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Xu X, Zhu X, Wang H, Liu X, Yang C, Liu L, Chen T, Cai L, Zhu H. Evaluation of the Prognostic Role of Neutrophil-Lymphocyte Ratio, C-Reactive Protein-Albumin Ratio, and Platelet-Lymphocyte Ratio in Patients with the Co-Presentation of Coronary Artery Disease and COVID-19. Infect Drug Resist 2024; 17:885-897. [PMID: 38468845 PMCID: PMC10926874 DOI: 10.2147/idr.s450318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024] Open
Abstract
Aim The purpose of this study was to investigate the role of neutrophil-lymphocyte ratio (NLR), C-reactive protein-albumin ratio (CAR), and platelet-lymphocyte ratio (PLR) in the prognosis of patients with coronary artery disease (CAD) complicated with coronavirus disease 2019 (COVID-19). Methods This study included 265 patients. A receiver operating characteristic (ROC) curve analysis was performed to preliminarily evaluate the predictive ability of NLR, CAR, and PLR for all-cause death. The primary outcome was all-cause death during hospitalization, while the secondary outcomes were cardiovascular death and respiratory failure death. The Cox proportional hazard model with adjusted covariates was used to analyze the cumulative risk of outcomes. We also conducted subgroup analyses based on the acute and chronic characteristics of CAD. Propensity score matching (PSM) was used to further evaluate the robustness of the primary outcome. Results The ROC curve analysis results showed that the area under curve (AUC) values were 0.686 (95% CI 0.592-0.781, P<0.001) for NLR, 0.749 (95% CI 0.667-0.832, P<0.001) for CAR, and 0.571 (95% CI 0.455-0.687, P=0.232) for PLR. The Cox proportional hazard model showed that trends in NLR and PLR did not affect the risk of all-cause death (P=0.096 and P=0.544 for trend, respectively), but a higher CAR level corresponded to a higher risk of all-cause death (P<0.001 for trend). Similarly, The trends of NLR and PLR did not affect the risk of cardiovascular death and respiratory failure death, while a higher CAR level corresponded to a higher risk of cardiovascular death and respiratory failure death. The results of subgroup analyses and PSM were consistent with the total cohort. Conclusion In patients with CAD complicated with COVID-19, a higher CAR level corresponded to a higher risk of all-cause death, cardiovascular death, and respiratory failure death, while trends in NLR and PLR did not.
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Affiliation(s)
- Xiaoqun Xu
- Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Xinyu Zhu
- Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Hanxin Wang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Xiao Liu
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Chao Yang
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Libin Liu
- Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Tielong Chen
- Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
| | - Long Cai
- Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Houyong Zhu
- Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China
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Menekşe TS, Kaçer İ, Hacımustafaoğlu M, Gül M, Ateş C. C-reactive protein to albumin ratio may predict in-hospital mortality in non-ST elevation myocardial infarction. Biomark Med 2024; 18:103-113. [PMID: 38440872 DOI: 10.2217/bmm-2023-0682] [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] [Indexed: 03/06/2024] Open
Abstract
Objective: The authors investigated the value of novel inflammatory markers, systemic immune-inflammation index and C-reactive protein to albumin ratio (CAR), to predict in-hospital mortality in patients with non-ST elevation myocardial infarction (NSTEMI). Materials & methods: A total of 308 patients who underwent percutaneous coronary intervention because of NSTEMI were retrospectively included in the study. Killip classification, Thrombolysis in Myocardial Infarction score, SYNTAX score, and CAR and systemic immune-inflammation index values were calculated. Results: CAR (cutoff: 0.0864; sensitivity: 94.1%; specificity: 40.5%; p = 0.008) and Killip classification (cutoff: 2.5; sensitivity: 64.7%; specificity: 8.9%; p = 0.001) were found to be significantly higher in determining in-hospital mortality. Conclusion: This study revealed that CAR is an inexpensive and significant factor in predicting in-hospital mortality in patients undergoing percutaneous coronary intervention for NSTEMI.
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Affiliation(s)
- Tuğba S Menekşe
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey
| | - İlker Kaçer
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey
| | - Muhammet Hacımustafaoğlu
- Department of Emergency Medicine, Aksaray University Training and Research Hospital, Aksaray, Turkey
| | - Murat Gül
- Department of Cardiology, School of Medicine, Aksaray University, Aksaray, Turkey
| | - Can Ateş
- Department of Biostatistics, Faculty of Medicine, Aksaray University, Aksaray, Turkey
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Vakhshoori M, Nemati S, Sabouhi S, Shakarami M, Yavari B, Emami SA, Bondariyan N, Shafie D. Prognostic impact of monocyte-to-lymphocyte ratio in coronary heart disease: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231204469. [PMID: 37848392 PMCID: PMC10586014 DOI: 10.1177/03000605231204469] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Inflammatory biomarkers are novel tools to assess the prognosis of different cardiovascular diseases. We evaluated the impact of the monocyte-to-lymphocyte ratio (MLR) on clinical outcomes in patients with coronary heart disease (CHD). METHODS We systematically screened English-language articles in PubMed, Scopus, and Web of Science to 31 August 2022. Relevant articles reporting the MLR and its association with clinical outcomes (major adverse cardiovascular events (MACE), coronary artery disease (CAD) severity, mortality, cardiac rupture, subclinical CAD, acute coronary syndrome (ACS) prediction, thin-cap fibroatheroma, no-reflow phenomenon, MLR-related differences in percutaneous coronary intervention, heart failure hospitalization, and depression) in patients with CHD were collected for further analysis. RESULTS Nineteen articles were selected. The mean MLR was 0.34. A higher MLR was significantly associated with an increased risk of MACE among patients with CHD. The MLR was an independent predictor of MACE in patients with ACS. No significant association was found for CAD severity. A complementary analysis was not performed because of few studies focusing on the other predefined endpoints. CONCLUSIONS The MLR is a simple and widely available tool to predict MACE in patients with CHD. This biomarker can be utilized in emergency settings to prioritize high-risk patients and optimize therapeutic interventions.
