Is Lactate Dehydrogenase An Important Mortality Predictor in Covid-19 Patients with Atrial Fibrillation?

INTRODUCTION: Abnormal laboratory parameters can be detected in severe patients with COVID-19, which are associated with adverse outcomes. Increased lactate dehydrogenase (LDH) is usually associated with tissue damage. Cardiovascular disease is a common comorbidity in COVID-19 disease. In the current report, the objective was to examine the relationship between LDH levels and atrial fibrillation (AF) in COVID-19 patients. METHODS: This investigation involved a retrospective and cross-sectional study. A total of 195 consecutive COVID-19 [45 AF (+) and 150 AF (-)] subjects were enrolled in the study. COVID-19 cases were determined from analysis of an oropharyngeal/nasopharyngeal swab using RT-PCR. LDH, procalcitonin, and D-dimer were recorded from the hospital records. RESULTS: Fatal patients had higher LDH levels compared to non-fatal patients (470+-144 vs 404+-60). A significant positive association was determined for LDH and troponin, CRP, and procalcitonin in all study subjects and AF patients. An LDH level of 443 was identified as the cut-off point in mortality of AF patients with a sensitivity and specificity of 73% and 74% (AUC= 0.744), respectively. LDH (OR: 1.009) and age (OR: 1.238) were shown to independently predict mortality in COVID-19-AF patients. DISCUSSION AND CONCLUSION: Increased LDH levels were essential predictor of mortality in COVID-19 subjects with AF. High LDH levels need careful observation to help prevent potential complications in COVID-19 subjects presenting with AF

Fibrinogen to albumin ratio as a powerful predictor of the exaggerated morning blood pressure surge in newly diagnosed treatment-naive hypertensive patients

Background The exaggerated morning blood pressure surge (MS) is a risk factor for cardiovascular diseases. Inflammation is associated with the pathogenesis of hypertension. We aimed to investigate the association between fibrinogen, albumin, fibrinogen to albumin ratio (FAR), and exaggerated MS, and which of those variables is a better predictor for identifying an exaggerated MS in newly diagnosed treatment-naive hypertensive patients. Material and Methods The study included 249 treatment-naive patients who were newly diagnosed with hypertension in both clinical and ambulatory blood pressure (BP) monitoring measurements. Morning BP was defined as the mean of BPs measured during the first 2 hours after wake-up. The lowest BP was defined as the mean of 3 BP measurements focused on the lowest nighttime computations. The MS was calculated as the morning systolic BP minus the lowest systolic BP. Fibrinogen and albumin levels were measured from venous blood. FAR was obtained by dividing the fibrinogen to the albumin. Results Patients with higher-value MS had a higher fibrinogen, FAR, and a lower albumin than those with low-value MS. MS was positively correlated with fibrinogen and FAR, and negatively correlated with albumin (for all, p < .001). Fibrinogen, albumin, and FAR were independent predictors of exaggerated MS. FAR was a more powerful predictor than fibrinogen (p < .001) and albumin (p = .02) in determining exaggerated MS. Conclusion Patients with exaggerated MS had a higher fibrinogen and FAR, and a lower albumin level than those without exaggerated MS. FAR may be a better predictor than fibrinogen and albumin for determining exaggerated MS