Newly defined biomarker for the no reflow phenomenon in patients with non-ST elevation acute coronary syndrome; uric acid to creatinine ratio

Background: The present study aimed to investigate whether newly defined serum uric acid (SUA) to serum creatinine ratio (SUA/SCr) predicts no-reflow phenomenon (NRP) development in patients with non-ST-elevated acute coronary syndrome (NSTE-ACS). Methods: The study group was divided into two groups: those who developed NRP and those who did not. Complete blood counts, SUA, serum creatinine, C-reactive protein (CRP) and albumin were obtained at admission. The SUA/SCr, SUA to albumin ratio (UAR), C-reactive protein to albumin ratio (CAR) and systemic immune inflammation (SII) index values of all patients were calculated and their relationships with NRP were evaluated. Results: Patients with NRP had higher mean SUA/SCr ratio (7.19 +/- 2.14 vs 5.30 +/- 1.70, p < 0.001), mean UAR (1.73 +/- 0.69 vs 1.38 +/- 0.47, p < 0.001), median CAR (1.73 vs 1.54, p = 0.002), and median SII index (861.9 vs 730.9, p = 0.015) levels than in those who did not develop NRP. According to multivariant analysis models, SUA/SCr ratio, UAR, CAR and SII index were found to be independent predictors of NRP development (p < 0.05 for all) but only the area under the curve (AUC) for SUA/SCr ratio (AUC = 0.73, p < 0.001) was above the 0.70 proficiency level, performing markedly better than the other evaluated parameters. A SUA/SCr ratio >= 5.34 predicted the NRP with 75% sensitivity and 55% specificity. Conclusion: SUA/SCr ratio can be used as a reliable marker in prediction the development of NRP in NSTE-ACS patients.