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Copeptin Level in Isolated Coronary Artery Ectasia

Yıl 2018, Cilt: 21 Sayı: 2, 117 - 121, 19.08.2018

Öz

Introduction:
The
level of copeptin was investigated in patients who underwent coronary
angiography for suspected coronary artery disease and diagnosed with isolated
coronary artery ectasia (CAE).



Patients
and Methods:
A total of 308 patients were diagnosed as having coronary
ectasia out of 3412 patients who underwent coronary angiography between May
2015 and July 2016. The evaluations were performed by two experienced
physicians who were aware of the study design. Among these patients, 41
patients who did not have severe coronary artery disease (CAD) and who were
diagnosed as having isolated CAE were included in the study. The control group
comprised 33 age- and gender-matched individuals diagnosed as having normal
coronary arteries following coronary angiography for suspected CAD. Patients
with a previous coronary revascularization for severe CAD, known congestive
heart disease and severe cardiac valve disease, and a left ventricular ejection
fraction below 50% were excluded from the study. Blood samples were obtained
from both groups and the serum copeptin levels were compared with each other.



Results: Among
patients with CAE, the frequency of isolated CAE was 14.9%. Among the total
coronary angiography series, the frequency of isolated CAE was 1.34%. Most patients
with isolated CAE were men (70%; women: 30%), and the mean age of the patients
was 58 ± 9.2 years. In patients with isolated CAE, the frequencies of type I,
type II, type III, and type IV CAE were found to be 4.3%, 17.4%, 32.6%, and
45.6%, respectively, according to Markis classification. The level of copeptin
was found to be 7.8 ± 0.9 pmol/L in patients with normal coronary arteries and
9.7 ± 1.6 pmol/L in patients with isolated CAE (p< 0.028).



Conclusion: The level of copeptin is
increased in patients with isolated CAE. However, our results have to be
supported by long-term randomized studies on isolated CAE patients with and
high copeptin levels.

