Systemic immune-inflammation index, and neutrophilto-lymphocyte and platelet-to-lymphocyte ratios can predict clinical outcomes in patients with acute coronary syndrome

PMID: 37145864WOS:000989138200001Objective: Inflammatory mechanisms play an important role in the pathogenesis of atherosclerosis and myocardial infarction. The clinical and prognostic importance of inflammatory parameters, such as neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) in complete blood counts in acute myocardial infarction and other cardiovascular diseases has been demonstrated. However, systemic immune-inflammation index (SII) calculated from neutrophils, lymphocytes and platelets in the complete blood cell count has not been studied sufficiently and is thought to provide a better prediction. This study investigated whether haematological parameters such as SII, NLR and PLR were associated with clinical outcomes in acute coronary syndrome (ACS) patients. Methods: We included 1 103 patients who underwent coronary angiography for ACS between January 2017 and December 2021. The association between major adverse cardiac events (MACE) that developed in hospital and at 50 months of follow up and SII, NLR and PLR was compared. Long-term MACE were defined as mortality, re-infarction and target-vessel revascularisation. SII was calculated using the formula: NLR × total platelet count in the peripheral blood (per mm3). Results: Of the 1 103 patients, 403 were diagnosed with ST-elevation myocardial infarction and 700 with non-STelevation myocardial infarction. The patients were divided into a MACE and a non-MACE group. In hospital and during the 50-month follow up, 195 MACE were observed. SII, PLR and NLR were found to be statistically significantly higher in the MACE group (p < 0.001). SII, C-reactive protein level, age and white blood cell count were independent predictors of MACE in ACS patients. Conclusions: SII was found to be a strong independent predictor of poor outcomes in ACS patients. This predictive power was greater than that of PLR and NLR

High triglyceride-glucose index is associated with poor prognosis in patients with acute coronary syndrome in long-term follow-up

WOS:000854797500001 PubMed ID36112779The triglyceride-glucose (TyG) index is calculated from fasting triglycerides and fasting glucose levels and is an indicator of insulin resistance. The present study investigates whether the TyG index has a role in predicting clinical outcomes in cases of acute coronary syndrome (ACS). This retrospective study included 646 patients with ST-elevation myocardial infarction (STEMI) and 1048 patients with non-ST-elevation myocardial infarction (NSTEMI). The association between major adverse cardiac events (MACEs) that developed in-hospital and at 60 months of follow-up and TyG index values were compared. Patients were divided into 2 groups: TyG index values of >= 8.65 and = 8.65 (P < .001). TyG index, C-reactive protein, and age were independent predictors of MACEs in both the NSTEMI and STEMI groups. The present study found a significant association between higher TyG index values and increased risk of MACEs in ACS patients. The TyG index may prove useful to predict clinical outcomes in ACS patients

The relationship of the c-reactive protein /albumin ratio to in-hospital mortality in elderly patients with non- st-elevation myocardial infarction who have undergone percutaneous coronary intervention

WOS:000961949400002Introduction: Acute myocardial infarction is the most common cardiovascular disease and the cause of significant mortality worldwide. The C-reactive protein/ albumin ratio, which measures inflammatory conditions, can be used to predict mortality. In this study, we aimed to investigate the relationship between in-hospital mortality and the C-reactive protein/albumin ratio in patients diagnosed with non-ST-elevation myocardial infarction who underwent interventional treatment at our hospital. Materials and Method: Two hundred and ninety-seven elderly patients were included in the study. The information of the patients was obtained from the hospital database. The C-reactive protein/albumin ratio was calculated for each patient. We used regression analysis to investigate the relationship between the C-reactive protein/albumin ratio and in-hospital mortality. Results: A univariate analysis showed that gender, ejection fraction, white blood cell, glucose, creatinine, systolic and diastolic blood pressure, heart rate, GRACE risk score, and CAR ratio were significant predictors of mortality (Table 2). All parameters were added to a multivariable logistic regression, and multivariable logistic regression analysis showed that the GRACE risk score (OR: 0.956, 95% CI: 0.941-0.971; p<0.001) and the C-reactive protein/albumin ratio (OR: 0.812, 95% CI: 0.661-0.998; p=0.048) were the only significant predictors of mortality. Furthermore, bivariate correlation analysis showed a weak but statistically significant correlation between GRACE risk score and C-reactive protein/albumin ratio (r=0.180, p<0.001). Conclusion: We found a significant relationship between C-reactive protein/ albumin and in-hospital mortality. C-reactive protein/albumin ratio can be used in clinical practice because it is inexpensive and easy to apply and has a strong prognostic value for elderly non-ST-elevation myocardial infarction patients

