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    Comparison of Zwolle, Cadillac and Syntax-2 risk scores in predicting contrast nephropathy development in patients with ST elevation
    (2019) Kalkan, Kamuran
    Aim: It is known that early prediction of the patients who may develop contrast-induced is nephropathy (CIN) and initiate prophylactic treatment to reduce the risk of morbidity-mortality, hospitalization and prolonged length of stay. In our study, we aimed to compare the Zwolle, Cadillac and Syntax 2 (SS-2) risk scores that are currently used in the management of and predict mortality in patients with ST elevation myocardial infarction (STEMI) in terms of predicting CIN development.Material and Methods: We enrolled 1622 patients who were diagnosed as STEMI and underwent primary coronary angiography between July 2014 and December 2018. 1381 patients were taken to the final analysis and two groups; CIN - (n=1295) and CIN + (n=86) were formed. Risk scores were compared in terms of CIN prediction.Results: The mean age of the patients was 62±8 years and 72% of them were males. SS-2, Zwolle and Cadillac scores were significantly higher in CIN+ group (all p values 0.001). A comparative ROC curve analysis was performed for the estimation and clinical use of CIN. In the ROC curve analysis, the cut-off value for SS-2 was 16.7 (AUC:0.82) with a sensitivity of 80.1% and a specificity of 58%. The cut-off value for Cadillac was 1.5 (AUC:0.80), 78% sensitivity and 58% specificity. For Zwolle, the cut-off value was 2.5 (AUC:0.75) and the sensitivity was 73% and the specificity was 69%.Conclusions: CIN, which develops after coronary angiography in STEMI patients, causes an increase in morbidity and mortality. The risk scores used in STEMI patients, in particular SS-2, may be more useful in predicting the development of CIN than in the Zwolle and Cadillac scores.Keywords: Zwolle; Cadillac; Syntax 2 score; contrast induced nephropathy.
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    Predictive value of CRP/albumin ratio for in-hospital atrial fibrillation development in ST segment elevation myocardial infarctionPredictive value of CRP/albumin ratio for in-hospital atrial fibrillation development in ST segment elevation myocardial infarction
    (2019) Kalkan, Kamuran
    Aim: Atrial fibrillation(AF) development in ST elevation myocardial infarction (STEMI) patients is associated with increased cardiovascular mortality and morbidity. The CRP to Albumin ratio(CAR) is a new described parameter and it has been suggested that this parameter may also be correlated with cardiovascular diseases. In this study, we investigated the association between AF development and the CAR in STEMI patients undergoing percutaneous coronary intervention. Material and Methods: This study was conducted in patients presenting to our department with a diagnosis of STEMI retrospectively and undergoing percutaneous coronary intervention. A total of 110 patients were included in the study. The patients were divided into two groups according to AF development and the predictors for AF development were investigated. Results: The mean age of the patients was 62±5.1 years and 72% of them were males. While CAR, TIMI, CRP, albumin, neutrophil to lymphocyte to ratio, lesion localization, myocardial blush grade and syntax score were associated with the AF development in the univariate analysis, the CAR was determined to be an independent predictor of AF development in the multivariate regression analysis. Conclusions: We have demonstrated that the CAR was an independent predictor for prediction of AF development and we think that this parameter may be useful in clinical practice.