RESUMEN
OBJECTIVE: Aortic valve stenosis is a common valve disease in developed countries where the elderly population is high. Aortic valve stenosis is not a simple calcification; it is a dynamic process in which uric acid plays a serious role. We investigated the role of the serum uric acid/creatinine (SUA/Cr) ratio, which is an indicator of uric acid level independent of renal function, in determining the prognosis in patients who had undergone transcatheter aortic valve implantation (TAVI). PATIENTS AND METHODS: In this retrospective cohort study, 357 patients who underwent TAVI for symptomatic severe aortic stenosis between March 2019 and March 2022 were retrospectively analyzed. After applying exclusion criteria, the remaining 269 patients were included in the study. According to the Valve Academic Research Consortium criteria, major adverse cardiac and cerebrovascular events (MACCE) defined the endpoint of the study. Therefore, patients were divided into two groups: the MACCE group and the no MACCE group. RESULTS: Serum uric acid level was significantly higher in the MACCE group (7.0 ± 2.6) than in the no MACCE group (6.0 ± 1.7) (p = 0.008). SUA/Cr ratio was significantly higher in the MACCE group (6.7 ± 2.3) than in the no MACCE group (5.9 ± 1.1) (p = 0.007). CONCLUSIONS: The serum UA/creatinine ratio is important in determining the prognosis of patients undergoing TAVI.
Asunto(s)
Estenosis de la Válvula Aórtica , Reemplazo de la Válvula Aórtica Transcatéter , Humanos , Anciano , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Ácido Úrico , Estudios Retrospectivos , Creatinina , Resultado del Tratamiento , Pronóstico , Estenosis de la Válvula Aórtica/diagnóstico , Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica , Factores de RiesgoRESUMEN
OBJECTIVE: The incidence of contrast-induced nephropathy (CIN) is higher than 20% in patients with chronic kidney disease. In this study, we sought to define the predictors of CIN and develop a risk prediction tool in patients with chronic kidney disease. PATIENTS AND METHODS: Patients aged 18 years and older who underwent invasive coronary angiography with an iodine-based contrast media between March 2014 and June 2017 were retrospectively analyzed. Independent predictors for CIN development were identified and a new risk prediction tool was created that included these predictors. RESULTS: In total, 283 patients included in the study were divided into those who developed CIN (n=39, 13.8%) and those who did not (n=244, 86.2%). Male gender (OR: 4.874, 95% CI: 2.044-11.621), LVEF (OR: 0.965, 95% CI: 0.936-0.995), diabetes mellitus (OR: 1.711, 95% CI: 1.094-2.677), and e-GFR (OR: 0.880, 95% CI: 0.845-0.917), were identified as independent predictors for the development of CIN in the multivariate analysis. A new scoring system has been designed that can score a minimum of 0 and a maximum of 8 points. Patients with a new scoring system score of ≥4 were at approximately 40 times higher risk of developing CIN than others (OR: 39.9, 95% CI: 5.4-295.3). The area under the curve value of CIN's new scoring system was 0.873 (95% CI, 0.821-0.925). CONCLUSIONS: We found that four easily accessible and routinely collected variables, including sex, diabetes status, e-GFR, and LVEF, were independently associated with the development of CIN. We believe that using this risk prediction tool in routine clinical practice may guide physicians to use preventive medications and techniques in high-risk patients for CIN.
Asunto(s)
Enfermedades Renales , Intervención Coronaria Percutánea , Insuficiencia Renal Crónica , Humanos , Masculino , Angiografía Coronaria/efectos adversos , Estudios Retrospectivos , Factores de Riesgo , Enfermedades Renales/inducido químicamente , Enfermedades Renales/diagnóstico , Medios de Contraste/efectos adversos , Insuficiencia Renal Crónica/complicaciones , Intervención Coronaria Percutánea/efectos adversosRESUMEN
PURPOSE: The aim of this study was to investigate the relationship between monocyte count/high density lipoprotein cholesterol (HDL-C) ratio (MHR) and the severity of coronary atherosclerosis, as assessed by the SYNTAX score (SXscore), in patients with stable coronary artery disease (CAD) undergoing coronary angiography. MATERIALS AND METHODS: A total of 428 patients were included in the study between March 2012 and February 2015. The SXscore was determined with baseline coronary angiography. An SXscore ≥ 23 was regarded as severe CAD by definition, and the patients were divided into two groups: those with low SXscores (< 23) and those with high SXscores (≥ 23). RESULTS: MHR and C-reactive protein (CRP) were significantly higher in patients with high SXscores (p < 0.001 and p < 0.001, respectively). Left ventricular ejection fraction (LVEF) was lower in the group with high MHR and high SXscores. The cutoff value of MHR that predicted a high SXscore was 24, with a sensitivity of 66 % and a specificity of 65.1 %. CONCLUSION: To the best of our knowledge, this is the first study in the literature showing that MHR is significantly associated with SXscores. Our results suggest that MHR can be used as a prognostic marker in patients with stable CAD, since it is an easily available and inexpensive test.