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INTRODUCTION: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II and the Society of Thoracic Surgeons (STS) are validated scoring systems for short-term risk estimation after coronary artery bypass grafting (CABG). The Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score is originally aimed to estimate mortality in heart failure patients; however, it has showed a similar power to predict mortality after heart valve surgery. In this study, we sought to evaluate whether MAGGIC score may predict short and long-term mortality after CABG and to compare its power with EuroSCORE II and STS scoring systems. METHODS: Patients who underwent CABG due to chronic coronary syndrome at our institution were included in this retrospective study. Follow-up data were used to define the predictive ability of MAGGIC and to compare it with STS and EuroSCORE-II for early, one-year, and up to 10-year mortality. RESULTS: MAGGIC, STS, and EuroSCORE-II scores had good prognostic power, moreover MAGGIC was better for predicting 30-day (area under the curve [AUC]: 0.903; 95% confidence interval [CI]: 0.871-0.935), one-year (AUC: 0.931; 95% CI: 0.907-0.955), and 10-year (AUC: 0.923; 95% CI: 0.893-0.954) mortality. MAGGIC was found to be an independent predictor to sustain statistically significant association with mortality in follow-up. CONCLUSION: MAGGIC scoring system had a good predictive accuracy for early and long-term mortality in patients undergoing CABG when compared to EuroSCORE-II and STS scores. It requires limited variables for calculation and still yields better prognostic power in determining 30-day, one-year, and up to 10-year mortality.
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Ponte de Artéria Coronária , Insuficiência Cardíaca , Humanos , Valva Aórtica/cirurgia , Estudos Retrospectivos , Medição de Risco , Fatores de RiscoRESUMO
Abstract Objective: We aimed to investigate whether C-reactive protein to albumin ratio (CAR) predicts the early and late mortality in patients undergoing transcatheter aortic valve replacement (TAVR). Methods: This study was retrospectively designed and includes 170 TAVR patients with a mean age of 78.4±7.1 years. Patients were divided into 2 groups as those who died and those who survived, taking into account the follow-up period. Complete blood count, serum CRP and serum albumin were obtained on admission. The CAR value of all patients was calculated and the relationship of CAR with early (≤30 days) and late mortality (>30 days) was evaluated. Results: The median follow-up period was 19 [7-31] months (maximum 66 months). Early mortality was observed in 20 (11.8%) patients, whereas late mortality was observed in 39 (22.9%) patients, most of them male (61.1%, P=0.04). Non-survivors had greater CAR value, higher baseline serum CRP level and lower baseline albumin level than survivors (P<0.01, for all parameters). According to multivariate analysis models, CAR (HR: 1.020, P<0.01) and TVAR score (HR: 1.294, P<0.01) were found to be independent predictors of early mortality while CRP and albumin were not. The area under the curve (AUC) for CAR was 0.73 with a P <0.01. A CAR >15.6 predicted the early mortality with 80% sensitivity and 57% specificity. Conclusion: The novel inflammatory marker CAR can be used as a reliable marker in predicting 30-day mortality in patients undergoing TAVR.
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OBJECTIVE: We aimed to investigate whether C-reactive protein to albumin ratio (CAR) predicts the early and late mortality in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: This study was retrospectively designed and includes 170 TAVR patients with a mean age of 78.4±7.1 years. Patients were divided into 2 groups as those who died and those who survived, taking into account the follow-up period. Complete blood count, serum CRP and serum albumin were obtained on admission. The CAR value of all patients was calculated and the relationship of CAR with early (≤30 days) and late mortality (>30 days) was evaluated. RESULTS: The median follow-up period was 19 [7-31] months (maximum 66 months). Early mortality was observed in 20 (11.8%) patients, whereas late mortality was observed in 39 (22.9%) patients, most of them male (61.1%, P=0.04). Non-survivors had greater CAR value, higher baseline serum CRP level and lower baseline albumin level than survivors (P<0.01, for all parameters). According to multivariate analysis models, CAR (HR: 1.020, P<0.01) and TVAR score (HR: 1.294, P<0.01) were found to be independent predictors of early mortality while CRP and albumin were not. The area under the curve (AUC) for CAR was 0.73 with a P <0.01. A CAR >15.6 predicted the early mortality with 80% sensitivity and 57% specificity. CONCLUSION: The novel inflammatory marker CAR can be used as a reliable marker in predicting 30-day mortality in patients undergoing TAVR.
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Estenose da Valva Aórtica , Substituição da Valva Aórtica Transcateter , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Biomarcadores , Proteína C-Reativa , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
Background: Serum C-reactive protein (CRP) to albumin ratio (CAR) has been defined as an inflammation-based prognostic marker. We evaluated the association and prognostic value of CRP/albumin ratio in patients with pulmonary embolism (PE). Methods: A total of 256 patients with acute PE who were hospitalized between March 2016 and December 2020 were retrospectively reviewed. PE severity index (PESI) was calculated. Serum levels of CRP and albumin that were obtained at the time of admission were used for calculation. CAR was evaluated for correlation with PESI, and thus, foresee the risk of death due to PE. Results: There were 186 patients eligible for inclusion. 54 patients were in intermediate, 34 patients were in high risk and 98 patients were in very high-risk group according to PESI score. In the correlation analysis, we observed moderate positive correlations between CRP/albumin ratio, troponin and PESI score (r = 0.584, p < 0.0001; r = 521, p < 0.0001, respectively). Regression analysis revealed that only CRP/albumin ratio and PESI score were independent risk factors associated with 6-month mortality of acute PE patients. The AUC for CRP/albumin ratio was 0.643, 0.751, and 0.763 for 30-day, 90-day, and 6-month mortality, respectively (95% CI: 0.550-0.737, 0.672-0.830, 0.687-0.838]. A cut-off value of 5.33 for CRP/albumin ratio was associated with 65.3% sensitivity and 65.6% specificity in predicting 6-month mortality. Conclusion: The CRP/albumin ratio, an inexpensive and easily measurable laboratory variable, may be a useful prognostic marker of PE, especially when other causes that alter serum levels are excluded from the study.