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The association of serum albumin with coronary slow flow

Zusammenhang zwischen Serum Albumin und langsamem Koronorarfluss

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Summary

Background

A number of inflammatory markers such as high-sensitivity C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and fibrinogen have been shown to be associated with coronary slow flow (CSF). Our aim was to investigate the relationship between albumin, a long-acting negative acute-phase protein, and CSF.

Methods

A total of 106 patients with angiographically proven slow coronary flow and 57 control subjects with normal coronary flow were included in the study. Serum levels of Hs-CRP and albumin were measured. CSF was defined by Thrombolysis In Myocardial Infarction (TIMI) frame count (TFC) method.

Results

Serum albumin (s-albumin) was significantly lower in the CSF group (3.79 ± 0.3 vs 4.17 ± 0.3, p < 0.001), whereas Hs-CRP level was significantly higher in the CSF group compared with the controls (1.22 ± 0.79 vs 0.76 ± 0.44, p < 0.001). S-albumin and Hs-CRP were correlated with the mean TFC in the whole study population (r= − 0.574, p < 0.001; r = 0.376, p < 0.001, respectively). Hs-CRP and low s-albumin were found to be significant predictors of CSF in the multivariate analysis. The comparison of receiver-operating characteristics curves for s-albumin and Hs-CRP demonstrated that s-albumin was the strongest predictor of CSF.

Conclusions

We found that s-albumin levels decreased and Hs-CRP levels increased in patients with CSF. S-albumin was also found to have superior predictive value than Hs-CRP for diagnosing CSF. S-albumin, an inexpensive and easily measurable laboratory variable, may be a useful predictor of CSF, especially when other reasons which alter its serum levels were excluded.

Zusammenfassung

Grundlagen

Von mehreren Entzündungsmarkern, wie hochsensitivem C-reaktiven Protein (hs-CRP), Interleukin-6 (IL-6) und Fibrinogen konnte gezeigt werden, dass sie mit langsamem koronarem Durchfluss („coronary slow flow“, CSF) vergesellschaftet sind. Ziel unserer Studie war es, zu prüfen, ob ein Zusammenhang zwischen Albumin, einem lang-wirksamen negativen Akutphasenprotein und CSF besteht.

Methodik

Insgesamt wurden 106 Patienten mit angiographisch nachgewiesenem CSF und 57 Kontrollen mit normalem Koronarfluss in die Studie aufgenommen. Die Serumkonzentrationen von hs-CRP und Albumin wurden gemessen. CSF wurde durch die TIMI (Thrombolysis In Myocardial Infarction) Frame Count (TFC) Methode erhoben.

Ergebnisse

Das Serum Albumin war in der Gruppe mit CSF im Vergleich zur Kontrolle signifikant erniedrigt (3,79 ± 0,3 vs 4,17 ± 0,3, p < 0,001) – die hs-CRP Konzentrationen dahingegen signifikant erhöht (1,22 ± 0,79 vs 0,76 ± 0,44, p < 0,001). Serum Albumin und hs-CRP waren in der Gesamtpopulation mit dem mittleren TFC korrelieret (r= − 0,574, p < 0,001; r = 0,376, p < 0,001, respektive). In der Multivarianzanalyse zeigte sich, dass hs-CRP und niedriges Serum Albumin signifikante Prädiktoren eines CSF sind. Der Vergleich der ROC Analysen für hs CRP und Serum Albumin ergab, dass das Serum Albumin der stärkste Prädiktor eines CSF war.

Schlussfolgerungen

Bei unseren Patienten mit CSF waren die Serum Albumin-Konzentrationen erniedrigt und die hs-CRP Werte erhöht. Das Serum Albumin war in unseren Händen der bessere Prädiktor als das hs-CRP für einen CSF. Serum Albumin ist ein billiger und leicht messbarer Laborparameter, der – nach Ausschluss anderer Albumin beeinflussender Faktoren - ein nützlicher Prädiktor für einen CSF sein kann.

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Conflict of interest

All authors declared that there is no conflict of interest.

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Authors and Affiliations

  1. School of Medicine, Department of Cardiology, Adiyaman University, Kahta Street, 02000, Adiyaman, Turkey

    Mustafa Cetin MD, Hakan Tasolar MD, Mehmet Balli MD & Erdal Akturk MD

  2. School of Medicine, Department of Cardiology, Adnan Menderes University, Aydin, Turkey

    Cemil Zencir MD

  3. Department of Cardiology, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey

    Erkan Baysal MD

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  1. Mustafa Cetin MD
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  2. Cemil Zencir MD
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  3. Hakan Tasolar MD
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Correspondence to Mustafa Cetin MD.

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Cetin, M., Zencir, C., Tasolar, H. et al. The association of serum albumin with coronary slow flow. Wien Klin Wochenschr 126, 468–473 (2014). https://doi.org/10.1007/s00508-014-0559-8

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