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Hu X, Sui Y, Yang X, Yang Z, Wang Q, Yuan J, Li M, Ma X, Qiu C, Sun Q. Association of the High-Sensitivity C-Reactive Protein-to-Albumin Ratio with Carotid Atherosclerotic Plaque: A Community-Based Cohort Study. J Inflamm Res 2024; 17:4027-4036. [PMID: 38919510 PMCID: PMC11197952 DOI: 10.2147/jir.s464491] [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: 02/17/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
Background The inflammatory response is a pivotal factor in accelerating the progression of atherosclerosis. The high-sensitivity C-reactive protein-to-albumin ratio (CAR) has emerged as a novel marker of systemic inflammation. However, few studies have shown the CAR to be a promising prognostic marker for carotid atherosclerotic disease. This study aimed to analyse the predictive role of the CAR in carotid atherosclerotic disease. Methods This community-based cohort study recruited 2003 participants from the Rose asymptomatic IntraCranial Artery Stenosis (RICAS) study who were free of stroke or transient ischemic attack. Carotid atherosclerotic plaques and their stability were identified via carotid ultrasound. Logistic regression models were utilized to investigate the association between CAR and the presence of carotid atherosclerotic plaques. Results The prevalence of carotid atherosclerotic plaques was 38.79% in this study. After adjusting for clinical risk factors, including sex, age, dyslipidemia, hypertension, diabetes mellitus (DM), and smoking and drinking habits, a high CAR-level was independently associated with carotid plaque (odds ratio [OR] of upper: 1.46, 95% confidence interval [CI]: 1.13-1.90, P = 0.004; P for trend = 0.011). The highest CAR tertile was still significantly associated with carotid plaques among middle-aged (40-64 years) or female participants. Notably, an elevated CAR may be an independent risk factor for vulnerable carotid plaques (OR of upper: 2.06, 95% CI: 1.42-2.98, P < 0.001; P for trend <0.001). Conclusion A high CAR may be correlated with a high risk of carotid plaques, particularly among mildly aged adults (40-64 years) or females. Importantly, the CAR may be associated with vulnerable carotid plaques, suggesting that the CAR may be a new indicator for stroke prevention.
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Affiliation(s)
- Xinyan Hu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Yanling Sui
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Xinhao Yang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Zhengyu Yang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People’s Republic of China
| | - Qiuting Wang
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People’s Republic of China
| | - Jiehong Yuan
- Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, People’s Republic of China
| | - Maoyu Li
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Xiaotong Ma
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Qinjian Sun
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People’s Republic of China
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2
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Sacoransky E, Yu Jia Ke D, Dave P, Alexander B, El Sherbini A, Abunassar J, Abuzeid W. Incidence of left ventricular thrombus following STEMI in the modern era via multimodality imaging: A systematic review and meta-analysis. IJC HEART & VASCULATURE 2024; 52:101396. [PMID: 38584672 PMCID: PMC10992728 DOI: 10.1016/j.ijcha.2024.101396] [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: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/09/2024]
Abstract
Background Left ventricular thrombus (LVT) is a significant complication in STEMI. Previous studies were conducted prior to modern timely percutaneous reperfusion networks. Current expert opinion suggests incidence in the current era has decreased. We conducted a systematic review and meta-analysis to better understand the incidence and diagnosis of LVT in patients with STEMI treated with timely percutaneous techniques as assessed by multimodality imaging. Methods Cochrane, EMBASE, LILACS, and MEDLINE were searched over the last 10 years only including studies using contemporary techniques. The primary outcome was detection of LVT in patients via echocardiogram with or without contrast or Cardiac MRI (cMRI) following STEMI (both anterior and any territory) treated with PCI. Data was pooled across studies and statistical analysis was conducted via random effects model. Results 31 studies were included. 18 studies included data on any territory STEMI, totaling 14,172 patients, and an incidence of 5.6% [95% CI 4.3-7.0]. 18 studies were included in analysis for anterior STEMI, totaling 7382 patients and incidence of 12.7% [95% CI 9.8-15.6]. Relative to cMRI as a gold standard, the sensitivity of non-contrast echocardiography to detect LVT was 58.2% [95% CI 46.6-69.2] with a specificity of 97.8% [95% CI 96.3-98.8]. Conclusions Incidence of LVT in STEMI patients treated with contemporary timely percutaneous revascularization is in keeping with historical data and remains significant, suggesting this remains an ongoing issue for further investigation. Numerically, both cMRI and contrast echo detected more LVT compared to non-contrast echo in any-territory STEMI patients.
