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Journals / Anatolian Journal of Emergency Medicine / 2026 / Cilt: 9 Sayı: 2

Prognostic Value of Laboratory Biomarkers and Risk Scores in STEMI Patients Presenting to the Emergency Department Undergoing Manual Thrombus Aspiration

Acil Servise Başvuran ve Manuel Trombüs Aspirasyonu Uygulanan STEMİ Hastalarında Laboratuvar Biyobelirteçleri ve Risk Skorlarının Prognostik Değeri

Recep Sami Özay(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0009-0005-2067-7064
Melih Yüksel(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0000-0002-0793-3693
Barış Şensoy(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiology)0000-0003-0066-9946
Mehmet Oğuzhan Ay(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0000-0003-1061-5327
Yeşim İşler(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0000-0002-6389-5361
Halil Kaya(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0000-0003-2005-6100
Umut Ocak(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0000-0002-6549-4246
Abdurrahman Sadullah Akyıldız(University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Emergency Medicine)0009-0005-0388-4694
Pages
91–98
Publication Date
2026-06-28
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings suggest that BAR, a simple and rapidly available laboratory parameter, may assist emergency physicians in early risk stratification of high-risk STEMI patients, whereas traditional risk scores showed limited utility for predicting short-term non-fatal outcomes.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: Early risk stratification in the emergency department (ED) is critical for patients presenting with ST-elevation myocardial infarction (STEMI).
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Key Findings & Data:This study aimed to evaluate the prognostic performance of commonly used clinical risk scores (TREWS, REMS, TIMI, and C-ACS) and readily available laboratory ratios, including the D-dimer/Albumin ratio (DAR) and Blood Urea Nitrogen/Albumin ratio (BAR), for short-term outcomes in STEMI patients presenting to the ED who subsequently underwent manual thrombus aspiration (MTA) during percutaneous coronary intervention (PCI).
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Conclusion & Impact:These findings suggest that BAR, a simple and rapidly available laboratory parameter, may assist emergency physicians in early risk stratification of high-risk STEMI patients, whereas traditional risk scores showed limited utility for predicting short-term non-fatal outcomes.
🔬Design:Araştırma Makalesi
📍Scope:2023 Verileri
⚙️Variables:ST-elevasyonlu miyokard enfarktüsü · acil servis · manuel trombüs aspirasyonu

Abstract

Aim: Early risk stratification in the emergency department (ED) is critical for patients presenting with ST-elevation myocardial infarction (STEMI). This study aimed to evaluate the prognostic performance of commonly used clinical risk scores (TREWS, REMS, TIMI, and C-ACS) and readily available laboratory ratios, including the D-dimer/Albumin ratio (DAR) and Blood Urea Nitrogen/Albumin ratio (BAR), for short-term outcomes in STEMI patients presenting to the ED who subsequently underwent manual thrombus aspiration (MTA) during percutaneous coronary intervention (PCI). Material and Methods: This prospective, single-center study included consecutive STEMI patients presenting to the ED between February 2023 and January 2024. Patients who underwent MTA during PCI were analyzed. The ability of clinical scores and laboratory ratios obtained during the initial ED evaluation to predict 28-day all-cause mortality, recurrent acute coronary syndrome (ACS), and stroke was assessed using receiver operating characteristic (ROC) curve analysis. Results: Among 363 STEMI patients, 30 (8.3%) underwent MTA. MTA was more frequently performed in patients with anterolateral and posterolateral STEMI. Significant differences were observed in age, REMS, and C-ACS scores between patients who did and did not undergo MTA. The TIMI score differed significantly across STEMI localization subgroups. BAR demonstrated excellent prognostic performance for 28-day mortality (AUC = 0.889; 95% CI: 0.766–1.000; p < 0.05). None of the evaluated scores or laboratory ratios reliably predicted recurrent ACS or stroke. Conclusion: Among the evaluated laboratory biomarkers and clinical scores, BAR demonstrated the highest prognostic performance for predicting 28-day mortality in STEMI patients undergoing MTA. These findings suggest that BAR, a simple and rapidly available laboratory parameter, may assist emergency physicians in early risk stratification of high-risk STEMI patients, whereas traditional risk scores showed limited utility for predicting short-term non-fatal outcomes.

Özet

Amaç: Acil serviste (AS) erken risk sınıflaması, ST-elevasyonlu miyokard enfarktüsü (STEMİ) ile başvuran hastalar için kritik öneme sahiptir. Bu çalışmada, acil servise başvuran ve perkütan koroner girişim (PKG) sırasında manuel trombüs aspirasyonu (MTA) uygulanan STEMİ hastalarında, sık kullanılan klinik risk skorlarının (TREWS, REMS, TİMİ ve C-ACS) yanı sıra D-dimer/albümin oranı (DAO) ve kan üre nitrojeni/albümin oranı (BAO) gibi kolay ulaşılabilir laboratuvar oranlarının kısa dönem sonuçları öngörmedeki prognostik performansının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu prospektif, tek merkezli çalışmaya Şubat 2023 – Ocak 2024 tarihleri arasında acil servise STEMI tanısı ile başvuran ardışık hastalar dahil edildi. PKG sırasında MTA uygulanan hastalar analiz edildi. İlk acil servis değerlendirmesinde elde edilen klinik risk skorları ve laboratuvar oranlarının 28 günlük tüm nedenlere bağlı mortalite, tekrarlayan akut koroner sendrom (AKS) ve inme gelişimini öngörme yetenekleri, alıcı işletim karakteristiği (ROC) eğrisi analizi ile değerlendirildi. Bulgular: Toplam 363 STEMİ hastasının 30’unda (%8,3) MTA uygulandı. MTA, anterolateral ve posterolateral STEMİ hastalarında daha sık gerçekleştirildi. MTA uygulanan ve uygulanmayan hastalar arasında yaş, REMS ve C-ACS skorları açısından anlamlı farklar saptandı. TİMİ skoru, STEMİ lokalizasyon alt grupları arasında anlamlı farklılık gösterdi. BAO, 28 günlük mortaliteyi öngörmede mükemmel prognostik performans sergiledi (AUC = 0,889; %95 GA: 0,766–1,000; p < 0,05). İncelenen skorların ve laboratuvar oranlarının hiçbiri tekrarlayan AKS veya inmeyi güvenilir şekilde öngöremedi. Sonuç: Değerlendirilen laboratuvar biyobelirteçleri ve klinik skorlar arasında, BAR, MTA uygulanan STEMI hastalarında 28 günlük mortaliteyi öngörmede en yüksek prognostik performansı göstermiştir. Basit ve hızlı bir şekilde elde edilebilen bir laboratuvar parametresi olan BAO, yüksek riskli STEMI hastalarının erken risk sınıflamasında acil servis hekimlerine yardımcı olabilirken, geleneksel risk skorlarının kısa dönem fatal olmayan sonuçları öngörmedeki değeri sınırlı bulunmuştur.

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Cite This Article

Özay, R. S., Yüksel, M., Şensoy, B., Ay, M. O., İşler, Y., Kaya, H., Ocak, U., Akyıldız, A. S. (2026). Prognostic Value of Laboratory Biomarkers and Risk Scores in STEMI Patients Presenting to the Emergency Department Undergoing Manual Thrombus Aspiration. Anatolian Journal of Emergency Medicine, Cilt: 9 Sayı: 2, 91–98. https://doi.org/10.54996/anatolianjem.1871675

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