背景:尿酸/白蛋白比值(UAR)是一种新型的复合生物标志物,对心血管疾病具有优异的预测价值。
目的:探讨非ST段抬高型心肌梗死(NSTEMI)患者UAR与冠状动脉侧支循环(CCC)的关系。
方法:总共205例NSTEMI患者接受了冠状动脉造影,至少有一个主要的冠状动脉狭窄,95%都包括在内。根据CCC的发展将患者分为两组:发育不良的CCC组(Rentrop0-1)和发育良好的CCC组(Rentrop2-3)。采用单因素分析和logistic回归分析探讨NSTEMI患者不良CCC形成的影响因素。绘制受试者工作特征(ROC)曲线以评估UAR的预测值,C反应蛋白(CRP),尿酸,和白蛋白的患者有不发达的CCC,并比较曲线下面积(AUC)。
结果:NSTEMI患者的UAR值在发展不良的CCC组中明显高于发展良好的CCC组(10.19[8.80-11.74]vs.7.79[6.28-9.55],p<.001)。在多元逻辑回归检验中,UAR(优势比[OR]:1.365,95%置信区间[CI]:1.195-1.560,p<.001),CRP(OR:1.149,95%CI:1.072-1.231,p<.001),和糖尿病(OR:2.924,95%CI:1.444-5.920,p=.003)是发展不良的CCC的独立预测因子。ROC曲线分析表明,UAR预测低发展CCC的最佳临界值为8.78,灵敏度为76.8%,特异性为62.4%。AUC为0.737(95%Cl:0.668-0.805,p<.001)。
结论:UAR升高可能是预测NSTEMI患者发展不良的独立且有效的生物标志物。
BACKGROUND: Uric acid/albumin ratio (UAR) is a novel composite biomarker with superior predictive value for cardiovascular disease.
OBJECTIVE: To investigate the relationship between UAR and coronary collateral circulation (CCC) in patients with non-ST segment elevation myocardial infarction (NSTEMI).
METHODS: A total of 205 NSTEMI patients who underwent coronary arteriography with at least one major coronary stenosis, 95% were included. Patients were divided into two groups according to CCC development: poorly-developed CCC group (Rentrop 0-1) and well-developed CCC (Rentrop 2-3). Univariate analysis and logistic regression analysis were utilized to investigate the factors influencing adverse CCC formation in NSTEMI patients. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of UAR, C-reactive protein (CRP), uric acid, and albumin for patients with poorly developed CCC, and the area under the curve (AUC) was compared.
RESULTS: The UAR values of NSTEMI patients were significantly higher in the poorly developed CCC group than those in the well-developed CCC group (10.19 [8.80-11.74] vs. 7.79 [6.28-9.55], p < .001). In the multiple logistic regression tests, UAR (odds ratio [OR]: 1.365, 95% confidence interval [CI]: 1.195-1.560, p < .001), CRP (OR: 1.149, 95% CI: 1.072-1.231, p < .001), and diabetes (OR: 2.924, 95% CI: 1.444-5.920, p = .003) were independent predictors of poorly developed CCC. The ROC curve analysis showed that the optimal cut-off value of UAR was 8.78 in predicting poorly developed CCC with a sensitivity of 76.8% and specificity of 62.4%, with the AUC of 0.737 (95% Cl: 0.668-0.805, p < .001).
CONCLUSIONS: Elevated UAR may be an independent and effective biomarker for predicting poorly-developed CCC development in NSTEMI patients.