RESUMEN
Aim This study evaluated the prognostic ability of the APACHE II score and compared it with inflammatory indices in patients with acute coronary syndrome (ACS).Material and Methods A total of 525 patients with ACS were retrospectively enrolled in the study. APACHE II scores were calculated and C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammatory index (SII) were recorded. The APACHE II score was compared with inflammatory indices for predicting in-hospital mortality.Results Univariate logistic regression (LR) analysis showed that CRP, SII, NLR, ejection fraction, chronic kidney disease, gender, and APACHE II score were significant predictors of mortality. In multiple LR analysis, the APACHE II score was found to be a solitary, significant predictor of in-hospital mortality (OR: 1.201, 95â% CI: 1.122-1.285; p<0.001). In the Receiver Operating Characteristics curve, using a cut-off point of 16.5, the APACHE II score predicted in-hospital mortality with 70.4â% sensitivity and 92.9â% specificity.Conclusion The APACHE II score may be used as a predictor of in-hospital mortality better than inflammatory markers in ACS patients.
Asunto(s)
Síndrome Coronario Agudo , Proteína C-Reactiva , APACHE , Síndrome Coronario Agudo/diagnóstico , Mortalidad Hospitalaria , Humanos , Pronóstico , Curva ROC , Estudios RetrospectivosAsunto(s)
Adenocarcinoma , Quimioradioterapia , Neoplasias Cardíacas , Neoplasias Pulmonares , Neoplasias Primarias Secundarias , Venas Pulmonares/patología , Adenocarcinoma/patología , Adenocarcinoma/terapia , Anciano , Atrios Cardíacos/patología , Neoplasias Cardíacas/patología , Neoplasias Cardíacas/terapia , Humanos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/terapia , Masculino , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/terapiaRESUMEN
Systemic amyloid light-chain (AL) amyloidosis is caused by deposition of immunoglobulin light-chain proteins. AL amyloidosis is a rapidly progressive disease that affects multiple organs. Cardiac involvement is frequent (50%) and the median survival is 5 months following diagnosis. Although transthoracic echocardiography can show characteristics findings, further diagnostic modalities are required for diagnosis. The gold standard of the diagnosis is presence of the amyloid in a tissue biopsy specimen. We present here a case of AL amyloidosis with presenting rapid progressive heart failure. Despite improvements in diagnostic and therapeutic modalities, diagnosis is difficult and prognosis is still poor in patients with cardiac involvement as in the present case.