Abstract 13743: Prognostic Values of Ratio of Serum Eicosapentaenoic Acid to Arachidonic Acid on Clinical Outcome after Endovascular Therapy in Patients with Peripheral Artery Disease due to Femoropopliteal Artery Lesions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Keiichi Hishikari ◽  
Shigeki Kimura ◽  
Yosuke Yamakami ◽  
Keisuke Kojima ◽  
Takatoshi Shigeta ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Clinical Outcome ◽  
Endovascular Therapy ◽  
Roc Curve ◽  
Curve Analysis ◽  
Peripheral Artery ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Femoropopliteal Artery ◽  
Artery Disease

Background: Peripheral artery disease (PAD) patients have a substantially increased risk of mortality and cardiovascular morbidity than those without PAD. However, risk prediction tools have not been established among patients with PAD to identify who is likely destined for adverse clinical outcome. Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio has emerged as predictor of mortality endpoints in vascular diseases, especially, coronary artery disease and cerebrovascular disease. In contrast, the prognostic value of EPA/AA ratios in patients with PAD is unclear. We sought to examine whether assessment of serum ratio of EPA/AA in patients with PAD due to femoropopliteal artery lesions can predict clinical outcome after endovascular therapy (EVT). Methods: We obtained serum EPA/AA ratio in 132 consecutive patients with PAD due to femoropopliteal artery lesions before EVT. We analyzed the incidence of major adverse event (MAE) including major adverse limb event (MALE) and any-cause death. The clinical characteristics and laboratory variables were compared and analyzed between MAE group and non-MAE group. Cox regression analyses were used for survival tests. Receiver operating characteristics (ROC) curve analysis was used to determine an optimal cutoff value for EPA/AA ratio to predict MAE after EVT. Results: At a median follow-up of 17 months, MALE occurred in 39 patients (29.5%) and 10 patients (7.6%) died. Significantly lower level of preprocedural serum EPA/AA ratio was observed in the MAE group than non-MAE group. Multivariable Cox analysis showed critical limb ischemia (hazard ratio, 2.93; 95% confidence interval [CI], 1.59-5.40; P = 0.001) and preprocedural serum EPA/AA ratio (hazard ratio, 0.08; 95% CI, 0.02-0.43; P = 0.003) were independent predictors of MAE after EVT. The cutoff value of EPA/AA ratio via ROC curve analysis was 0.29 (66.3% sensitivity, 73.5% specificity). Conclusions: Our findings suggest that lower serum EPA/AA ratio is associated with a greater risk of MALE and any-cause death after EVT in patients with PAD due to femoropopliteal artery lesions.

scholarly journals Ascitic pseudouridine discriminates between hepatocarcinoma-derived ascites and cirrhotic ascites

1996 ◽  
Vol 42 (11) ◽  
pp. 1843-1846 ◽  
Author(s):  
G Castaldo ◽  
M Intrieri ◽  
G Calcagno ◽  
L Cimino ◽  
G Budillon ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Roc Curve ◽  
Curve Analysis ◽  
Diagnostic Sensitivity ◽  
Serum Concentrations ◽  
Diagnostic Specificity ◽  
Roc Curve Analysis ◽  
Neoplastic Cells ◽  
Cutoff Value ◽  
Cirrhotic Patients

Abstract Various biochemical indexes discriminate neoplastic from nonneoplastic ascites. However, within the latter group, the distinction between cirrhotic ascites and ascites caused by hepatocarcinoma (HC) is usually based on liver biopsy or cytology. HC-derived ascites is included in the group of nonneoplastic ascites because it is not associated with peritoneal spreading of neoplastic cells. In 54 cases of cirrhotic ascites and 17 cases of HC ascites, all histologically diagnosed, ascitic pseudouridine concentrations discriminated cirrhotic from HC ascites. For example, using the cutoff value of 4.25 mumol/L (obtained by ROC curve analysis) resulted in a diagnostic sensitivity of 88.2% and a diagnostic specificity of 90.8%. Moreover, in cirrhosis, the ascitic concentrations of pseudouridine were lower than serum concentrations, and the two sets of values were correlated; in HC, however, ascitic pseudouridine concentrations were higher than serum concentrations, and the two were unrelated. These findings strongly suggest that in cirrhotic patients ascitic pseudouridine derives from serum by diffusion, whereas in HC patients the mechanism appears to be more complex.

