.: ORİJİNAL ARAŞTIRMA
The Relationship Between HbA1c/C-Peptide Ratio and Ischemic Event in a Patient with Atrial Fibrillation: Retrospective Study
Atriyal Fibrilasyonu Olan Hastalarda HbA1c/C-Peptid Oranı ile İskemik Olaylar Arasındaki İlişki: Retrospektif Çalışma
Turkiye Klinikleri J Cardiovasc Sci. 2024;36(2):39-46
doi: 10.5336/cardiosci.2024-104964
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Atrial fibrillation (AF) is a complex disease with irregular ventricular response and tachycardia as a result of irregular and rapid contraction of the atria. Many life-threatening ischemic events occur in AF. The aim of our study is to evaluate the HbA1c/C-peptide ratio (HCR) in AF patients with ischemic events. Material and Methods: The study was done retrospectively, and a total of 1,525 patients who were admitted to the cardiology outpatient clinic were recruited. The study's patient group with ischemic events consisted of 372 patients, and the group without ischemic events consisted of 853 patients. HCR was evaluated by dividing the patients into two groups. Results: It was observed that the HCR (3.41±1.18 vs 2.15±1.01, p<0.001) was statistically significantly higher in the group with an ischemic event compared to the group without an ischemic event. In the ROC analysis, the cut-off value of the HCR score in the group with an ischemic event was found to be 79% sensitivity and 81% specificity. It was determined as 2.82 (AUC=0.821, CI95=0.682- 0.889, p<001). In multivariate logistic regression analysis, HCR were identified as potential independent predictors of experiencing an ischemic event. Conclusion: In our study, the HCR was found to be higher in patients who developed ischemic events, and in statistical analysis, it was found to be an independent determinant of ischemic events in AF patients. Our study is the first to evaluate this situation. Therefore, the HCR may be an important parameter that should be used in the follow-up of AF patients experiencing ischemic events.
Keywords: Atrial fibrillation; HbA1c; C-peptide; HbA1c/C-peptide ratio; ischemic event
Objective: Atrial fibrillation (AF) is a complex disease with irregular ventricular response and tachycardia as a result of irregular and rapid contraction of the atria. Many life-threatening ischemic events occur in AF. The aim of our study is to evaluate the HbA1c/C-peptide ratio (HCR) in AF patients with ischemic events. Material and Methods: The study was done retrospectively, and a total of 1,525 patients who were admitted to the cardiology outpatient clinic were recruited. The study's patient group with ischemic events consisted of 372 patients, and the group without ischemic events consisted of 853 patients. HCR was evaluated by dividing the patients into two groups. Results: It was observed that the HCR (3.41±1.18 vs 2.15±1.01, p<0.001) was statistically significantly higher in the group with an ischemic event compared to the group without an ischemic event. In the ROC analysis, the cut-off value of the HCR score in the group with an ischemic event was found to be 79% sensitivity and 81% specificity. It was determined as 2.82 (AUC=0.821, CI95=0.682- 0.889, p<001). In multivariate logistic regression analysis, HCR were identified as potential independent predictors of experiencing an ischemic event. Conclusion: In our study, the HCR was found to be higher in patients who developed ischemic events, and in statistical analysis, it was found to be an independent determinant of ischemic events in AF patients. Our study is the first to evaluate this situation. Therefore, the HCR may be an important parameter that should be used in the follow-up of AF patients experiencing ischemic events.