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Affiliation(s)
- Mehrbod Vakhshoori
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepehr Nemati
- School of Medicine, Tehran Azad University of Medical Sciences, Tehran, Iran
| | - Sadeq Sabouhi
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnaz Shakarami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Yavari
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Ali Emami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloofar Bondariyan
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Mao T, Zhang B, Yang T, Qian Y, Zhou C, He C. Evaluation of five lymphocyte-based scores for prediction of mortality in hepatitis B virus-associated decompensated cirrhosis. Heliyon 2023; 9:e18556. [PMID: 37520964 PMCID: PMC10374927 DOI: 10.1016/j.heliyon.2023.e18556] [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: 05/24/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023] Open
Abstract
Background Lymphocytes are generally accepted to be a key component of the immune response, and an inadequate immune response is closely associated with disease severity and adverse outcomes in hepatitis B virus (HBV)-infected patients. The present study aimed to determine and compare the prognostic values of five lymphocyte-based scores (monocyte-to-lymphocyte ratio [MLR], mean platelet volume-to-lymphocyte ratio [MPVLR], neutrophil-to-lymphocyte ratio [NLR], red cell distribution width-to-lymphocyte ratio [RLR], and C-reactive protein-to-lymphocyte ratio [CLR]) for HBV-associated decompensated cirrhosis (HBV-DC). Methods Data were extracted from an institutional database. The outcome was 30-day mortality. Receiver operating characteristic curve analyses were conducted, and the resulting area under the curve (AUC) values were used to evaluate the predictive capabilities of the five lymphocyte-based scores for mortality in HBC-DC relative to Model for End-Stage Liver Disease (MELD) score. Results The study included 273 patients, and the 30-day mortality was 20.9%. Lymphocyte counts were slightly lower in non-survivors than in survivors. The prognostic values of CLR, NLR, MLR, MPVLR, and RLR for mortality in HBV-DC were different. The predictive powers of NLR and MLR were superior to those of the other three scores and similar to that of MELD score. Multivariate analyses identified NLR, MLR, and MELD score as independent prognostic predictors. Conclusion High NLR and MLR are easily accessible and reliable indicators for predicting 30-day mortality in HBV-DC and have superior prognostic ability compared with other lymphocyte-based scores.
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Affiliation(s)
- Ting Mao
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Bin Zhang
- Department of Clinical Laboratory, Kunshan Hospital of Chinese Medicine, Affiliated Hospital of Yangzhou University, Kunshan, Jiangsu, China
| | - Ti Yang
- Department of Clinical Laboratory, Kunshan Hospital of Chinese Medicine, Affiliated Hospital of Yangzhou University, Kunshan, Jiangsu, China
| | - Yinyan Qian
- Department of Clinical Laboratory, Kunshan Hospital of Chinese Medicine, Affiliated Hospital of Yangzhou University, Kunshan, Jiangsu, China
| | - Chenchen Zhou
- Department of Clinical Laboratory, Kunshan Hospital of Chinese Medicine, Affiliated Hospital of Yangzhou University, Kunshan, Jiangsu, China
| | - Chunyan He
- Department of Clinical Laboratory, Kunshan Hospital of Chinese Medicine, Affiliated Hospital of Yangzhou University, Kunshan, Jiangsu, China
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Li J, Zhu P, Li Y, Yan K, Tang X, Xu J, Yang W, Qiao S, Yang Y, Gao R, Xu B, Yuan J, Zhao X. A novel inflammatory biomarker, high-sensitivity C-reactive protein-to-albumin ratio, is associated with 5-year outcomes in patients with type 2 diabetes who undergo percutaneous coronary intervention. Diabetol Metab Syndr 2023; 15:14. [PMID: 36747210 PMCID: PMC9901126 DOI: 10.1186/s13098-022-00977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/28/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Patients with coronary artery disease (CAD) combined with diabetes have a higher risk of cardiovascular events, and high-sensitivity C-reactive protein (hs-CRP)-to-albumin ratio (CAR) is a novel inflammatory biomarker. However, whether the CAR can identify high-risk patients with CAD and type 2 diabetes (T2DM) remains unclear. METHODS The present study was based on a prospective and observational cohort with 10,724 individuals who undergo percutaneous coronary intervention (PCI) in Fu Wai Hospital throughout the year 2013 consecutively enrolled. The primary endpoint was all-cause mortality. The secondary endpoint was cardiac mortality. CAR was calculated with the formula: hs-CRP (mg/L)/albumin (g/L). According to the optimal cut-off value of CAR for all-cause mortality, patients were divided into higher CAR (CAR-H) and lower CAR (CAR-L) groups. RESULTS A total of 2755 patients with T2DM who underwent PCI and received dual antiplatelet therapy were finally enrolled. During a follow-up of 5 years (interquartile range: 5.0-5.1 years), 126 (4.6%) all-cause mortalities and 74 (2.7%) cardiac mortalities were recorded. In the multivariable Cox model, CAR-H was associated with a higher risk of all-cause mortality (hazard ratio [HR]: 1.634, 95% confidence interval [CI] 1.121-2.380, p = 0.011) and cardiac mortality (HR: 1.733, 95% CI 1.059-2.835, p = 0.029) compared with CAR-L. When comparing the predictive value, CAR was superior to hs-CRP for all-cause mortality (area under the curve [AUC] 0.588 vs. 0.580, p = 0.002) and cardiac mortality (AUC 0.602 vs. 0.593, p = 0.004). CONCLUSION In this real-world cohort study, a higher level of CAR was associated with worse 5-year outcomes among diabetic patients with PCI.
