОV, Talaeva TV, Тretiak IV, Parkhomenko ОМ, Gurjeva OS. THE PROGNOSTIC UTILITY OF LEUKOCYTE AND PLATELET COUNTS FOR RISK ASSESSMENT OF IN-HOSPITAL COMPLICATIONS IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1317-1322. [PMID: 35758451 DOI: 10.36740/wlek202205216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: We have aimed to develop method of risk assessment in patients with acute STEMI using blood cells count useful in everyday clinical practice. PATIENTS AND METHODS Materials and methods: 317 STEMI patients admitted to ICCU starting at 01/2014 to 06/2020 were included in this study. Data were evaluated partially retrospectively (n=214), 1st group) and prospectively, applying new risk-assessment tool in 103 patients 2nd group). Study groups did not differ in terms of all clinical characteristics. RESULTS Results: To evaluate criteria of severity of in-hospital complication we have created in-hospital complication index (HCI), composed according to number of adverse events per patient. Based on correlation analyses we have composed complex WBC-platelets (WBC-PLT) index = ((GRA - MON) / LYM) · 10 + PDWc + P-LCR). In the 1st study group WBC-PLT index was associated with in-hospital complications' index and correlated with neutrophil-leukocytes ratio (NLR) (p<0,001 and p<0,0005 respectively). WBC-PLT index > 137 appeared to be mildly associated with increased risk of adverse in-hospital outcomes (with specificity of 78 % and low sensitivity of 64 %, AUC- 0,72). Further prospective study of WBC-PLT index measured on the first STEMI-day (group 2) revealed that this parameter was more informative regarding association with adverse in-hospital events whereas NLR had low accuracy in risk assessment. CONCLUSION Conclusions: WBC-PLT index assessed on the first STEMI day may be used as a tool for detection of patients at risk of adverse in-hospital events in the every-day clinical practice.
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Affiliation(s)
- Olexandr V Shumakov
- NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | - Оlena V Dovhan
- NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | - Tetiana V Talaeva
- NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | - Iryna V Тretiak
- NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | - Оlexandr М Parkhomenko
- NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
| | - Olga S Gurjeva
- NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE
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46
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Psarakis G, Farmakis I, Zafeiropoulos S, Kourti O, Konstantas O, Vrana E, Baroutidou A, Tsolakidis C, Touriki AV, Psathas T, Graidis S, Spyridaki K, Daniilidou A, Tsakiridis K, Tsalikakis D, Skoura L, Karvounis H, Giannakoulas G. Predictive Role of Platelet-Associated Indices on Admission and Discharge in the Long-Term Prognosis of Acute Coronary Syndrome Patients. Angiology 2021; 73:453-460. [PMID: 34779272 DOI: 10.1177/00033197211052134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our study aimed to investigate the association between platelet indices and their in-hospital change and long-term prognosis in acute coronary syndrome (ACS). Data from a randomized controlled trial (NCT02927808) recruiting ACS patients were analyzed (survival analysis). The examined variables were platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) on admission and discharge, as well as their alteration during hospitalization. The primary endpoint was major adverse cardiac events (MACE) (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke or hospitalization for unstable angina) and all-cause mortality, while secondary endpoints were all-cause hospitalization and bleeding events. The study included 252 patients with a follow-up of 39 (28-45) months. In the univariate analysis, MACE was associated with discharge PC [hazard ratio (HR) 2.20, 95% confidence interval (CI) 1.10-4.40], discharge MPV (HR 0.48, 95% CI 0.25-0.94), and in-hospital PC difference (HR 0.25, 95% CI 0.13-0.51). In the multivariable analysis, only in-hospital PC decrease correlated with lower MACE incidence (adjusted HR .27, 95% CI 0.14-0.54) and lower all-cause hospitalization risk (adjusted HR 0.36, 95% CI 0.19-0.68). PC reduction during hospitalization for ACS is an independent predictor of better prognosis.