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Affiliation(s)
| | - Danny Yu Jia Ke
- School of Medicine, Queen’s University, Kingston, ON, Canada
| | - Prasham Dave
- School of Medicine, Queen’s University, Kingston, ON, Canada
- Division of Cardiology, Kingston Health Sciences Network, Kingston, ON, Canada
| | - Bryce Alexander
- School of Medicine, Queen’s University, Kingston, ON, Canada
- Division of Cardiology, Kingston Health Sciences Network, Kingston, ON, Canada
| | - Adham El Sherbini
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Joseph Abunassar
- School of Medicine, Queen’s University, Kingston, ON, Canada
- Division of Cardiology, Kingston Health Sciences Network, Kingston, ON, Canada
| | - Wael Abuzeid
- School of Medicine, Queen’s University, Kingston, ON, Canada
- Division of Cardiology, Kingston Health Sciences Network, Kingston, ON, Canada
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3
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Bayam E, Çakmak EÖ, Yıldırım E, Kalçık M, Bilen Y, Güner A, Küp A, Kahyaoğlu M, Çelik M, Öcal L, Avcı A, Zehir R. The relationship between CHA2DS2VASc score and left ventricular apical thrombus formation in patients with acute anterior ST segment elevation myocardial infarction. Acta Cardiol 2023; 78:24-31. [PMID: 34714216 DOI: 10.1080/00015385.2021.1991667] [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] [Indexed: 01/04/2023]
Abstract
BACKGROUND Left ventricular apical thrombus (LVAT) formation is a well-known complication of acute anterior myocardial infarction (AMI). The CHA2DS2VASc is a scoring system that has been used to estimate the risk of thromboembolism in patients with nonvalvular atrial fibrillation. This score has also been used for other clinical conditions. The aim of this study was to investigate the relationship between CHA2DS2VASc score and development of LVAT in patients with AMI. METHOD The study population included 378 patients (mean age: 56.5 ± 12.3 years, male: 318) presenting with AMI between January 2016 and January 2020. Primary percutaneous coronary intervention procedure was performed in all patients. Initial echocardiogram was performed within 7 days of admission. All patients were evaluated with echocardiography at 3rd, 6th and 12th months. Patients were divided into two groups according to the presence of LVAT on echocardiography. RESULTS The incidence of the LVAT was 8.5% (n = 32) during a mean follow-up time of 233.1 ± 66.7 days. The mean CHA2DS2VASc score was notably higher in patients with LVAT compared to patients in the control group (3.1 ± 1.9 vs. 1.9 ± 1.2, p < 0.001). In Cox regression analysis, high CHA2DS2VASc score, low left ventricular ejection fraction (LVEF) and the presence of LV apical akinesis/aneurysm were the independent predictors for LVAT formation. All of these parameters were associated with higher cumulative incidence of LVAT formation in Kaplan-Meier analyses (p < 0.001 for all). CONCLUSION High CHA2DS2VASc score, low LVEF and the presence of LV apical akinesis/aneurysm may be used for LVAT risk prediction among patients presenting with AMI.
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Affiliation(s)
- Emrah Bayam
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Ender Özgün Çakmak
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Ersin Yıldırım
- Depertament of Cardiology, University of Medical Sciences, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Macit Kalçık
- Depertament of Cardiology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Yusuf Bilen
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Güner
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Küp
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Muzaffer Kahyaoğlu
- Department of Cardiology, Abdülkadir Yüksel State Hospital, Gaziantep, Turkey
| | - Mehmet Çelik
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Lütfi Öcal
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Anıl Avcı
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
| | - Regayip Zehir
- Depertament of Cardiology, University of Medical Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, İstanbul, Turkey
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4
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Association between inflammation and left ventricular thrombus formation following ST-elevation myocardial infarction. Int J Cardiol 2022; 361:1-6. [DOI: 10.1016/j.ijcard.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/10/2022] [Accepted: 05/04/2022] [Indexed: 12/11/2022]
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5
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Cheng L, Meng Z, Wang Q, Jian Z, Fan P, Feng X, Qiao X, Yang J, Yuan Z, Li B, Wu Y. The Usefulness of C-Reactive Protein to Albumin Ratio in the Prediction of Adverse Cardiovascular Events in Coronary Chronic Total Occlusion Undergoing Percutaneous Coronary Intervention. Front Cardiovasc Med 2021; 8:731261. [PMID: 34869630 PMCID: PMC8636141 DOI: 10.3389/fcvm.2021.731261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022] Open
Abstract
Inflammation and nutrition as main factors can affect the prognosis of patients with chronic total coronary occlusion (CTO) undergoing percutaneous coronary intervention (PCI). The C-reactive protein to albumin ratio (CAR) can clarify the inflammation and nutrition status, which are highly related to clinical outcomes. This study aims to investigate the association between CAR and adverse cardiovascular events in patients with CTO undergoing PCI. For this study, 664 patients were divided into three groups based on the tertiles of CAR. The primary endpoint was all-cause mortality and the secondary endpoint was major adverse cardiovascular events (MACE). Over a median follow-up of 33.7 months, the primary endpoint occurred in 64 patients (9.6%) and the secondary endpoint occurred in 170 patients (25.6%). The patients with higher CAR represented a worse prognosis with all-cause death and cardiovascular death after the adjustment for the baseline risk factors. Adding the CAR values raised the predictive value for the incidence of the all-cause death and cardiovascular death but not MACE. The capacity of prognosis prediction was improved after the addition of the CAR value to the traditional prediction model.