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Affiliation(s)
- Jiawen Li
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Pei Zhu
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Yulong Li
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Kailun Yan
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Xiaofang Tang
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Jingjing Xu
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Weixian Yang
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Shubin Qiao
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Yuejin Yang
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Runlin Gao
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Bo Xu
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Jinqing Yuan
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
| | - Xueyan Zhao
- National Clinical Research Center for Cardiovascular Diseases and State Key Laboratory of Cardiovascular Diseases, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing, 100037, China.
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Ma X, Gui C. Letter: C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast-Induced Nephropathy in Patients With Stable Angina Pectoris. Angiology 2023; 74:197-198. [PMID: 35959768 DOI: 10.1177/00033197221121017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Xiao Ma
- Department of Cardiology, 117742The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Chun Gui
- Department of Cardiology, 117742The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Altıparmak IH, Tanrıverdi Z, Taşcanov MB, Güngören F, Biçer A, Fedai H, Toprak K, Elmas AN, Demirbağ R. C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast Induced Nephropathy in Patients With Stable Angina Pectoris. Angiology 2023; 74:189-196. [PMID: 35589620 DOI: 10.1177/00033197221103635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The relationship between C-reactive protein (CRP) to albumin ratio (CAR) and contrast-induced nephropathy (CIN) in patients with acute coronary syndrome has been reported. However, the relevance of CAR in patients with stable angina pectoris (SAP) has not been clarified. We hypothesized that CAR might predict the development of CIN in patients with SAP undergoing coronary angiography (CAG). Patients (n = 554) with SAP who underwent CAG were included in the study. CIN was defined as a ≥25% increase in serum creatinine compared with baseline value within 72 h of CAG. Participants were divided into two groups: CIN (n = 87) and non-CIN (n = 467). Age, CRP, CAR, mean corpuscular volume (MCV), urea, uric acid, contrast medium volume, the percent of percutaneous coronary intervention were significantly greater, whereas albumin and high-density lipoprotein were significantly lower in the CIN group than non-CIN group (p < .05, for all). Multivariate analysis showed that CAR was the only independent predictor for CIN (odds ratio = 7.065, 95% confidence interval (CI); 3.279-15.221, p < .001). Receiver operating characteristic ROC analysis showed that a CAR ≥ 0.1164 could predict CIN (sensitivity of 71% and specificity of 72%; area under curve = 0.736; 95% CI: 0.677-0.795, p < .001). CAR was significantly greater in patients who developed CIN and this independently predicted CIN.
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Affiliation(s)
| | - Zülkif Tanrıverdi
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Mustafa Begenç Taşcanov
- Department of Cardiology, 218511Şanlıurfa Education and Research Hospital, Şanlıurfa, Turkey
| | - Fatih Güngören
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Asuman Biçer
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Halil Fedai
- Department of Cardiology, 218511Şanlıurfa Education and Research Hospital, Şanlıurfa, Turkey
| | - Kenan Toprak
- Cardiology Clinic, Siverek State Hospital, Şanlıurfa, Turkey
| | - Ali Nizami Elmas
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
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Sahin Ozdemirel T, Akkurt ES, Ertan O, Gökler ME, Ozyurek BA. Comparison of clinical characteristics in adult patients under 65 years of age with and without Covid-19 pneumonia. Lung India 2022; 39:422-427. [PMID: 36629202 PMCID: PMC9623856 DOI: 10.4103/lungindia.lungindia_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/05/2022] [Accepted: 06/23/2022] [Indexed: 01/14/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) can cause asymptomatic, mild upper respiratory tract symptoms and pneumonia in young persons. How the disease will progress in each patient is still unknown. Therefore, we aimed to investigate the prognostic markers of the development of pneumonia and the clinical characteristics of patients under 65 years with COVID-19 confirmed by a positive reverse transcriptase polymerase chain reaction test. Methods In this retrospective study, a total of 271 patients admitted in our unit were included. The patients were divided into two groups, those who did and those who did not develop pneumonia. Their clinical features, treatment protocols, and laboratory parameters were recorded retrospectively. Results Pneumonia developed in 67.9% (n = 184) of the cases. The age in the pneumonia group was higher than that in the non-pneumonia group (p < 0.001). In the logistic regression analysis, the symptom and co-morbidity status were examined according to the presence of pneumonia; hypertension (HT) (OR: 4525, 95% CL: 1,494-13,708) was the most important risk factor for pneumonia. When age and laboratory values were examined according to the presence of pneumonia, advanced age (OR: 1.042, 95% CL: 1.01-1.073), low albumin (OR: 0.917, 95% CL: 0.854-0.986), and high troponin (OR: 1.291, 95% CL: 1.044-1.596) were identified as risk factors for pneumonia. Conclusion In this article, HT (22.3%, P < 0.001) has been considered as an important risk factor, whereas association of diabetes mellitus (21.2%, P 0.029) and smoking (25.0%, P 0.038) was also significant. The median age of the group was 51 (41.5-58) in the group developing pneumonia and 41 (30-48) in the non-developing group. Young patients with these predictive factors should be more carefully evaluated by further diagnostic procedures, such as thoracic computed tomography.