Keywords: Atrial fibrillation; HbA1c; C-peptide; HbA1c/C-peptide ratio; ischemic event
ÖZET
Amaç: Atriyal fibrilasyon (AF), atriyumların düzensiz ve hızlı kasılması sonucu düzensiz ventriküler yanıt ve taşikardi ile karakterize karmaşık bir hastalıktır. AF'de yaşamı tehdit eden birçok iskemik olay meydana gelir. Çalışmamızın amacı, iskemik olay yaşayan AF hastalarında HbA1c/C-peptid oranını (HCR) değerlendirmektir. Gereç ve Yöntemler: Çalışma retrospektif olarak yapılmış olup, kardiyoloji polikliniğine başvuran toplam 1.525 hasta çalışmaya dâhil edilmiştir. Çalışmanın iskemik olay yaşayan hasta grubu 372 hastadan, iskemik olay yaşamayan grup ise 853 hastadan oluşmuştur. HCR, hastalar iki gruba ayrılarak değerlendirilmiştir. Bulgular: İskemik olay yaşayan grupta HCR'nin (3,41±1,18'e karşı 2,15±1,01, p<0,001) iskemik olay yaşamayan gruba göre istatistiksel olarak anlamlı derecede daha yüksek olduğu gözlendi. ROC analizinde iskemik olay yaşayan grupta HCR skorunun kesme değeri 2,82 (AUC=0,821, CI95=0,682-0,889, p<0,001), ve %79 duyarlılık ve %81 özgüllük olarak saptandı. Çok değişkenli lojistik regresyon analizinde HCR, iskemik olay yaşamanın potansiyel bağımsız öngördürücüsü olarak tanımlandı. Sonuç: Çalışmamızda iskemik olay yaşayan hastalarda HCR'nin daha yüksek olduğu ve istatistiksel analizde AF hastalarında iskemik olayların bağımsız bir belirleyicisi olduğu bulundu. Çalışmamız bu durumu değerlendiren ilk çalışmadır. Bu nedenle, HCR iskemik olaylar yaşayan AF hastalarının takibinde kullanılması gereken önemli bir parametre olabilir.
Anahtar Kelimeler: Atriyal fibrilasyon; HbA1c; C-peptid; HbA1c/C-peptid oranı; iskemik olay
Amaç: Atriyal fibrilasyon (AF), atriyumların düzensiz ve hızlı kasılması sonucu düzensiz ventriküler yanıt ve taşikardi ile karakterize karmaşık bir hastalıktır. AF'de yaşamı tehdit eden birçok iskemik olay meydana gelir. Çalışmamızın amacı, iskemik olay yaşayan AF hastalarında HbA1c/C-peptid oranını (HCR) değerlendirmektir. Gereç ve Yöntemler: Çalışma retrospektif olarak yapılmış olup, kardiyoloji polikliniğine başvuran toplam 1.525 hasta çalışmaya dâhil edilmiştir. Çalışmanın iskemik olay yaşayan hasta grubu 372 hastadan, iskemik olay yaşamayan grup ise 853 hastadan oluşmuştur. HCR, hastalar iki gruba ayrılarak değerlendirilmiştir. Bulgular: İskemik olay yaşayan grupta HCR'nin (3,41±1,18'e karşı 2,15±1,01, p<0,001) iskemik olay yaşamayan gruba göre istatistiksel olarak anlamlı derecede daha yüksek olduğu gözlendi. ROC analizinde iskemik olay yaşayan grupta HCR skorunun kesme değeri 2,82 (AUC=0,821, CI95=0,682-0,889, p<0,001), ve %79 duyarlılık ve %81 özgüllük olarak saptandı. Çok değişkenli lojistik regresyon analizinde HCR, iskemik olay yaşamanın potansiyel bağımsız öngördürücüsü olarak tanımlandı. Sonuç: Çalışmamızda iskemik olay yaşayan hastalarda HCR'nin daha yüksek olduğu ve istatistiksel analizde AF hastalarında iskemik olayların bağımsız bir belirleyicisi olduğu bulundu. Çalışmamız bu durumu değerlendiren ilk çalışmadır. Bu nedenle, HCR iskemik olaylar yaşayan AF hastalarının takibinde kullanılması gereken önemli bir parametre olabilir.
Anahtar Kelimeler: Atriyal fibrilasyon; HbA1c; C-peptid; HbA1c/C-peptid oranı; iskemik olay
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