Vitamin D Deficiency Is a Potential Risk for Blood Pressure Elevation and the Development of Hypertension

Background and objectives: Hypertension is a global health problem and a major risk factor for cardiovascular diseases. Vitamin D deficiency is closely related to high blood pressure and the development of hypertension. This study investigated the relationship between the vitamin D and blood pressure status in healthy adults, and their 8-year follow-up was added. Materials and Methods: A total of 491 healthy middle-aged participants without any chronic illness, ages 21 to 67 at baseline, were divided into two groups as non-optimal blood pressure (NOBP) and optimal blood pressure (OBP). NOBP group was divided into two subgroups: normal (NBP) and high normal blood pressure (HNBP). Serum 25-hydroxy vitamin D levels were measured with the immunoassay method. 8-year follow-up of the participants was added. Results: The average vitamin D level was detected 32.53 &plusmn; 31.50 nmol/L in the OBP group and 24.41 &plusmn; 14.40 nmol/L in the NOBP group, and a statistically significant difference was found (p &lt; 0.001). In the subgroup analysis, the mean vitamin D level was detected as 24.69 &plusmn; 13.74 and 24.28 &plusmn; 14.74 nmol/L in NBP and HNBP, respectively. Together with parathyroid hormone, other metabolic parameters were found to be significantly higher in the NOBP. During a median follow-up of 8 years, higher hypertension development rates were seen in NOBP group (p &lt; 0.001). Conclusions: The low levels of vitamin D were significantly associated with NBP and HNBP. The low levels of vitamin D were also associated with the development of hypertension in an 8-year follow-up

Is the Naples prognostic score useful for predicting heart failure mortality

Pubmed ID:37061862WOS:000978343400008Aim The Naples prognostic score (NPS) simultaneously evaluates inflammation and malnutrition, which are two main factors that play a role in the pathophysiology and prognosis of heart failure (HF). In this study, we aimed to examine the relationship of NPS with in-hospital mortality of hospitalized patients with a diagnosis of HF.Material and Methods A total of 496 hospitalized HF patients included in this study. The patients were divided into two groups as deceased and living. The clinical and demographic characteristics of each patient were recorded. NPS of each patient was calculated.Results NPS was significantly higher in the deceased group compared to the living group (3.6±0.61, 3.21±0.97, respectively; p=0.003). According to multivariate regression analysis: NPS (OR: 1.546, 95 % CI: 1.027-2.327; p=0.037), systolic blood pressure (OR: 0.976, 95 % CI: 0.957-0.995; p=0.015), and white blood cell count (OR: 1.072, 95 % CI: 1.007-1142; p=0.03) are independent predictors for in-hospital mortality in HF patients.Conclusion This study demonstrated a strong correlation between NPS and mortality in HF. This new score can be used to predict the prognosis of HF as it shows both the level of inflammation and nutrition

IS THE NAPLES PROGNOSTIC SCORE USEFUL FOR PREDICTING HEART FAILURE MORTALITY

Aim The Naples prognostic score (NPS) simultaneously evaluates inflammation and malnutrition, which are two main factors that play a role in the pathophysiology and prognosis of heart failure (HF). In this study, we aimed to examine the relationship of NPS with in-hospital mortality of hospitalized patients with a diagnosis of HF. Material and Methods A total of 496 hospitalized HF patients included in this study. The patients were divided into two groups as deceased and living. The clinical and demographic characteristics of each patient were recorded. NPS of each patient was calculated.Results NPS was significantly higher in the deceased group compared to the living group (3.6 +/- 0.61, 3.21 +/- 0.97, respectively; p=0.003). According to multivariate regression analysis: NPS (OR: 1.546, 95 % CI: 1.027-2.327; p=0.037), systolic blood pressure (OR: 0.976, 95 % CI: 0.957-0.995; p=0.015), and white blood cell count (OR: 1.072, 95 % CI: 1.007-1142; p=0.03) are independent predictors for in-hospital mortality in HF patients.Conclusion This study demonstrated a strong correlation between NPS and mortality in HF. This new score can be used to predict the prognosis of HF as it shows both the level of inflammation and nutrition.AO Bayer [PP-M_VER-RU-0015-1]The publication was supported by AO Bayer. PP-M_VER-RU-0015-

Guideline-adherent therapy for stroke prevention in atrial fibrillation in different health care settings: Results from RAMSES study