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Affiliation(s)
- Tugce Sahin Ozdemirel
- Department of Chest Disease, University of Health Sciences Ankara Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
| | - Esma Sevil Akkurt
- Department of Chest Disease, University of Health Sciences Ankara Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
| | - Ozlem Ertan
- Department of Chest Disease, University of Health Sciences Ankara Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
| | - Mehmet Enes Gökler
- Department of Public Health, Yıldırım Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Berna Akinci Ozyurek
- Department of Chest Disease, University of Health Sciences Ankara Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey
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C-Reactive Protein-to-Albumin Ratio as an Early Biomarker to Identify Sepsis in Neonates with Pneumonia. Mediators Inflamm 2022; 2022:4711018. [PMID: 35873709 PMCID: PMC9303482 DOI: 10.1155/2022/4711018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/08/2022] [Accepted: 06/21/2022] [Indexed: 01/08/2023] Open
Abstract
Objectives Neonates with pneumonia often also have sepsis, and the identifying sepsis from pneumonia may be a challenge for clinicians. However, there are no available data regarding the clinical value C-reactive protein-to-albumin ratio (CAR) in identifying sepsis in neonates with pneumonia. The aim of this study was to evaluate the clinical value of CAR in identifying sepsis in neonates with pneumonia. Methods 847 neonates with pneumonia were included in this study, of which 511 neonates were diagnosed with sepsis. Neonates were divided into the sepsis group and the nonsepsis group. All neonates underwent extensive and necessary clinical and laboratory tests. CAR was calculated as serum C-reactive protein (ng/ml)/albumin (mg/ml). All statistical analyses were performed using the statistical package SPSS 24.0, as appropriate. Results Compared with the nonsepsis group, neonates with sepsis have a higher CAR (P < 0.001). Further analysis showed that the prevalence of neonates with sepsis increased significantly from 41.0% in the low CAR group (CAR ≤ 0.024 × 10−3) to 80.0% in the high CAR group (CAR > 0.024 × 10−3) (P < 0.001). Correlation analysis showed that there was a strong positive correlation between CAR and PCT (r = 0.452, P < 0.001), nSOFA (r = 0.267, P < 0.001), and the prolonged length of hospital stay (r = 0.311, P < 0.001). Multiple logistic regression showed that CAR was an independent risk factor for the presence of sepsis in neonates with pneumonia. Receiver operating characteristic curve analysis revealed that CAR had adequate discriminatory power in predicting sepsis in neonates with pneumonia (area under curve (AUC) = 0.76, 95% CI 0.73-0.79, P < 0.001). Conclusions CAR can be used as a new marker to identify sepsis in neonates with pneumonia.
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Sharma D, Spring KJ, Bhaskar SMM. Role of Neutrophil-Lymphocyte Ratio in the Prognosis of Acute Ischaemic Stroke After Reperfusion Therapy: A Systematic Review and Meta-analysis. J Cent Nerv Syst Dis 2022; 14:11795735221092518. [PMID: 35492740 PMCID: PMC9052237 DOI: 10.1177/11795735221092518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/21/2022] [Indexed: 12/22/2022] Open
Abstract
Background Inflammation may mediate response to acute reperfusion therapy (RT) in acute
cerebral ischaemia. Neutrophil-lymphocyte ratio (NLR), an inflammatory
biomarker, may play an important role in acute ischaemic stroke (AIS)
prognostication. Objective This meta-analysis sought to examine the effect of NLR on functional
outcomes, mortality and adverse outcomes in AIS patients receiving RT. Methods Individual studies were retrieved from PubMed/Medline, EMBASE and Cochrane
databases. Data were extracted using a standardised data sheet and
meta-analysis on association of admission (pre-RT) or delayed (post-RT) NLR
with clinical/safety outcomes after RT was conducted. Results Thirty-five studies (n = 10 308) were identified for the systematic review
with 27 (n = 8537) included in the meta-analyses. Lower admission NLR was
associated with good functional outcomes (GFOs), defined as 3-month modified
Rankin scale (mRS) 0–2 (SMD = −.46; 95% CI = −.62 to −.29; P < .0001),
mRS 0–1 (SMD = −.44; 95% CI = −.66 to −.22; P < .0001) and early
neurological improvement (ENI) (SMD = −.55; 95 %CI = −.84 to −.25; P <
.0001). Lower delayed admission NLR was also associated with GFOs (SMD =
−.80; 95%CI = −.91 to −.68; P < .0001). Higher admission NLR was
significantly associated with mortality (SMD = .49; 95%CI = .12 to .85; P =
.009), intracerebral haemorrhage (ICH) (SMD = .34; 95% CI = .09 to .59; P =
.007), symptomatic ICH (sICH) (SMD = .48; 95% CI = .07 to .90; P = .022) and
stroke-associated infection or pneumonia (SMD = .85; 95% CI = .50, 1.19; P
< .0001). Higher delayed NLR was significantly associated with sICH (SMD
= 1.40; 95% CI = .60 to 2.19; P = .001), ICH (SMD = .94; 95% CI = .41 to
1.46; P < .0001) and mortality (SMD = 1.12; 95% CI = .57 to 1.67; P <
.0001). There were variations in outcomes across RT groups. Conclusion Higher admission or delayed NLR is significantly associated with worse
morbidity, mortality and safety outcomes in AIS patients receiving RT.