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Affiliation(s)
- Georgios Psarakis
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Ioannis Farmakis
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | - Olga Kourti
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Orestis Konstantas
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Eleni Vrana
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Amalia Baroutidou
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | | | - Thomas Psathas
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | - Spyridon Graidis
- Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece
| | | | | | | | - Dimitrios Tsalikakis
- Department of Informatics and Telecommunication Engineering, University of Western Macedonia, Kozani, Greece
| | - Lemonia Skoura
- Department of Microbiology, Medical School, 37782Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Izzi B, Gialluisi A, Gianfagna F, Orlandi S, De Curtis A, Magnacca S, Costanzo S, Di Castelnuovo A, Donati MB, de Gaetano G, Hoylaerts MF, Cerletti C, Iacoviello L. Platelet Distribution Width Is Associated with P-Selectin Dependent Platelet Function: Results from the Moli-Family Cohort Study. Cells 2021; 10:cells10102737. [PMID: 34685717 PMCID: PMC8535046 DOI: 10.3390/cells10102737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/09/2021] [Indexed: 12/12/2022] Open
Abstract
Defined as an index of platelet size heterogeneity, the platelet distribution width (PDW) is still a poorly characterized marker of platelet function in (sub)clinical disease. We presently validated PDW as a marker of P-selectin dependent platelet activation in the Moli-family cohort. Platelet-bound P-selectin and platelet/leukocyte mixed aggregates were measured by flow cytometry in freshly collected venous blood, both before and after in vitro platelet activation, and coagulation time was assessed in unstimulated and LPS- or TNFα-stimulated whole blood. Closure Times (CT) were measured in a Platelet Function Analyzer (PFA)-100. Multivariable linear mixed effect regression models (with age, sex and platelet count as fixed and family structure as random effect) revealed PDW to be negatively associated with platelet P-selectin, platelet/leukocyte aggregates and von Willebrand factor (VWF), and positively with PFA-100 CT, and LPS- and TNF-α-stimulated coagulation times. With the exception of VWF, all relationships were sex-independent. In contrast, no association was found between mean platelet volume (MPV) and these variables. PDW seems a simple, useful marker of ex vivo and in vitro P-selectin dependent platelet activation. Investigations of larger cohorts will define the usefulness of PDW as a risk predictor of thrombo-inflammatory conditions where activated platelets play a contributing role.
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Affiliation(s)
- Benedetta Izzi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
- Correspondence:
| | - Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | - Francesco Gianfagna
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy;
- Mediterranea Cardiocentro, 80133 Napoli, Italy; (S.M.); (A.D.C.)
| | - Sabatino Orlandi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | - Sara Magnacca
- Mediterranea Cardiocentro, 80133 Napoli, Italy; (S.M.); (A.D.C.)
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | | | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | - Marc F. Hoylaerts
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, University of Leuven, 3000 Leuven, Belgium;
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, 86077 Pozzilli, Italy; (A.G.); (S.O.); (A.D.C.); (S.C.); (M.B.D.); (G.d.G.); (C.C.); (L.I.)
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy;
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48
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Ebina T, Tochihara S, Okazaki M, Koike K, Tsuto Y, Tayama M, Takanami Y, Hirose H, Horii M, Okada K, Matsuzawa Y, Maejima N, Iwahashi N, Hibi K, Kosuge M, Tamura K, Kimura K. Impact of red blood cell distribution width and mean platelet volume in patients with ST-segment elevation myocardial infarction. Heart Vessels 2021; 37:392-399. [PMID: 34518907 DOI: 10.1007/s00380-021-01936-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 09/03/2021] [Indexed: 12/12/2022]
Abstract
The complete blood cell count is one of the most frequently ordered laboratory tests, and many parameters, including red blood cell distribution width (RDW) and mean platelet volume (MPV), are available. The purpose of this study was to investigate the usefulness of the combination of RDW and MPV in patients with ST-segment elevation myocardial infarction (STEMI). Patients with STEMI who underwent primary percutaneous coronary intervention were retrospectively enrolled (n = 229). The association between RDW as well as MPV and cardiovascular events was investigated. The median age was 67 years, and males made up 85% of the sample. Median RDW was 13.6%, and median MPV was 8.2 fL. During a median follow-up period of 528 days (IQR 331.5-920.5), 41 patients died or experienced major adverse cardiac and cerebrovascular events (MACCEs). Patients with RDW ≧ 13.7% had more deaths or MACCEs with marginal significance (p = 0.0799). Patients with MPV ≧ 8.3 fL had significantly more deaths or MACCEs (p = 0.0283). Patients with RDW ≧ 13.7% and MPV ≧ 8.3 fL had significantly more deaths or MACCEs (p = 0.0185). MPV was significantly associated with death or adverse events in patients with STEMI who were treated with primary PCI. RDW had only a weak association with death or adverse events. The results of the combination of MPV and RDW were similar to those of MPV.
