Abstract:

The Role of Uric Acid to HDL Cholesterol Ratio in Predicting Myocardial Ischemia in Myocardial Perfusion Scintigraphy in Diabetic Patients Abstract Objective: Diabetes Mellitus (DM) is a significant risk factor for cardiovascular diseases, particularly myocardial ischemia. Both diabetes mellitus type 2 and cardiovascular conditions are characterized by a high burden of inflammation. The uric Acid to High-Density Lipoprotein cholesterol ratio (UHR) has been suggested as a novel marker of metabolic and inflammatory diseases. Hence, this study investigated the predictive role of the Uric Acid to High-Density Lipoprotein cholesterol ratio (UHR) in myocardial ischemia detected by Myocardial Perfusion Scintigraphy (MPS) in diabetic patients. Materials and Methods: This study included patients who underwent MPS between January 2022 and March 2023 at the Nuclear Medicine Department of Abant Izzet Baysal University Hospital. Based on the MPS results, the participants were divided into normal perfusion and myocardial ischemia. Variables such as age, sex, leukocyte count, hemoglobin, hematocrit, platelet count, serum uric acid, urea, creatinine, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglyceride, transaminase, blood fasting glucose, C-reactive protein, and serum albumin were recorded and compared between the groups. Results: Among the 73 diabetic patients, 37 had myocardial ischemia, and 36 had normal MPS. Serum uric acid levels were higher in the ischemic group (6.3 ± 1.5 mg/dL) than in the normal group (5.1 ± 1.8 mg/dL) (p<0.05). The UHR in the ischemic group was significantly higher (0.15 ± 0.05) than that in the normal MPS group (0.11 ± 0.04). Serum UHR was significantly positively correlated with myocardial ischemia (r=0.36, p=0.002) )(p<0.05). With a cut-off value of ≥ 0.11, UHR exhibited 76% sensitivity and 58% specificity in detecting myocardial ischemia (p<0.05). Conclusions: High UHR is an independent predictor and diagnostic tool for myocardial ischemia in patients with diabetes and coronary artery disease. Routine use of UHR as an independent predictive marker is recommended for diabetic patients with myocardial ischemia who undergo MPS.