Kaynakça

  • 1. Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation 1983;67:134-8.
  • 2. Falsetti HL, Carrol RJ. Coronary artery aneurysm. A review of the literature with a report of 11 new cases. Chest 1976;69:630-6.
  • 3. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary arterial ectasia. Am J Cardiol 1976;37:217-22.
  • 4. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126.595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990;21:28-40.
  • 5. Pinar Bermúdez E, López Palop R, Lozano Martínez-Luengas I, Cortés Sánchez R, Carrillo Sáez P, Rodríguez Carreras, et al. Coronary ectasia: prevalence, and clinical and angiographic characteristics. Rev Esp Cardiol 2003;56:473-9.
  • 6. Kruger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronopathy”). J Am Coll Cardiol 1999;34:1461-70.
  • 7. Befeler B, Aranda MJ, Embi A, Mullin FL, El-Sherif N, Lazzara R. Coronary artery aneurysms: study of the etiology, clinical course and effect on left ventricular function and prognosis. Am J Med 1977;62:597-607.
  • 8. Adiloglu AK, Can R, Nazli C, Ocal A, Ergene O, Tinaz G, et al. Ectasia and severe atherosclerosis: relationships with chlamydia pneumoniae, helicobacterpylori, and inflammatory markers. Tex Heart Inst J 2005;32:21-7.
  • 9. Yilmaz H, Tayyareci G, Sayar N, Gurkan U, Tangurek B, Asilturk R, et al. Plasma soluble adhesion molecule levels in coronary artery ectasia. Cardiology 2006;105:176-81.
  • 10. Holwerda DA. A glycopeptide from the posterior lobe of pig pituitaries. I. Isolation and characterization. Eur J Biochem 1972;28:334-9.
  • 11. Khan SQ, Dhillon OS, O’Brien RJ, Struck J, Quinn PA, Morgenthaler NG, et al. C-terminal provasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) study. Circulation 2007;115:2103-10.
  • 12. Von Haehling S, Papassotiriou J, Morgenthaler NG, Hartmann O, Doehner W, Stellos K, et al. Copeptin as a prognostic factor for major adverse cardiovascular events in patients with coronary artery disease. Int J Cardiol 2012;162:27-32.
  • 13. Hartnell GG, Parnell BM, Pridie RB. Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients. Br Heart J 1985;54:392-5.
  • 14. Ede H, Karaçavuş S, Göçmen AY, Yaylak B, Akkaya S, Açıkgöz B, et al. Serum copeptin level can be a helpful biomarker in evaluation of myocardial perfusion scintigraphy results. Cardiol J 2016;23:71-7.
  • 15. Sharma SN, Kaul U, Sharma S, Wasir HS, Manchanda SC, Bahl VK, et al. Coronary arteriographic profile in young and old Indian patients with ischaemic heart disease: a comparative study. Indian Heart J 1990;42:365-9.
  • 16. Sudhir K, Ports TA, Amidon TM, Goldberger JJ, Bhushan V, Kane JP, et al. Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia. Circulation 1995;91:1375-80.
  • 17. Androulakis AE, Andrikopoulos GK, Kartalis AN, Stougiannos PN, Katsaros AA, Syrogiannidis DN, et al. Relation of coronary artery ectasia to diabetes mellitus. Am J Cardiol 2004;93:1165-7.
  • 18. Altinbas A, Nazli C, Kinay O, Ergene O, Gedikli O, Ozaydin M, et al. Predictors of exercise induced myocardial ischemia in patients with isolated coronary artery ectasia. Int J Cardiovasc Imaging 2004;20:3-17.
  • 19. Sorrell VL. Origins of coronary artery ectasia. Lancet 1996;20:136-13.
  • 20. Lamblin N, Bauters C, Hermant X, Lablanche JM, Helbecque N, Amouyel P. Polymorphisms in the promoter regions of MMP-2, MMP-3, MMP-9 and MMP-12 genes as determinants of aneurysmal coronary artery disease. J Am Coll Cardiol 2002;40:43-4.
  • 21. Turban H, Erbay AR, Yasar AS, Balci M, Bicer A, Yetkin E. Comparison of c-reactive protein levels in patients with coronary artery ectasia versus patients with obstructive coronary artery disease. Am J Cardiol 2004;94:1303-6.
  • 22. Tokgozoglu L, Ergene O, Kinay O, Nazli C, Hascelik G, Hoscan Y. Plasma interleukin-6 levels are increased in coronary artery ectasia. Acta Cardiol 2004;59:515-9.
  • 23. Turhan H, Erbay AR, Yasar AS, Aksoy Y, Bicer A, Yetkin G, et al. Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selection levels in patients with isolated coronary artery ectasia. Coron Artery Dis 2005;16:45-50.
  • 24. Gulec S, Atmaca Y, Kilickap M, Nazli C, Haselik G, Hoscan YU. Angiographic assessment of myocardial perfusion in patients with isolated coronary artery ectasia. Am J Cardiol 2003;91:996-9.
  • 25. Akyürek O, Berkalp B, Sayin T, Kumbasar D, Kervancioğlu C, Oral D. Altered coronary flow properties in diffuse coronary artery ectasia. Am Heart J 2003;145:66-72.
  • 26. Staub D, Morgenthaler NG, Buser C, Breidthardt T, Potocki M, Noveanu M, et al. Use of copeptin in the detection of myocardial ischemia. Clin Chim Acta 2009;399:69-73.
  • 27. Möckel M, Searle J. Copeptin-marker of acute myocardial infarction. Curr Atheroscler Rep 2014;16:421.
  • 28. Pozsonyi Z, Förhécz Z, Gombos T, Karádi I, Jánoskuti L, Prohászka Z. Copeptin (C-terminal pro arginine-vasopressin) is an ındependent long-term prognostic marker in heart failure with reduced ejection fraction. Heart Lung Circ 2015;24:359-67.
  • 29. Stoiser B, Mörtl D, Hülsmann M, Berger R, Struck J, Morgenthaler NG, et al. Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure. Eur J Clin Invest 2006;36:771-8.
  • 30. Morgenthaler NG, Müller B, Struck J, Bergmann A, Redl H, Christ-Crain M. Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock. Shock 2007;28:219-26.

İzole Koroner Ektazide Kopeptin Düzeyi

Yıl 2018, Cilt: 21 Sayı: 2, 117 - 121, 19.08.2018

Öz

Giriş: Bu çalışmada koroner arter hastalığı şüphesiyle
koroner anjiyografi yapılan ve izole koroner ektazi saptanan hastalarda
kopeptin düzeyi araştırıldı.



Hastalar ve Yöntem: Merkezimizde Mayıs 2015-Temmuz 2016
tarihleri arasında koroner anjiyografi uygulanan 3412 hastada, en az iki
bağımsız operatörün değerlendirilmesi sonucunda 308 koroner arter ektazi (KAE)
olgusu saptandı. Bu hastalardan ciddi koroner arter hastalığı (KAH)
olmayan  izole KAE’si olan 41 hasta
çalışmaya alındı. Kontrol grubu, KAH şüphesiyle koroner anjiyografisi yapılıp
normal koroner arter saptanan yaş ve cinsiyet olarak uyumlu 33 bireyden
oluşturuldu. Daha önce ciddi KAH nedeniyle koroner revaskülarizasyon yapılan
hastalar, bilinen konjestif kalp yetersizliği ve ciddi kalp kapak hastalığı
olanlar ve sol ventrikül ejeksiyon fraksiyonu %50’nin altında olanlar çalışma
dışı bırakıldı. Her iki grupta kan örneği alınarak kopeptin düzeyleri
karşılaştırıldı.



