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=> "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Percentage of heart rate reserve (HRR) achieved at peak heart rate (HR) during cardiac rehabilitation at T1 (1st week), T2 (4th week) and T3 (8th week), according to HRR calculated at initial exercise testing (ET) (left) and final ET (right) for the total sample (solid line), subgroup 1 (dashed line) and subgroup 2 (dotted line). 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AUC: area under the curve; CRP: C-reactive protein.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ibrahim Rencuzogullari, Yavuz Karabağ, Metin Çağdaş, Süleyman Karakoyun, Sabri Seyis, Mustafa Ozan Gürsoy, Mahmut Yesin, İnanç Artaç, Doğan İliş, İbrahim Halil Tanboğa" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Ibrahim" "apellidos" => "Rencuzogullari" ] 1 => array:2 [ "nombre" => "Yavuz" "apellidos" => "Karabağ" ] 2 => array:2 [ "nombre" => "Metin" "apellidos" => "Çağdaş" ] 3 => array:2 [ "nombre" => "Süleyman" "apellidos" => "Karakoyun" ] 4 => array:2 [ "nombre" => "Sabri" "apellidos" => "Seyis" ] 5 => array:2 [ "nombre" => "Mustafa Ozan" "apellidos" => "Gürsoy" ] 6 => array:2 [ "nombre" => "Mahmut" "apellidos" => "Yesin" ] 7 => array:2 [ "nombre" => "İnanç" "apellidos" => "Artaç" ] 8 => array:2 [ "nombre" => "Doğan" "apellidos" => "İliş" ] 9 => array:2 [ "nombre" => "İbrahim Halil" "apellidos" => "Tanboğa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255117309782" "doi" => "10.1016/j.repc.2018.08.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117309782?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204919301126?idApp=UINPBA00004E" "url" => "/21742049/0000003800000004/v1_201906130915/S2174204919301126/v1_201906130915/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial comment</span>" "titulo" => "C-Rreactive protein/albumin ratio in the assessment of risk for in-stent restenosis: Another small piece in the puzzle of vascular inflammation" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "279" "paginaFinal" => "280" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luís Bronze" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Luís" "apellidos" => "Bronze" "email" => array:1 [ 0 => "luis.bronze@gmail.com" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Cardiologista, Marinha Portuguesa, Lisboa, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Linha de Saúde, Centro de Investigação Naval (Cinav), Marinha Portuguesa, Lisboa, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Professor Auxiliar, Mestrado Integrado de Medicina, Universidade da Beira Interior, Covilhã, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "A relação da proteína <span class="elsevierStyleSmallCaps">C</span>-reativa/albumina na avaliação do risco de reestenose de stent: mais uma pequena peça novasto puzzle da inflamação vascular" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The study presented by Rencuzogullari et al. in this issue of the <span class="elsevierStyleItalic">Journal</span><a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">1</span></a> is part of the large and important body of evidence on the role of inflammation in cardiovascular disease.<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">2–5</span></a> The authors aimed to investigate the ability of the ratio between serum levels of two important acute-phase proteins, C-reactive protein (CRP) and albumin, to predict in-stent restenosis. There is already an extensive literature on the association between CRP and cardiovascular risk,<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">6–8</span></a> but its ability to predict acute coronary syndromes is modest.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">9–11</span></a> A positive relationship between elevated serum CRP levels and in-stent restenosis, the clinical focus of the study under consideration, has also been established.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">12</span></a> At the same time, reduced serum concentrations of albumin have been related to increased cardiovascular risk.<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">13,14</span></a> Furthermore, the CRP/albumin ratio has been associated with worse prognosis in cancer<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">15</span></a> and can be used as a simple predictor of poor overall health.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">16</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">From a clinical standpoint, assessment of the combination of increased CRP and decreased albumin levels makes sense, seeing that these two molecules are involved in a range of complex and frequently interlinked processes ranging from inflammation to malnutrition, and so in theory the ratio between them should have considerable potential as a prognostic marker. However, Rencuzogullari et al. run a risk by attempting to associate this ratio with in-stent restenosis (a serious albeit uncommon complication of percutaneous revascularization<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">17</span></a>) since, like all indices of inflammatory markers used in cardiovascular assessment, it is non-specific.