Abstract
ObjectiveTo investigate the correlation between ischemia-modified albumin (IMA) levels and coronary collateral circulation (CCC) in patients with chronic total occlusive (CTO).MethodsCoronary angiography was performed in the Department of Cardiology, Zhongnan Hospital of Wuhan University from 2017 to 08 to 2019–02 to identify 128 patients with CTO lesions in at least one major coronary artery. According to the Rentrop evaluation criteria, the degree of CCC formation was divided into the poor CCC formation group (Rentrop0–1 grade,n = 69) and the good CCC formation group (Rentrop2–3 grade,n = 59). The IMA level of the patients was measured using an albumin-cobalt binding assay. The general data, routine blood panel, total bilirubin (TBIL), blood lipids, uric acid (UA), left ventricular ejection fraction (LVEF) and other indicators of the patients were recorded and analyzed while assessing the patients’ blood vessel occlusion.ResultsThe proportion of platelet count and diabetes in the poor CCC group was higher than that in the good CCC group (P < 0.05). The ratio of ischemia-modified albumin and total bilirubin in the poor CCC group was lower than that in the good CCC group (P < 0.05). Multivariate logistic regression analysis showed that ischemia-modified albumin was positively correlated with CCC formation [OR = 1.190,95% CI (1.092–1.297),P < 0.001], while diabetes was negatively correlated with CCC formation [OR = 0.285,95% CI (0.094–0.864), P < 0.05]. Ischemic modified albumin predicted good formation of CCC according to the ROC curve, and the area under the ROC curve was 0.769(95% CI,0.686–0.851, P<0.001); the optimal cut-off value was 63.35 KU/L, and the sensitivity was 71.2%,specificity is 71%.ConclusionThe IMA level is closely related to good formation of CCC. Higher IMA levels can be used as an effective predictor of good CCC formation in patients with CTO.
Highlights
Chronic total occlusion (CTO) is defined as the presence of Thrombolysis in myocardial infarction (TIMI) 0 flow within an occluded arterial segment for more than 3 months [1]
Inclusion criteria: According to the CTO diagnostic criteria of the American College of Cardiology Foundation (ACCF)/American Heart Association (AHA)/the Society for Cardiovascular Angiography and Interventions (SCAI) CTO in 2013 [10]:CTO was diagnosed on the basis of atherosclerotic lesions when the main coronary artery has at least one stenosis (> 90%) due to thrombosis and repeated organization and the course of the disease is more than 3 months
Multivariate logistic regression analysis With the formation of collateral circulation (CCC) as the dependent variable and the factors with P < 0.1 in the univariate analysis as the independent variables, multivariate logistic regression analysis showed that diabetes was negatively correlated with CCC [OR = 0.285 95% CI (0.094–0.864) P < 0.05] and Ischemia-modified albumin (IMA) was positively correlated with CCC [OR = 1.190 95% CI (1.092–1.297) P < 0.001]
Summary
Chronic total occlusion (CTO) is defined as the presence of TIMI 0 flow within an occluded arterial segment for more than 3 months [1]. Coronary collateral circulation (CCC) is a small blood flow channel between different coronary arteries or different segments of the same. In CTO percutaneous coronary intervention (PCI), the collateral vessels allow visualization of the distal coronary bed beyond the occlusive segment and provide retrograde access to the occluded vessel to facilitate recanalization [5]. Compared with other myocardial injury biochemicals in patients with acute coronary syndrome, Markers can be detected earlier and with higher sensitivity [8, 9]. IMA levels increase during myocardial ischemiareperfusion injury, which is associated with oxidative stress induced by cardiac and extracardiac events
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