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Affiliation(s)
- Toshiaki Ebina
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
| | - Shiori Tochihara
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Mai Okazaki
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Kazuyo Koike
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Yuko Tsuto
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Megumi Tayama
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Yukiko Takanami
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Haruka Hirose
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Mutsuo Horii
- Department of Laboratory Medicine and Clinical Investigation, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.,Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kozo Okada
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Matsuzawa
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Nobuhiko Maejima
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Noriaki Iwahashi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masami Kosuge
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuo Kimura
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
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Kim HJ, Lee JH, Jang SY, Bae MH, Yang DH, Park HS, Cho Y, Jeong MH, Park JS, Kim HS, Hur SH, Seong IW, Cho MC, Chae SC. Prognostic value of novel neutrophil-to-hemoglobin and lymphocyte score in patients with acute myocardial infarction. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211039095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We developed and assessed whether a novel neutrophil-to-hemoglobin and lymphocyte (NHL) score would improve the ability to predict clinical outcome compared with neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in acute myocardial infarction (AMI). We examined 13,072 AMI patients from the Korean AMI Registry–National Institute of Health database. NHL score was calculated as follows: NHL score (U) = N/(Hb × L), where N, Hb, and L are baseline blood neutrophil, hemoglobin, and lymphocyte count. The primary outcome was the occurrence of major adverse cerebrocardiovascular events (MACCEs) at 2 years. The NLR, SII, and NHL score were independent predictors of 2-year MACCEs. The area under the curve of the NHL score (0.637) for predicting 2-year MACCEs was significantly higher compared with those of SII (0.589) and NLR (0.607). The NHL score significantly improved the reclassification and integrated discrimination compared with NLR ( p < 0.0001) and SII ( p < 0.0001). A high NHL score (≥ 0.35 U) was an independent predictor of 2-year MACCEs (adjusted hazard ratio, 1.41; 95% confidence interval, 1.29–1.55; p < 0.001). The NHL score could be a novel model for predicting long-term MACCEs in patients with AMI.
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Affiliation(s)
- Hyeon Jeong Kim
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Se Yong Jang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung Hwan Bae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Dong Heon Yang
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hun Sik Park
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Yongkeun Cho
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Myung H Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jong-Seon Park
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Hyo-Soo Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung-Ho Hur
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - In-Whan Seong
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Myeong-Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Shung Chull Chae
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
- School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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50
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Han JB, Shu QH, Zhang YF, Yi YX. Predictive Value of Inflammation Biomarkers in Patients with Portal Vein Thrombosis. J Clin Transl Hepatol 2021; 9:384-391. [PMID: 34221924 PMCID: PMC8237143 DOI: 10.14218/jcth.2020.00159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/09/2021] [Accepted: 02/26/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS To investigate the usefulness of inflammation biomarkers to serve as a predictors of portal vein thrombosis (PVT) postoperatively (post) in patients with portal hypertension after splenectomy and periesophagogastric devascularization. METHODS A total of 177 liver cirrhosis patients were recruited from January 2013 to December 2017. They were divided into a PVT group (n=71) and a non-PVT group (n=106), according to ultrasound examination findings at 7-day post. Inflammation biomarkers involving platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), red blood cell distribution width-to-platelet ratio(RPR), mean platelet volume-to-platelet ratio (MPR) preoperatively (pre) and at 1, 3, 7-days post were recorded. RESULTS The univariate logistic regression analysis indicated that PLR (pre) (odds ratio (OR)=3.963, 95% confidence interval (CI)=2.070-7.587, p<0.000), MLR (pre) (OR=2.760, 95% CI=1.386-5.497, p=0.004), PLR (post-day 7) (OR=3.345, 95% CI=1.767-6.332, p=0.000) were significantly associated with the presence of PVT. The multivariate logistic regression analysis results indicated that PLR (pre) (OR=3.037, 95% CI=1.463-6.305, p=0.003), MLR (pre) (OR=2.188, 95% CI=1.003-4.772, p=0.049), PLR(post-day 7) (OR=2.166, 95% CI=1.053-4.454, p=0.036) were independent factors for predicting PVT. CONCLUSIONS The PLR (pre), MLR (pre), and PLR (post-day 7) are predictors of portal vein thrombosis post in patients with portal hypertension after splenectomy and periesophagogastric devascularization.
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Affiliation(s)
| | | | - Yu-Feng Zhang
- Correspondence to: Yu-Feng Zhang and Yong-Xiang Yi, Department of Hepatopancreatobiliary Surgery, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, No. 1 Zhongfu Road, Nanjing, Jiangsu 210003, China. Tel/Fax: +86-25-83626570, E-mail: (YFZ) and (YXY)
| | - Yong-Xiang Yi
- Correspondence to: Yu-Feng Zhang and Yong-Xiang Yi, Department of Hepatopancreatobiliary Surgery, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, No. 1 Zhongfu Road, Nanjing, Jiangsu 210003, China. Tel/Fax: +86-25-83626570, E-mail: (YFZ) and (YXY)
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