PubMed ID: 28238569Objective No studies have been conducted in Turkey to compare the quality of stroke prevention therapies provided in different healthcare settings in patients with atrial fibrillation (AF). Therefore, we aimed to evaluate possible differences between secondary (SH) and tertiary hospital (TH) settings in the effectiveness of implementing AF treatment strategies. Methods Baseline characteristics of 6273 patients with non-valvular AF enrolled in the RAMSES (ReAl-life Multicentre Survey Evaluating Stroke Prevention Strategies in Turkey) study were compared. Results Of the study population, 3312 (52.8%) patients were treated in THs and 2961 (47.2%) patients were treated in SHs. Patients treated in the SH setting were older (70.8 ± 9.8 vs. 68.7 ± 11.4 years, p &lt; 0.001), had a lower socioeconomic status, had a higher CHA2DS2VASc and HASBLED scores (3.4 ± 1.4 vs. 3.1 ± 1.7, p &lt; 0.001 and 1.7 ± 1.0 vs. 1.6 ± 1.1, p &lt; 0.001 respectively), and had more comorbidities than patients treated in THs. Inappropriate oral anticoagulant use was more prevalent in SHs than THs (31.4% vs. 25.6%, p &lt; 0.001). When over- and undertreatment rates were compared among hospital types, overtreatment was more prevalent in THs (7.6% vs. 0.9%, p &lt; 0.001) while undertreatment was more common in SHs (30.5% vs. 17.9%, p &lt; 0.001). Conclusion This study demonstrates the marked disparity between patient groups with AF presenting at SHs and THs. The use of guideline-recommended therapy is not adequate in either type of centre, overtreatment was more prevalent in THs and undertreatment was more prevalent in SHs. © 2017 European Federation of Internal Medicin

Effects of an Impaired Fasting Glucose on the Left Atrial Strain Evaluated by Speckle Tracking Echocardiography

Background and Objectives: Similar to diabetes, the presence of left ventricular (LV) diastolic function (DD) has been reported in various studies which were conducted with people with a diagnosis of an impaired fasting blood glucose (FBG). This study aimed to examine the effects of the fasting blood glucose (FBG) levels on the left atrial strain (LAS) estimated by two-dimensional echocardiography speckle tracking analyses in patients without known diabetes. Material and Methods: The study included 148 participants (74 female and 74 male) without a history of diabetes mellitus or chronic disease. The patients were divided into two groups as follows: individuals with an FBG Results: There was a significant decrease in the LA reservoir (52.3 ± 15 vs. 44.5 ± 10.7; p = 0.001) and conduit strain (36.9 ± 11.7 vs. 28.4 ± 9.7; p = 0.001) in the impaired FBG group. When the STE findings of both ventricles were compared, no significant difference was observed between the groups in right and left ventricular strain imaging. Conclusions: In the earliest stage of LVDD, changes in atrial functional parameters become particularly evident. Echocardiographic analyses of these parameters can help to diagnose and determine the degree of LVDD while the morphological parameters are still normal. The addition of LAS imaging to routine transthoracic echocardiography (TTE) studies in patients with an impaired FBG but without a DM diagnosis may be helpful in demonstrating subclinical LVDD or identifying patients at risk for LVDD in this patient group

Misperceptions and management of LDL-cholesterol in secondary prevention of patients with familial hypercholesterolemia in cardiology practice: Real-life evidence from the EPHESUS registry

BACKGROUND AND AIMS: Familial hypercholesterolemia (FH) is a common inherited disease, leading to premature atherosclerotic cardiovascular disease (ASCVD) due to elevated low-density lipoprotein cholesterol (LDL-C) levels. Achieving LDL-C goals is extremely important for preventing the complications of this fatal disease. We evaluated the management of FH patients with ASCVD in cardiology practice. METHODS: We analyzed patients with ASCVD from the nationwide EPHESUS registry, which was conducted in 40 cardiology outpatient clinics, and compared those with and without FH. RESULTS: Of the 1482 consecutively enrolled patients with ASCVD, 618 (41.7%) had FH, among which 455 were categorized as 'Possible FH' and 163 as 'Probable or Definite FH'. Proposed LDL-C goals were not attained in more than 90% of the patients with FH. The proportion of those on statin therapy was 77% for possible and 91% for probable or definite FH, whereas 34.2 % and 59.4% were in use of high-intensity statins, respectively. None of the patients were on PCSK-9 inhibitors, and only 2 used ezetimibe. Adverse media coverage was the most common cause of statin discontinuation (32.5% in 'possible FH' and 45.7% in 'probable/definite FH'). The negative impact of media in the decision to stop lipid lowering therapy (LLT) was increasing with education level. CONCLUSIONS: In real life most of the FH patients with ASCVD are undertreated in cardiology practice regarding statin dosing and combined LLT. Drug discontinuation rates are notably high and are mostly media-related, and side effects very rarely cause cessation of LLT. Urgent measures are needed to increase the awareness of FH among healthcare providers and patients and to develop improved treatment strategies aimed at preventing the complications of FH