Uric acid-to-albumin ratio × monocyte-to-lymphocyte ratio is a novel biomarker for predicting all-cause mortality and cardiovascular mortality in patients with ST-segment elevation myocardial infarction.
Hong Wei, Yanji Zhou, Yu Wang, Dan Xu, Yunhong Yang, Tao Shi, Sirui Yang, Xinuo Ma, Lixing Chen
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引用次数: 0
Abstract
Background: Uric acid-to-albumin ratio (UAR) and monocyte-to-lymphocyte ratio (MLR) predict adverse outcomes in cardiovascular disease (CVD). We aim to explore the predictive value of UAR combined with MLR for all-cause and cardiovascular mortality in patients with ST-segment elevation myocardial infarction (STEMI).
Methods: This retrospective cohort study included 1045 patients with STEMI who had undergone emergency percutaneous coronary intervention (PCI) (2018-2023). Uric acid-to-albumin ratio × monocyte-to-lymphocyte ratio (UAML) was defined as the product of UAR and MLR. Mortality prediction was evaluated via Kaplan-Meier, Cox regression, and time-dependent receiver operating characteristic (ROC) analyses.
Results: Stratifying 1045 patients with STEMI by median UAML (3.35) revealed significantly higher cumulative all-cause mortality (log-rank χ2 =41.114, P < 0.001) and cardiovascular mortality (χ2 = 32.153, P < 0.001) in the high-UAML (≥3.35) vs. low-UAML (<3.35) group. Multivariate Cox analysis confirmed UAML as an independent predictor of all-cause mortality [hazard ratio (HR) = 2.217, 95% confidence interval (CI): 1.399-3.514; P < 0.001] and cardiovascular mortality (HR = 2.160, 95% CI: 1.267-3.618; P = 0.005). Time-dependent ROC demonstrated superior predictive discrimination for UAML over individual components in both all-cause mortality [area under the ROC curve (AUC) = 0.704 vs. UAR = 0.686/MLR = 0.627] and cardiovascular mortality (AUC = 0.700 vs. 0.690/0.615).
Conclusion: UAML may serve as a strong prognostic factor for all-cause and cardiovascular mortality in patients with STEMI who undergo emergency PCI, and UAML has a stronger predictive value than UAR or MLR.
期刊介绍：
Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management.
Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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