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Affiliation(s)
- Lele Cheng
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Department of Medical Imaging, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology, Xi'an, China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China
| | - Zixuan Meng
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Qi Wang
- First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Zhijie Jian
- Department of Medical Imaging, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Pengcheng Fan
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xinxin Feng
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Xiangrui Qiao
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology, Xi'an, China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China
| | - Jian Yang
- Department of Medical Imaging, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology, Xi'an, China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China
| | - Bolin Li
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory of Molecular Cardiology, Xi'an, China.,Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, Xi'an, China
| | - Yue Wu
- Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China
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6
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Peng Q, Hou J, Wang S, Zhou F, E Y, Wang W, Huang T, Wang M, Huang S, Zhou J, Chen N, Zhang Y. Hypersensitive C-reactive protein-albumin ratio predicts symptomatic intracranial hemorrhage after endovascular therapy in acute ischemic stroke patients. BMC Neurol 2021; 21:47. [PMID: 33522912 PMCID: PMC7849085 DOI: 10.1186/s12883-021-02066-2] [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: 10/10/2020] [Accepted: 01/20/2021] [Indexed: 11/15/2022] Open
Abstract
Background Approximately 10% of patients would develop symptomatic intracranial hemorrhage (sICH) after endovascular therapy. The aim of our study was to explore the ability of hypersensitive C-reactive protein-albumin ratio (HAR) in predicting sICH after endovascular therapy. Methods From April 2016 to December 2018, 334 consecutive patients with anterior circulation infarction undergoing endovascular therapy were enrolled in our study. sICH was defined using Heidelberg bleeding classification after endovascular therapy. Multiple regression analysis was used to investigate the potential risk factors of sICH after endovascular therapy. We used receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the HAR in predicting sICH after endovascular therapy. Results Among these 334 patients enrolled, 37 (11.1%) patients with anterior circulation infarction were identified with sICH after endovascular therapy. Univariate logistic regression analysis demonstrated that patients with higher levels of HAR may be inclined to develop sICH (odds ratio, 10.994; 95% confidence interval, 4.567–26.463; P = 0.001). This association remained significant even after adjustment for potential confounders. Also, a cutoff value of 0.526× 10− 3 for HAR was detected in predicting sICH (area under curve, 0.763). Furthermore, nomogram analysis also suggested that HAR was an indicator of sICH (c-index was 0.890, P< 0.001). Conclusions This study showed that high levels of HAR could predict sICH after endovascular therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02066-2.
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Affiliation(s)
- Qiang Peng
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Jiankang Hou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Siyu Wang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Feng Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Yan E
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Wei Wang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Ting Huang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Meng Wang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Shi Huang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China
| | - Junshan Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China.
| | - Nihong Chen
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China. .,Department of Neurology, Nanjing Yuhua Hospital, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China.
| | - Yingdong Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, P.R. China.
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Yilmaz A, Kahraman F, Ergül E, Çetin M. Left atrial volume index to left ventricular ejection fraction ratio predicted major adverse cardiovascular event in ST-Elevated myocardial infarction patients during 8 years of follow-up. J Cardiovasc Echogr 2021; 31:227-233. [PMID: 35284216 PMCID: PMC8893117 DOI: 10.4103/jcecho.jcecho_38_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/26/2021] [Accepted: 08/07/2021] [Indexed: 11/04/2022] Open
Abstract
Objective: Methods: Results: Conclusion:
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