scholarly journals A Novel Inflammation-Based Prognostic Score: The Fibrinogen/Albumin Ratio Predicts Prognoses of Patients after Curative Resection for Hepatocellular Carcinoma

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Qiaodong Xu ◽  
Yongcong Yan ◽  
Songgang Gu ◽  
Kai Mao ◽  
Jianlong Zhang ◽  
...  
Keyword(s):  
Roc Curve ◽  
Prognostic Value ◽  
Curative Resection ◽  
Operating Characteristic ◽  
Curve Analysis ◽  
Prognostic Scores ◽  
Roc Curve Analysis ◽  
Optimal Cutoff ◽  
Albumin Ratio ◽  
Cutoff Value

Background. Inflammation is an important hallmark of cancer. Fibrinogen and albumin are both vital factors in systemic inflammation. This study investigated the prognostic value of the fibrinogen/albumin ratio in HCC patients who underwent curative resection. Methods. HCC patients (n=151) who underwent curative resection were evaluated retrospectively. The optimal cutoff value for the fibrinogen/albumin ratio was selected by receiver operating characteristic (ROC) curve analysis. Correlations between preoperative fibrinogen/albumin ratios and clinicopathologic characteristics were analyzed by χ2 test. The area under the receiver operating characteristic curve (AUC) was calculated to compare the prognostic value of the fibrinogen/albumin ratio with other prognostic scores (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and albumin-bilirubin (ALBI) score). The overall survival (OS) and time to recurrence (TTR) were assessed by the log-rank test and the Cox proportional hazard regression model. Results. An optimal cutoff value of the preoperative fibrinogen/albumin ratio (0.062) was determined for 151 patients who underwent curative resection for HCC via a ROC curve analysis. Fibrinogen/albumin ratio > 0.062 was significantly associated with microvascular invasion, an advanced BCLC stage, and ALBI grade. Multivariate analyses revealed that fibrinogen/albumin ratio was an independent predictor for OS (P=0.003) and TTR (P=0.035). The prognostic ability of fibrinogen/albumin ratio was comparable to other prognostic scores (NLR, PLR, and ALBI score) by AUC analysis. Patients with a fibrinogen/albumin ratio > 0.062 had lower 1-, 3-, and 5-year OS rates (66.0%, 41.8%, and 28.2% versus 81.9%, 69.3%, and 56.1%, resp., P<0.001) and higher 1-, 3-, and 5-year recurrence rates (60.9%, 79.2%, and 90.5% versus 49.5%, 69.1%, and 77.1%, resp., P=0.008) compared with patients with fibrinogen/albumin ratio ≤ 0.062. Conclusion. The preoperative fibrinogen/albumin ratio is an effective prognostic factor for HCC patients who underwent curative resection. An elevated fibrinogen/albumin ratio significantly correlates with poorer survival and a higher risk of recurrence in HCC patients.

ROC Curve Analysis: An Example Showing the Relationships Among Serum Lipid and Apolipoprotein Concentrations in Identifying Patients with Coronary Artery Disease

1992 ◽  
Vol 38 (8) ◽  
pp. 1425-1428 ◽  
Author(s):  
M H Zweig ◽  
S K Broste ◽  
R A Reinhart
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Roc Curve ◽  
Serum Lipid ◽  
Fundamental Property ◽  
Roc Curves ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Clinical Sensitivity ◽  
Artery Disease

Abstract Clinical accuracy, defined as the ability to discriminate between states of health, is the fundamental property of any diagnostic test or system. It is readily expressed as clinical sensitivity and specificity, and elegantly represented by the receiver operating characteristic (ROC) curve. To demonstrate the use of ROC curves, we reexamine a study of the ability of serum lipid and apolipoprotein measures to discriminate among degrees of coronary artery disease in patients undergoing coronary angiography. ROC curve analysis reveals that none of these indexes is highly accurate, but demonstrates a modest increase in the accuracy of apolipoprotein over lipid indexes.