Bulgular: KAE’li hastalar içinde izole KAE sıklığı %14.9 idi. Total
koroner anjiyografi serisi arasında ise izole KAE sıklığı %1.34 idi. İzole
KAE’li hastaların %70’i erkek %30’u kadın idi. Ortalama yaş 58 ± 9.2 idi.
Kontrol ve hasta grubu arasında KAH risk faktörleri olan sigara, diyabet ve
hipertansiyon sıklığı açısından belirgin farklılık yoktu ancak hiperlipidemi
izole KAE’li hastalarda daha fazlaydı. Markis sınıflamasına göre KAE’li
hastaların, %4.3’ü tip I, %17.4’ü tip II, %32.6’sı tip III ve %45.6’sı tip IV
olarak saptandı. Koroner arterleri normal saptanan hastalarda kopeptin düzeyi
7.8 ± 0.9 pmol/L iken izole KAE’li hastalarda bu değer 9.7 ± 1.6 pmol/L olarak
saptandı (p< 0.028).



Sonuç: İzole KAE’sinde kopeptin
düzeyi artmıştır. Çalışmamızın sonuçlarının kopeptin düzeylerinin artmış olduğu
izole KAE’li hastaların uzun dönem takip edildiği randomize çalışmalar ile
desteklenmesi gerekmektedir.