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Affiliation(s)
- Divyansh Sharma
- Global Health Neurology and Translational Neuroscience Laboratory, Sydney and Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- South-Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Kevin J. Spring
- South-Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia
- NSW Brain Clot Bank, NSW Health Pathology, Sydney, NSW, Australia
- Medical Oncology Group, Liverpool Clinical School, Western Sydney University and Ingham Institute of Applied Medical Research, Sydney, NSW, Australia
| | - Sonu M. M. Bhaskar
- Global Health Neurology and Translational Neuroscience Laboratory, Sydney and Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- South-Western Sydney Clinical School, University of New South Wales (UNSW), Sydney, NSW, Australia
- NSW Brain Clot Bank, NSW Health Pathology, Sydney, NSW, Australia
- Department of Neurology & Neurophysiology, Liverpool Hospital and South-Western Sydney Local Health District, Comprehensive Stroke Center, Sydney, NSW, Australia
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11
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Urbanowicz T, Michalak M, Olasińska-Wiśniewska A, Witkowska A, Rodzki M, Błażejowska E, Gąsecka A, Perek B, Jemielity M. Monocyte-to-Lymphocyte Ratio as a Predictor of Worse Long-Term Survival after Off-Pump Surgical Revascularization-Initial Report. Medicina (B Aires) 2021; 57:medicina57121324. [PMID: 34946269 PMCID: PMC8706717 DOI: 10.3390/medicina57121324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background and objective: Coronary artery disease is one of the leading causes of deaths nowadays and the trends in diagnosis and revascularization are still in plateau despite well-known factors. Simple whole blood count parameters may be used to measure inflammatory reactions that are involved in processes of atherosclerosis progression. The aim of our study was to analyse the association between simply available hematologic indices and long-term mortality following off-pump coronary artery bypass grafting (OPCAB). Material and Methods: The study group comprised 129 consecutive patients (16 females and 113 males, mean age 66 ± 6 years) who underwent surgical revascularization with off-pump technique between January 2014 and September 2019. The mean follow-up was 4.7 +/−1.9 years. A receiver operating characteristics curve was applied to estimate demographical and perioperative parameters including MLR for mortality. Results: Cox regression analysis revealed chronic pulmonary obstructive disease (HR = 2.86, 95%CI 1.05–7.78), MLR (HR = 3.81, 95%CI 1.45–10.06) and right coronary artery blood flow (HR = 1.06, 95%CI 1.00–1.10) as significant factors predicting increased mortality risk. In the presented model, the MLR > 1.44 on 1st postoperative day was a significant predictor of late mortality after the OPCAB procedure (HR = 3.82, 95%CI 1.45–10.06). Conclusions: Pronounced inflammatory reaction after off-pump surgery measured by MLR > 1.44 can be regarded as a worse long-term prognostic factor.
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Affiliation(s)
- Tomasz Urbanowicz
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
- Correspondence: ; Tel.: +48-61-854-9210
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Anna Olasińska-Wiśniewska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Anna Witkowska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Michał Rodzki
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Ewelina Błażejowska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.B.); (A.G.)
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.B.); (A.G.)
| | - Bartłomiej Perek
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Marek Jemielity
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
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12
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Li T, Li X, Wei Y, Dong G, Yang J, Yang J, Fang P, Qi M. Predictive Value of C-Reactive Protein-to-Albumin Ratio for Neonatal Sepsis. J Inflamm Res 2021; 14:3207-3215. [PMID: 34285544 PMCID: PMC8286121 DOI: 10.2147/jir.s321074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/03/2021] [Indexed: 01/08/2023] Open
Abstract
Purpose Previous studies have reported that C-reactive protein-to-albumin ratio (CAR) was a risk factor for sepsis in adults. However, little is known regarding the role of CAR in neonates with sepsis. The aim of this study was to explore the relationship between CAR and neonatal sepsis. Patients and Methods In this research, from January 2016 to February 2020, a total of 1076 neonates were enrolled at Henan Children’s Hospital in China. Complete clinical and laboratory data were collected. To identify the potential independent risk factor for neonatal sepsis, multivariate logistic regression analysis was performed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction accuracy of CAR in identifying neonatal sepsis. Results CAR levels were higher in neonates with sepsis and showed a gradual increase among the control group, mild sepsis group and severe sepsis group. The prevalence of neonates with overall sepsis, mild sepsis and severe sepsis increased significantly from CAR tertile 1 to tertile 3. Multiple logistic regression analysis showed that CAR was an independent risk factor for the presence of sepsis (OR = 10.144, 95% CI 4.151–24.790, P < 0.001) and severe sepsis (OR = 1.876, 95% CI 1.562–2.253, P < 0.001). ROC curve analysis showed that CAR had a well discriminatory power in predicting sepsis (area under curve (AUC) = 0.74, 95% CI, 0.71–0.77, P < 0.001) and severe sepsis (AUC = 0.70, 95% CI, 0.67–0.74, P < 0.001). Conclusion CAR was an independent predictor for the presence and severity of neonatal sepsis.
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Affiliation(s)
- Tiewei Li
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Xiaojuan Li
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Yulei Wei
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Geng Dong
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Jianwei Yang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Junmei Yang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Panpan Fang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China
| | - Minglu Qi
- General Hospital of Taiyuan Steel (Group) Co., Ltd., Taiyuan, 030000, People's Republic of China
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13
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Engel LC, Landmesser U, Abdelwahed YS, Gigengack K, Wurster T, Manes C, Skurk C, Lauten A, Schuster A, Noutsias M, Hamm B, Botnar RM, Bigalke B, Makowski MR. In vivo assessment of endothelial permeability of coronary lesions with variable degree of stenosis using an albumin-binding MR probe. Int J Cardiovasc Imaging 2021; 37:3049-3055. [PMID: 34247318 PMCID: PMC8494683 DOI: 10.1007/s10554-021-02293-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/17/2021] [Indexed: 10/29/2022]
Abstract
MR imaging with an albumin-binding probe enables the visualization of endothelial permeability and damage in the arterial system. The goal of this study was to compare signal enhancement of lesions with different grades of stenosis segments on molecular CMR in combination with the albumin-binding probe gadofosveset. This prospective clinical study included patients with symptoms suggestive of coronary artery disease (CAD). Patients underwent gadofosveset-enhanced cardiovascular magnetic resonance (CMR) imaging and x-ray angiography (QCA) within 24 h. CMR imaging was performed prior to and 24 h following the administration of gadofosveset. Contrast-to-noise ratios (CNRs) between segments with different grades of stenosis were compared. Overall, n = 203 segments of 26 patients were included. Lesions with more than > 70% stenosis demonstrated significantly higher CNRs compared to lesions < 70% (7.6 ± 8.3 vs. 2.5 ± 4.9; p < 0.001). Post-stenotic segments of lesions > 70% stenosis showed significant higher signal enhancement compared to segments located upstream of these lesions (7.3 ± 8.8 vs. 2.8 ± 2.2; p = 0.02). No difference in signal enhancement between segments proximal and distal of lesions with stenosis greater than 50% was measured (3.3 ± 2.8 vs. 2.4 ± 2.7; p = 0.18). ROC analysis for the detection of lesions ≥ 70% revealed an area under the curve of 0.774 (95% CI 0.681-0.866). This study suggests that relevant coronary stenosis and their down-stream segments are associated with increased signal enhancement on Gadofosveset-enhanced CMR, suggesting a higher endothelial permeability in these lesions. An albumin-binding MR probe could represent a novel in vivo biomarker for the identification and characterization of these vulnerable coronary segments.