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The study is retrospective, reviewing around six years of data from a single institution. The population was of patients with ST-segment elevation myocardial infarction who underwent coronary angiography and percutaneous coronary intervention following standard indications. Of these, 448 who underwent repeat angiography due to recurrence of anginal symptoms were included in the study, of whom 25% (110/448) presented in-stent restenosis.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Unfortunately, the study did not use high-sensitivity CRP assays, which are firmly established in the literature as the gold standard for assessing vascular inflammation.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">18</span></a> The authors acknowledge that their use of an older test, which is less sensitive and more likely to be influenced by rises in CRP due to non-vascular causes, is a limitation to their study. Their results also include a wide range of laboratory results, from lipid profile to platelet count, as well as platelet distribution width, which is associated with myocardial infarction.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">19</span></a> The study thus has the characteristics of a general review of in-stent restenosis, even though drug-eluting stents, which were designed to be less prone to restenosis, were not used. This limitation was also pointed out by the authors.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The study concludes that the CRP/albumin ratio is a better predictor than CRP or albumin individually, at least in bare-metal stents. Overall, the work has merit, especially in the emphasis it places on the use of inflammatory parameters in clinical practice. However, despite recent successes in proof-of-concept trials,<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">20</span></a> and although inflammation has been the focus of much productive and challenging basic and clinical research over the last twenty years, there is still some way to go before all the accumulated evidence can be brought to bear on daily clinical practice.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">21</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">To conclude, despite its limitations, the paper under consideration adds another small piece to the puzzle in this challenging area in which research continues apace, even though its conclusions need to be confirmed by further studies.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The author has no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Bronze L. A relação da proteína <span class="elsevierStyleSmallCaps">C</span>-reativa/albumina na avaliação do risco de reestenose de stent: mais uma pequena peça no vasto puzzle da inflamação vascular. Rev Port Cardiol. 2019;38:279–280.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0110" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of the relationship between preporcedural C-reactive protein to albumin ratio and stent restenosis in patients with ST segment elevation myocardial infarction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "I. Rencuzogullari" 1 => "Y. Karabağ" 2 => "M. 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Year/Month | Html | Total | |
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2024 November | 9 | 4 | 13 |
2024 October | 42 | 33 | 75 |
2024 September | 48 | 22 | 70 |
2024 August | 47 | 35 | 82 |
2024 July | 30 | 28 | 58 |
2024 June | 26 | 22 | 48 |
2024 May | 26 | 22 | 48 |
2024 April | 41 | 29 | 70 |
2024 March | 29 | 26 | 55 |
2024 February | 24 | 17 | 41 |
2024 January | 36 | 32 | 68 |
2023 December | 23 | 37 | 60 |
2023 November | 38 | 33 | 71 |
2023 October | 26 | 16 | 42 |
2023 September | 42 | 32 | 74 |
2023 August | 35 | 14 | 49 |
2023 July | 27 | 12 | 39 |
2023 June | 24 | 19 | 43 |
2023 May | 47 | 26 | 73 |
2023 April | 23 | 11 | 34 |
2023 March | 56 | 25 | 81 |
2023 February | 36 | 13 | 49 |
2023 January | 17 | 20 | 37 |
2022 December | 43 | 27 | 70 |
2022 November | 37 | 33 | 70 |
2022 October | 44 | 23 | 67 |
2022 September | 31 | 43 | 74 |
2022 August | 19 | 25 | 44 |
2022 July | 27 | 43 | 70 |
2022 June | 30 | 29 | 59 |
2022 May | 25 | 35 | 60 |
2022 April | 37 | 37 | 74 |
2022 March | 24 | 48 | 72 |
2022 February | 19 | 35 | 54 |
2022 January | 35 | 33 | 68 |
2021 December | 22 | 29 | 51 |
2021 November | 24 | 34 | 58 |
2021 October | 34 | 39 | 73 |
2021 September | 14 | 21 | 35 |
2021 August | 23 | 28 | 51 |
2021 July | 10 | 19 | 29 |
2021 June | 20 | 14 | 34 |
2021 May | 38 | 34 | 72 |
2021 April | 50 | 25 | 75 |
2021 March | 42 | 25 | 67 |
2021 February | 35 | 8 | 43 |
2021 January | 29 | 19 | 48 |
2020 December | 24 | 3 | 27 |
2020 November | 18 | 13 | 31 |
2020 October | 25 | 21 | 46 |
2020 September | 22 | 15 | 37 |
2020 August | 16 | 12 | 28 |
2020 July | 35 | 9 | 44 |
2020 June | 13 | 15 | 28 |
2020 May | 13 | 11 | 24 |
2020 April | 30 | 14 | 44 |
2020 March | 24 | 13 | 37 |
2020 February | 47 | 32 | 79 |
2020 January | 29 | 5 | 34 |
2019 December | 17 | 10 | 27 |
2019 November | 26 | 7 | 33 |
2019 October | 16 | 6 | 22 |
2019 September | 17 | 8 | 25 |
2019 August | 22 | 10 | 32 |
2019 July | 21 | 12 | 33 |
2019 June | 43 | 29 | 72 |
2019 May | 5 | 4 | 9 |