Kaynakça

  • 1. Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation 1983;67:134-8.
  • 2. Falsetti HL, Carrol RJ. Coronary artery aneurysm. A review of the literature with a report of 11 new cases. Chest 1976;69:630-6.
  • 3. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary arterial ectasia. Am J Cardiol 1976;37:217-22.
  • 4. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126.595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990;21:28-40.
  • 5. Pinar Bermúdez E, López Palop R, Lozano Martínez-Luengas I, Cortés Sánchez R, Carrillo Sáez P, Rodríguez Carreras, et al. Coronary ectasia: prevalence, and clinical and angiographic characteristics. Rev Esp Cardiol 2003;56:473-9.
  • 6. Kruger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (“dilated coronopathy”). J Am Coll Cardiol 1999;34:1461-70.
  • 7. Befeler B, Aranda MJ, Embi A, Mullin FL, El-Sherif N, Lazzara R. Coronary artery aneurysms: study of the etiology, clinical course and effect on left ventricular function and prognosis. Am J Med 1977;62:597-607.
  • 8. Adiloglu AK, Can R, Nazli C, Ocal A, Ergene O, Tinaz G, et al. Ectasia and severe atherosclerosis: relationships with chlamydia pneumoniae, helicobacterpylori, and inflammatory markers. Tex Heart Inst J 2005;32:21-7.
  • 9. Yilmaz H, Tayyareci G, Sayar N, Gurkan U, Tangurek B, Asilturk R, et al. Plasma soluble adhesion molecule levels in coronary artery ectasia. Cardiology 2006;105:176-81.
  • 10. Holwerda DA. A glycopeptide from the posterior lobe of pig pituitaries. I. Isolation and characterization. Eur J Biochem 1972;28:334-9.
  • 11. Khan SQ, Dhillon OS, O’Brien RJ, Struck J, Quinn PA, Morgenthaler NG, et al. C-terminal provasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: Leicester Acute Myocardial Infarction Peptide (LAMP) study. Circulation 2007;115:2103-10.
  • 12. Von Haehling S, Papassotiriou J, Morgenthaler NG, Hartmann O, Doehner W, Stellos K, et al. Copeptin as a prognostic factor for major adverse cardiovascular events in patients with coronary artery disease. Int J Cardiol 2012;162:27-32.
  • 13. Hartnell GG, Parnell BM, Pridie RB. Coronary artery ectasia. Its prevalence and clinical significance in 4993 patients. Br Heart J 1985;54:392-5.
  • 14. Ede H, Karaçavuş S, Göçmen AY, Yaylak B, Akkaya S, Açıkgöz B, et al. Serum copeptin level can be a helpful biomarker in evaluation of myocardial perfusion scintigraphy results. Cardiol J 2016;23:71-7.
  • 15. Sharma SN, Kaul U, Sharma S, Wasir HS, Manchanda SC, Bahl VK, et al. Coronary arteriographic profile in young and old Indian patients with ischaemic heart disease: a comparative study. Indian Heart J 1990;42:365-9.
  • 16. Sudhir K, Ports TA, Amidon TM, Goldberger JJ, Bhushan V, Kane JP, et al. Increased prevalence of coronary ectasia in heterozygous familial hypercholesterolemia. Circulation 1995;91:1375-80.
  • 17. Androulakis AE, Andrikopoulos GK, Kartalis AN, Stougiannos PN, Katsaros AA, Syrogiannidis DN, et al. Relation of coronary artery ectasia to diabetes mellitus. Am J Cardiol 2004;93:1165-7.
  • 18. Altinbas A, Nazli C, Kinay O, Ergene O, Gedikli O, Ozaydin M, et al. Predictors of exercise induced myocardial ischemia in patients with isolated coronary artery ectasia. Int J Cardiovasc Imaging 2004;20:3-17.
  • 19. Sorrell VL. Origins of coronary artery ectasia. Lancet 1996;20:136-13.
  • 20. Lamblin N, Bauters C, Hermant X, Lablanche JM, Helbecque N, Amouyel P. Polymorphisms in the promoter regions of MMP-2, MMP-3, MMP-9 and MMP-12 genes as determinants of aneurysmal coronary artery disease. J Am Coll Cardiol 2002;40:43-4.
  • 21. Turban H, Erbay AR, Yasar AS, Balci M, Bicer A, Yetkin E. Comparison of c-reactive protein levels in patients with coronary artery ectasia versus patients with obstructive coronary artery disease. Am J Cardiol 2004;94:1303-6.
  • 22. Tokgozoglu L, Ergene O, Kinay O, Nazli C, Hascelik G, Hoscan Y. Plasma interleukin-6 levels are increased in coronary artery ectasia. Acta Cardiol 2004;59:515-9.
  • 23. Turhan H, Erbay AR, Yasar AS, Aksoy Y, Bicer A, Yetkin G, et al. Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selection levels in patients with isolated coronary artery ectasia. Coron Artery Dis 2005;16:45-50.
  • 24. Gulec S, Atmaca Y, Kilickap M, Nazli C, Haselik G, Hoscan YU. Angiographic assessment of myocardial perfusion in patients with isolated coronary artery ectasia. Am J Cardiol 2003;91:996-9.
  • 25. Akyürek O, Berkalp B, Sayin T, Kumbasar D, Kervancioğlu C, Oral D. Altered coronary flow properties in diffuse coronary artery ectasia. Am Heart J 2003;145:66-72.
  • 26. Staub D, Morgenthaler NG, Buser C, Breidthardt T, Potocki M, Noveanu M, et al. Use of copeptin in the detection of myocardial ischemia. Clin Chim Acta 2009;399:69-73.
  • 27. Möckel M, Searle J. Copeptin-marker of acute myocardial infarction. Curr Atheroscler Rep 2014;16:421.
  • 28. Pozsonyi Z, Förhécz Z, Gombos T, Karádi I, Jánoskuti L, Prohászka Z. Copeptin (C-terminal pro arginine-vasopressin) is an ındependent long-term prognostic marker in heart failure with reduced ejection fraction. Heart Lung Circ 2015;24:359-67.
  • 29. Stoiser B, Mörtl D, Hülsmann M, Berger R, Struck J, Morgenthaler NG, et al. Copeptin, a fragment of the vasopressin precursor, as a novel predictor of outcome in heart failure. Eur J Clin Invest 2006;36:771-8.
  • 30. Morgenthaler NG, Müller B, Struck J, Bergmann A, Redl H, Christ-Crain M. Copeptin, a stable peptide of the arginine vasopressin precursor, is elevated in hemorrhagic and septic shock. Shock 2007;28:219-26.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırmalar
Yazarlar

Osman Bektaş

Diyar Köprülü Bu kişi benim

Sezgin Albayrak Bu kişi benim

Adil Bayramoğlu Bu kişi benim

Zeki Yüksel Günaydın Bu kişi benim

Mehmet Yaman Bu kişi benim

Ahmet Kaya Bu kişi benim

Yayımlanma Tarihi 19 Ağustos 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 21 Sayı: 2

Kaynak Göster

Vancouver Bektaş O, Köprülü D, Albayrak S, Bayramoğlu A, Günaydın ZY, Yaman M, Kaya A. Copeptin Level in Isolated Coronary Artery Ectasia. Koşuyolu Heart Journal. 2018;21(2):117-21.