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Affiliation(s)
- Leif-Christopher Engel
- Department of Cardiology, German Heart Center, Munich, Germany. .,Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany.
| | - Ulf Landmesser
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Youssef S Abdelwahed
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Kevin Gigengack
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Wurster
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Costantia Manes
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Skurk
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander Lauten
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Schuster
- Department of Cardiology and Pulmonology, German Centre for Cardiovascular Research (DZHKPartner Site), Göttingen, Germany.,Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, 5th Floor, Acute Services Building, Reserve Road, St Leonard's, Sydney, NSW, Australia
| | - Michel Noutsias
- Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle-Wittenberg, Halle (Saale), Germany
| | - Bernd Hamm
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rene M Botnar
- Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.,Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Boris Bigalke
- Department of Cardiology, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Berlin, Germany
| | - Marcus R Makowski
- Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Radiology, Klinikum Rechts Der Isar, TU München, München, Germany
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14
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Bingol Tanriverdi T, Patmano G, Bozkurt FT, Kaya BC, Tercan M. Prognostic value of C-reactive protein to albumin ratio in patients resuscitated from out-of-hospital cardiac arrest. Int J Clin Pract 2021; 75:e14227. [PMID: 33864410 DOI: 10.1111/ijcp.14227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/12/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite major advances in basic and advanced life supports, patients who survived from out-of-hospital cardiac arrest (OHCA) have still poor prognosis. Several inflammatory parameters have been used to determine early and long-term prognosis in patients with OHCA. C-reactive protein-to-albumin ratio (CAR) is also a novel marker of systemic inflammation. To our knowledge, there is no study evaluating the clinical importance of CAR in OHCA patients. AIMS To evaluate the effect of CAR on in-hospital mortality in patients with OHCA. METHODS A total of 102 patients with OHCA were included in this study. The study population was divided into two groups as survivour (n = 43) and non-survivour (n = 59) during follow-up. Complete blood cell counts, biochemical and blood gas analyses were recorded for all patients. Neutrophil to lymphocyte ratio (NLR) was calculated as the ratio of neutrophil to lymphocyte. CAR was calculated as the ratio of C-reactive protein to the albumin. RESULTS NLR (P = .012), CAR (P < .001) and serum lactate level (P = .002) were significantly higher whereas lymphocyte (P = .008) and serum albumin (P < .001) were significantly lower in the non-survivour group compared with the survivour group. Multivariate logistic regression analysis showed that NLR (odds ratio [OR]: 1.044, 95% confidence interval [CI]: 1.044-1.437, P = .013), CAR (OR: 1.971, 95% CI: 1.327-2.930, P = .001) and lactate level (OR: 1.268, 95% CI: 1.095-1.469, P = .002) were independent predictors of in-hospital mortality. CONCLUSIONS We have demonstrated for the first time that CAR was an independent predictor of in-hospital mortality in OHCA patients.
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Affiliation(s)
- Tugba Bingol Tanriverdi
- Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Gulcin Patmano
- Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Firdevs Tugba Bozkurt
- Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Bedri Caner Kaya
- Department of Cardiology, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Mehmet Tercan
- Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
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15
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Stefanescu S, Cocoș R, Turcu-Stiolica A, Shelby ES, Matei M, Subtirelu MS, Meca AD, Stanciulescu EC, Popescu SO, Biciusca V, Pisoschi CG. Prediction of Treatment Outcome with Inflammatory Biomarkers after 2 Months of Therapy in Pulmonary Tuberculosis Patients: Preliminary Results. Pathogens 2021; 10:pathogens10070789. [PMID: 34206598 PMCID: PMC8308673 DOI: 10.3390/pathogens10070789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
Pro-inflammatory mediators play an important role in the pathogenesis of pulmonary tuberculosis. Consecutively, 26 pulmonary tuberculosis patients were enrolled in our study based on the exclusion criteria. We have used Spearman’s correlation analysis, hierarchical clustering and regression modelling to evaluate the association of 11 biomarkers with culture status after antituberculosis treatment. The results of our study demonstrated that six inflammatory biomarkers of 11, C-reactive protein (CRP), white blood cells (WBC), neutrophils, interferon gamma inducible protein 10, C-reactive protein (CRP) to albumin ratio (CAR) and neutrophil to albumin ratio (NAR), were significantly associated with culture negativity. The predictive ability of a composite model of seven biomarkers was superior to that of any single biomarker based on area under the receiver operating characteristic curve (AUC) analysis, indicating an excellent prediction efficacy (AUC:0.892; 95% CI:0.732-1.0). We also found that the highest significant trends and lower levels of CRP and IP-10 were observed in the two-month treated tuberculosis (TB) patients. We believe that our study may be valuable in providing preliminary results for an additional strategy in monitoring and management of the clinical outcome of pulmonary tuberculosis. Using a panel of predictors added a superior value in predicting culture status after anti-TB therapy.