Abstract 19569: High-sensitive Troponin T Cut-off Value for Myocardial Infarction After Vascular Surgery

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Danielle M Gualandro ◽  
Gisela B Llobet ◽  
Pai C Yu ◽  
Daniela Calderaro ◽  
Andre C Marques ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vascular Surgery ◽  
Roc Curve ◽  
Troponin T ◽  
Curve Analysis ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Coronary Syndrome ◽  
High Sensitive Troponin

Introduction: Isolated high sensitive cardiac troponin T (hsTnT) elevations after vascular surgery are frequent and may lead to over diagnosis of myocardial infarction (MI). The aim of our study was to determine the accuracy of the current hsTnT cut-off value in the setting of acute coronary syndrome (ACS) after vascular surgery. Methods: Between August 2012 and March 2014, we included 337 consecutive patients submitted to arterial vascular surgery for which cardiac perioperative evaluation was requested. Perioperative surveillance included 12-lead electrocardiogram and hsTnT measurements on the three days following surgery. Patients were followed-up by cardiologists until hospital discharge and monitored for ACS. A receiver operating characteristics (ROC) curve analysis was performed to determine the hsTnT cut-off value with better accuracy for the diagnosis of perioperative ACS. Results: Of the 337 patients included, 240 (71.2%) presented hsTnT elevation above the manufacturer-provided cut-off value (0.014 ng/ml), whereas 22 (6.5%) fulfilled criteria for ACS. Median post-operative peak hsTnT of ACS patients were 0.215 ng/ml (IQR 0.043-0.493 ng/ml), versus 0.02 ng/ml (IQR 0.012-0.038 ng/ml) in patients that did not have events (P<0.001). After performing a ROC curve analysis (AUC = 0.876), we found that the manufacture-provided cutoff hsTnT value yielded a sensitivity of 100% and specificity of only 35% for diagnosis of perioperative ACS. A new hsTnT cutoff value of 0.0415 ng/ml was obtained with 86.4% sensitivity and 77% specificity for the diagnosis of perioperative ACS. Ninety-two patients (27.3%) had hsTnT elevations above the proposed new cutoff. Conclusion: A different hsTnT cutoff value of 0.0415 ng/ml is proposed and could be more useful for the diagnosis of perioperative ACS.

scholarly journals DEFINING TROCHLEAR DYSPLASIA VIA THE LATERAL TROCHLEAR INCLINATION ANGLE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0017
Author(s):  
Christopher Cheng ◽  
Jon Hedgecock ◽  
Matthew Solomito ◽  
Sheeba Joseph ◽  
J. Lee Pace
Keyword(s):  
Measurement Technique ◽  
Roc Curve ◽  
Patellar Instability ◽  
Clinical Decision Making ◽  
Trochlear Dysplasia ◽  
Curve Analysis ◽  
Threshold Values ◽  
Roc Curve Analysis ◽  
Good Discrimination ◽  
Cutoff Value

Background: Trochlear dysplasia (TD) is the principle anatomic risk factor for patellar instability (PI). The lateral trochlear inclination (LTI) is a quantitative measure of trochlear morphology on axial magnetic resonance imaging (MRI). Threshold values for patients at risk for PI via LTI measurement have ranged from 11o to 17o. Our group recently described a new technique for characterizing LTI by referencing the fully-formed posterior femoral condyles. This novel measurement technique revealed that the historically-used method was comparable in reliability but significantly underestimated TD. Purpose: The purpose of this study was to define, with high specificity, a LTI value cutoff value consistent with patellar instability using the new LTI measurement technique. Methods: MRI scans of 95 patients aged 9 to 18 years treated for PI at our tertiary referral center were compared with a control cohort of 98 age- and gender- matched patients with knee imaging but no clinical evidence of PI. LTI was measured as the angle formed between a line subtended from the cartilaginous surface of the lateral trochlea at its most proximal extent and a line parallel to the fully-formed posterior condyles. Receiver operator characteristic (ROC) curve analysis was conducted to establish a cutoff value with optimal specificity and sensitivity. Results: Average LTI was significantly lower in the study group (5.9±10.4o) than control (18.9±5.8o) (p<0.001). Area under the ROC curve was 0.86. A proposed 8.9o LTI threshold angle achieves good discrimination between the two groups, with specificity of 0.904 and sensitivity of 0.684. Conclusion: Re-examination of previously described threshold values using ROC curve analysis of LTI measured in reference to the posterior condyles found 8.9o as the optimal threshold value to achieve good discrimination between patients with and without PI. The novel technique has previously been established to have excellent intra- and inter-observer reliability and produced significantly lower LTI values than the historically-used technique. Taken in concert, this new cutoff is valuable to improve future clinical decision making in regards to risk stratification, treatment algorithms and research purposes.

