Monocyte count to high-density lipoprotein ratio predicts occlusion of the infarct-related artery in STEMI

Year 2017, , 91 - 96, 01.06.2017

Regayip Zehir , Taner Sarak , Suleyman Barutcu , Vedat Şimşek , Muhammed Karadeniz , Hüseyin Kandemir

https://doi.org/10.18663/tjcl.287859

Abstract

 Aim: Patency of infarct-related
artery (IRA) in patients with ST-segment elevation myocardial infarction
(STEMI) before primary percutaneous coronary intervention (pPCI) is associated
with better clinical outcomes. However, there were limited data regarding the
predictors of IRA patency before pPCI in the setting of STEMI. We intended to
evaluate the association of monocyte count to high-density lipoprotein ratio
(MHR) with IRA patency in STEMI.

Material and Methods: A total of
726 patients were recruited. IRA patency was determined by the thrombolysis in
myocardial infarction (TIMI) flow grade. According TIMI flow grade in the IRA
before PCI, the study population was divided into two groups as TIMI 0,1 or 2
group (occluded IRA, n=624) and TIMI 3 group (patent IRA, n=102). Blood samples
were collected on admission to calculate MHR. Of all patients, 92 (20.4%)
patients revealed pre-pPCI TIMI 3 flow in IRA.

Results: The MHR was significantly
higher in occluded IRA group (22.4 ± 5.4 vs 17.8 ± 6.9, P < 0.001). Glucose,
troponin I, and platelet to lymphocyte ratio (PLR) levels were also higher in
occluded IRA group (P < 0.05). Multivariate regression analysis demonstrated
the MHR on admission (odds ratio [OR]: 1.191; 95% confidence interval [CI]:
1.116-1.272, P < 0.001) and pre-hospital use of prasugrel or ticagrelor (OR:
7.045; CI: 1.687-29.414, P = 0.007) as independent predictors of IRA patency.

Conclusion: IRA
patency is more frequently found in patients having received fast acting

antiplatelet
therapy before pPCI and a higher MHR value independently predicts it.

Keywords

monocyte count to high-density lipoprotein ratio, ST-segment elevation myocardial infarction, infarct-related artery patency

Monosit sayısı /yüksek yoğunluklu lipoprotein oranı, STEMI'de enfarktla ilişkili arterin oklüzyonunu öngörür

Abstract

Amaç:
ST segment yükselmeli miyokard enfarktüsü (STEMI) olan hastalarda, primer
perkütan koroner girişim (pPKI) öncesi enfarktüs ilişkili arter acıklığı daha
iyi klinik sonuçlar ile ilişkilidir. Bununla birlikte, STEMI ortamında pPKI
öncesinde IRA açıklığının öngördürücüleri ile ilgili sınırlı veri vardır. STEMI'de
monosit sayısı /yüksek yoğunluklu lipoprotein oranı (MHR) ile enfarktla
ilişkili arterin acıklığı arasındaki ilişkiyi değerlendirmek istedik.

Gereç
ve Yöntemler: Toplam 726 hasta çalışmaya alındı. IRA açıklığı, miyokard
enfarktüsünde tromboliz (TIMI)  akım
sınıflaması ile belirlendi. PKI öncesi IRA'da TIMI akım derecesine göre çalışma
popülasyonu, TIMI 0,1 veya 2 grup (tıkalı IRA, n=624) ve TIMI 3 grubu (patent
IRA, n=102) olmak üzere iki gruba ayrıldı. MHR hesaplamak için basvuruda kan
örnekleri toplandı. Tüm hastaların 92'sinde (%20,4) IRA'da pre-pPKI TIMI 3
akımı vardı.

Bulgular:
MHR, tıkanan IRA grubunda anlamlı derecede yüksekti (22,4 ± 5,4'e karşılık 17,8
± 6,9, P < ,001). Tıkalı IRA grubunda, glikoz, troponin İ ve
trombosit/lenfosit oranı (PLR) düzeyleri de yüksekti (P < 0.05). Çok
değişkenli regresyon analizinde, başvuru sırasındaki MHR değeri (odds oranı
[1,391]; %95 güven aralığı [CI]: 1,116-1,272, P < 0,001) ve prasugrel veya
tikagrelorun hastane öncesi kullanımı (OR: 7,045; CI:1,687-29,414, P = 0,007)
IRA açıklığının bağımsız öngördürücüleri olarak bulundu.

Sonuçlar:
IRA açıklığı, pPKI öncesi hızlı etkili antitrombosit tedavi  alan hastalarda daha sık görülmektedir ve
daha düşük bir MHR değeri IRA açıklığını bağımsız bir şekilde tahmin eder.

Keywords

monosit sayısı / yüksek yoğunluklu lipoprotein oranı, ST segment yükselmesi miyokard enfarktüsü, infarkla ilişkili arter açıklığı

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