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Affiliation(s)
- Simona Stefanescu
- Clinical Analysis Laboratory, Clinical Emergency County Hospital Craiova, 200642 Craiova, Romania;
| | - Relu Cocoș
- Department of Medical Genetics, University of Medicine and Pharmacy “Carol Davila”, 020032 Bucharest, Romania
- Institute of Pneumophtisiology “Marius Nasta”, 050159 Bucharest, Romania
- Correspondence:
| | - Adina Turcu-Stiolica
- Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.T.-S.); (M.-S.S.)
| | - Elena-Silvia Shelby
- Scientific Research Nucleus, Dr. Nicolae Robanescu National Clinical Centre for Children’s Neurorecovery, 041408 Bucharest, Romania;
| | - Marius Matei
- Department of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mihaela-Simona Subtirelu
- Department of Pharmacoeconomics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.T.-S.); (M.-S.S.)
| | - Andreea-Daniela Meca
- Department of Pharmacology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Elena Camelia Stanciulescu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (E.C.S.); (S.O.P.); (C.-G.P.)
| | - Stefana Oana Popescu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (E.C.S.); (S.O.P.); (C.-G.P.)
| | - Viorel Biciusca
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Catalina-Gabriela Pisoschi
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (E.C.S.); (S.O.P.); (C.-G.P.)
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16
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Erdem B, Gok M. Evaluation of the Effects of Intravitreal Aflibercept and Ranibizumab on Systemic Inflammatory and Cardiovascular Biomarkers in Patients with Neovascular Age-related Macular Degeneration. Curr Eye Res 2021; 46:1387-1392. [PMID: 33471564 DOI: 10.1080/02713683.2021.1879868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: To investigate the effects of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) on systemic inflammatory and cardiovascular biomarkers in treatment-naive patients with neovascular age-related macular degeneration (nAMD)Methods: This study included 24 eyes of 24 patients treated with 0.5 mg ranibizumab (IVR group) and 25 eyes of 25 patients treated with 2.0 mg aflibercept (IVA group). Complete blood count, C-reactive protein (CRP), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), uric acid (UA), albumin, fibrinogen levels were measured in blood samples before and after the three-monthly loading dose treatment. Neutrophil/lymphocyte ratio (NLR), monocyte/HDL-c ratio (MHR), CRP/albumin ratio (CAR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) were also calculated.Results: A statistically significant decline was determined in post-treatment CRP (P = .002), LDL-c (P < .001) levels, white blood cell (WBC, P = .001), neutrophil (P < .001), monocyte (P = .019) counts and NLR (P = .020), MHR (P = .042), CAR (P = .010) ratios comparing with pre-treatment values in the IVA group. No statistically significant change was found in any of the parameters evaluated in the study in the IVR group. Also, there was no significant change in fibrinogen, lymphocyte count, MLR, HDL-c, UA, PLR, and platelet count values in both groups.Conclusion: Compared to IVR, IVA treatment had a small but significant effect on systemic inflammatory and cardiovascular biomarkers.
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Affiliation(s)
- Burak Erdem
- Department of Ophthalmology, Ordu University Faculty of Medicine, Ordu, Turkey
| | - Mustafa Gok
- Department of Ophthalmology, Private Atanur Eye Hospital, Isparta, Turkey
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17
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Efe SÇ, Özdemir Candan Ö, Gündoğan C, Öz A, Yüksel Y, Ayca B, Çermik TF. Value of C-reactive Protein/Albumin Ratio for Predicting Ischemia in Myocardial Perfusion Scintigraphy. Mol Imaging Radionucl Ther 2020; 29:112-117. [PMID: 33094574 PMCID: PMC7583749 DOI: 10.4274/mirt.galenos.2020.88261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 08/12/2020] [Indexed: 12/01/2022] Open
Abstract
Objectives Several studies demonstrate the relationship between coronary artery disease and inflammatory parameters. Nevertheless, there is paucity of data regarding the role of high sensitivity (hs)-C-reactive protein (CRP) to albumin ratio (CAR) in patients with ischemia on gated single photon emission tomography (SPECT) myocardial perfusion imaging (MPI). This study was aimed at demonstrating the relationship between CAR and the occurrence of ischemia on gated SPECT MPI. Methods We retrospectively evaluated 2.048 referred patients for gated SPECT MPI from a cardiology outpatient clinic between October 2017 and June 2019. After applying exclusion criteria and measuring serum CRP and albumin levels, we included 126 patients in the study. We then classified subjects into different groups according to the absence or presence of ischemia on gated SPECT MPI. Results According to laboratory findings, hs-CRP and CAR were significantly higher in the ischemia group, while the serum albumin was significantly lower in ischemia group (p<0.05 for each). The independent predictors of presence of ischemia in multivariate analysis were hypertension and CAR (CAR; odds ratio: 5.720, 95% confidence interval: 2.697-12.133, p<0.001). The optimal value of CAR for presence of ischemia was 0.96 with 76% sensitivity and 71% specificity. Conclusion We found CAR values as a predictor for ischemia before MPI.