scholarly journals Clinical outcome of the patients with femoropopliteal artery disease after endovascular therapy: focused on drug-coated-balloon-related distal embolism detected by laser doppler flowmetry

2021 ◽  
Author(s):  
Kuniyoshi Fukai ◽  
Takuo Nakagami ◽  
Tetsuro Hamaoka ◽  
Masakazu Kikai ◽  
Shinichiro Yamaguchi
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Laser Doppler Flowmetry ◽  
Endovascular Therapy ◽  
Previous History ◽  
Laser Doppler ◽  
Lesion Length ◽  
Doppler Flowmetry ◽  
Femoropopliteal Artery ◽  
Artery Disease

AbstractSeveral trials have shown that paclitaxel drug-coated balloons (DCBs) significantly reduce restenosis rates. However, some reports have shown distal embolisms occurring after DCBs. No study has analyzed the clinical outcomes of patients with DCB-induced distal embolism. This study aimed to investigate the clinical outcomes of DCB-induced distal embolism in patients with femoropopliteal artery disease. Between February 2018 and April 2019, consecutive patients (n = 32) who presented with de novo femoropopliteal artery disease and underwent endovascular therapy using DCB were retrospectively reviewed in a single-center study. Patients were divided into two groups based on whether distal embolism was detected using laser doppler flowmetry (DEL group) or not (non-DEL group). Baseline characteristics and 1-year clinical outcomes were compared between the groups. DEL was found in 44% of limbs (DEL group: n = 15, non-DEL group: n = 19). Below-the-knee arterial runoff ≤ 1 (p = 0.033), popliteal lesion (p = 0.044), ambulation difficulty (p = 0.021), and previous history of coronary artery disease (p = 0.013) were identified as predictive factors of DEL. Procedural factors, reference vessel diameter, lesion length, and total drug amount were not predictive of DEL. The overall target lesion restenosis (TLR) rate was 17.4% (n = 5). The TLR rate was not significantly different between the DEL and non-DEL groups (13.3% vs. 15.8%, p = 0.55). Severe calcification was the only significant factor for TLR (4.2% vs. 40.0%, p = 0.02). Among patients with femoropopliteal disease, there was no difference in 1-year clinical outcome between patients who underwent DEL and those who did not.

scholarly journals Efficacy of Differential Diagnosis of Thyroid Nodules by Shear Wave Elastography, the Stiffness Map

2021 ◽  
Author(s):  
Myung Hi Yoo ◽  
Hye Jeong Kim ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sumi Yun ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Shear Wave ◽  
Roc Curve ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Curve Analysis ◽  
Follicular Neoplasm ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Benign Pathology

Abstract Background Fine-needle aspiration is the gold standard, but malignancy rate of the indeterminate cytology is reported as 20-50 %. We aimed to evaluate the efficacy of shear wave elastography (SWE) added to ultrasonogram in the differential diagnosis of thyroid nodules. Methods We retrospectively reviewed the medical records of 258 consecutive patients. Thyroid nodules were divided in to 4 categoies according to maximum elasticity (EMax) and nodule depth/width (D/W) ratio; Category 1 (EMax ≥42.6 kPa & D/W&lt;0.9), Category 2 (EMax &lt;42.6 kPa & D/W&lt;0.9 ), Category 3 (EMax ≥42.6 kPa & D/W≥ 0.9) and Category 4 (EMax&lt;46.2 kPa & D/W≥ 0.9 ). The cutoff value of EMax was set using ROC curve analysis to predict nodular hyperplasia (NH) from follicular neoplasm (FN). Cutoff value ​​for nodule D/W ratio was set using ROC curve analysis for malignancy. Results NH was the most prevalent pathology group in category 1, FN in category 2 and PTC in category 3. The category 3 demonstrated the highest rate of malignancy (81.8%) and had 55.4% sensitivity and 90% specificity for predicting malignancy. When assessing the benign pathology of NH in follicular patterned lesion, category 1 demonstrated the highest NH prevalence of 88.9% (34/37) and had 73.9% sensitivity and 85.0% specificity. Conclusion The performance for malignancy was highest in category 3 and predictive ability for benign pathology of NH in follicular lesion was highest in category 1. So the information of EMax and nodule D/W ratio was useful to predict the pathology of thyroid nodules

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