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Affiliation(s)
- Süleyman Çağan Efe
- Kartal Koşuyolu Cardiovascular Diseases Training and Research Hospital, Clinic of Cardiology, İstanbul, Turkey
| | - Özlem Özdemir Candan
- Kartal Koşuyolu Cardiovascular Diseases Training and Research Hospital, Clinic of Cardiology, İstanbul, Turkey
| | - Cihan Gündoğan
- İstanbul Training and Research Hospital, Clinic of Nuclear Medicine, İstanbul, Turkey
| | - Ahmet Öz
- İstanbul Training and Research Hospital, Clinic of Cardiology, İstanbul, Turkey
| | - Yasin Yüksel
- İstanbul Training and Research Hospital, Clinic of Cardiology, İstanbul, Turkey
| | - Burak Ayca
- İstanbul Training and Research Hospital, Clinic of Cardiology, İstanbul, Turkey
| | - Tevfik Fikret Çermik
- İstanbul Training and Research Hospital, Clinic of Nuclear Medicine, İstanbul, Turkey
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18
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Diagnostic significance of C-reactive protein and hematological parameters in acute toxoplasmosis. J Parasit Dis 2020; 44:785-793. [PMID: 32904402 PMCID: PMC7456360 DOI: 10.1007/s12639-020-01262-0] [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: 06/09/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023] Open
Abstract
Abstract Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, which can be acquired by oral contact and may cause severe health problems especially for pregnant (congenital toxoplasmosis) and immunocompromised patients. This study aimed to verify the diagnostic significance of hematological parameters and C-reactive protein (CRP) for toxoplasmosis acute detection. A case-control study was carried out between December 2017 and May 2018, in samples of convenience independent of age and sex. The case group was formed by 25 patients with positive anti-Toxoplasma gondii IgG/IgM antibody and the control group was formed by 21 patients with non-positive anti-Toxoplasma gondii IgG/IgM antibody. The results of the hematological parameters and CRP were analyzed in these patients. The patients with Toxoplasma gondii IgM antibody reagent showed higher lymphocytes counting and lower neutrophils counting than the control group. C-reactive protein levels were not different between the groups case and control. ROC curve analysis highlighted that the cut-off value of > 32.00% for lymphocytes and < 57.50% for neutrophils were able to produce specificity higher than 90% for IgM antibody detection. The Naïve Bayes classifier was considered suitable (AUC ≈ 0.700) to separate both groups according to their white cell counting. Changes in lymphocytes and neutrophils may be useful parameters for toxoplasmosis identification and may be used as a tool in the complementary diagnosis of toxoplasmosis. Graphic abstract ![]()
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19
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From CT to artificial intelligence for complex assessment of plaque-associated risk. Int J Cardiovasc Imaging 2020; 36:2403-2427. [PMID: 32617720 DOI: 10.1007/s10554-020-01926-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
Abstract
The recent technological developments in the field of cardiac imaging have established coronary computed tomography angiography (CCTA) as a first-line diagnostic tool in patients with suspected coronary artery disease (CAD). CCTA offers robust information on the overall coronary circulation and luminal stenosis, also providing the ability to assess the composition, morphology, and vulnerability of atherosclerotic plaques. In addition, the perivascular adipose tissue (PVAT) has recently emerged as a marker of increased cardiovascular risk. The addition of PVAT quantification to standard CCTA imaging may provide the ability to extract information on local inflammation, for an individualized approach in coronary risk stratification. The development of image post-processing tools over the past several years allowed CCTA to provide a significant amount of data that can be incorporated into machine learning (ML) applications. ML algorithms that use radiomic features extracted from CCTA are still at an early stage. However, the recent development of artificial intelligence will probably bring major changes in the way we integrate clinical, biological, and imaging information, for a complex risk stratification and individualized therapeutic decision making in patients with CAD. This review aims to present the current evidence on the complex role of CCTA in the detection and quantification of vulnerable plaques and the associated coronary inflammation, also describing the most recent developments in the radiomics-based machine learning approach for complex assessment of plaque-associated risk.
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Dereli S, Çerik İB, Kaya A, Bektaş O. Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia. Angiology 2020; 71:840-846. [PMID: 32519552 DOI: 10.1177/0003319720930983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We investigated the relationship between C-reactive protein-to-albumin ratio (CAR) and coronary artery ectasia (CAE). The retrospective study population included 150 patients with isolated CAE, 150 with obstructive coronary artery disease (CAD), and 150 with a normal coronary artery angiogram (NCA). The severity of isolated CAE was determined according to the Markis classification. C-reactive protein-to-albumin ratio was significantly higher in patients with isolated CAE than in those with obstructive CAD and NCA (10.5 [5.9-30.9], 5.7 [1.8-13.2] and 3.0 [0.9-8.9], respectively). Logistic regression analysis showed that CAR (odds ratio [OR]: 3.054, 95% CI: 1.021-9.165, P = .001), platelet-to-lymphocyte ratio (PLR; OR: 1.330, 95% CI: 1.025-1.694, P = .044), and monocyte-to-high density cholesterol ratio (MHR; OR: 1.031, 95% CI: 1.009-1.054, P = .006) were independently associated with the presence of isolated CAE. Receiver operating characteristic curve analysis showed that CAR (area under the curve [AUC] ± standard error [SE] = 0.838 ± 0.016; P < .001) had a stronger diagnostic value for detecting significant CAE than PLR (AUC ± SE = 0.632 ± 0.023) and MHR (AUC ± SE = 0.726 ± 0.022). C-reactive protein-to-albumin ratio had a significantly strong correlation with the severity of isolated CAE (r = 0.536, P < .001). To the best of our knowledge, this study showed for the first time that CAR was significantly associated with CAE presence and severity.
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Affiliation(s)
- Seçkin Dereli
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - İdris Buğra Çerik
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - Ahmet Kaya
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - Osman Bektaş
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
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Naderi M, Sabour S. Diagnostic Value of the C-Reactive Protein to Albumin Ratio in Patients With Stable Angina Pectoris: Methodological Issue. Angiology 2020; 71:864-865. [PMID: 32338039 DOI: 10.1177/0003319720921716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mehdi Naderi
- Clinical Research Development Centre, Taleghani and Imam Ali Hospital, 48464Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Siamak Sabour
- Department of Clinical Epidemiology, School of Health and Safety, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Safety Promotions and Injury Prevention Research Centre, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
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