Comparison Of The Relationship Between Inflammatory Markers And Saphenous Vein Graft Disease In Patients With Stable Angina Pectoris.

Yıl 2023, Cilt: 7 Sayı: 3, 213 - 218, 31.12.2023

Çağrı Zorlu Sefa Erdi Ömür Samet Yılmaz

https://doi.org/10.30565/medalanya.1291772

Öz

Aim: Coronary artery bypass graft surgery is one of the most commonly used strategies to revascularization of occlusive coronary atherosclerotic lesions. Atherosclerosis is known to be a chronic inflammatory process. Many inflammatory cells and mechanisms are active in this process. Markers such as mean platelet volume-to-lymphocyte ratio (MPVLR) and C-reactive protein-to-albumin (CAR) which may be associated with the severity of inflammation. In this study, it was aimed to determine the relationship between these parameters and saphenous vein graft (SVG) diseases.

Methods: In this retrospective study, 314 patients SVG disease with stable angina pectoris were included. Patients were divided into two groups according to the severity of SVG disease. We compared 159 patients who had severe stenosis in SVG and 156 patients who did not,in terms of CAR, NLR, PLR, MPVLR.

Results: Patients who ≥50% stenosis in SVG had significantly higher CAR, MPVLR, NLR, and PLR (respectively 9.1 (4.2-16.8) p<0.001, 4.5)0.68) p<0.001, 2.4 (0.69) p=0.002, 153 )6) p=0.048). In line with these data, CAR and MPVLR values were also higher in the group with ≥50% stenosis in SVG, which was highly statistically significant (respectively 3.2 (0.9-4.4) vs 9.1 (4.2-16.8); p<0.001 and 3.64)0.43) vs 4.53)0.68); p<0.001).

Conclusion: C-reactive protein-to-albumin and MPVLR can be a useful and easily accessible markers to predict severity SVG stenosis.

Anahtar Kelimeler

C-reactive protein-to-albumin, mean platelet volume-to-lymphocytes ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, saphenous vein graft diseases.

Stabil Anjina Pektorisli Hastalarda İnflamatuvar Belirteçler ile Safen Damar Grefti Hastalığı Arasındaki İlişkinin Karşılaştırılması.

Öz

Amaç: Koroner arter baypas greft cerrahisi, tıkayıcı koroner aterosklerotik lezyonların revaskülarizasyonu için en sık kullanılan stratejilerden biridir. Aterosklerozun kronik bir inflamatuar süreç olduğu bilinmektedir. Bu süreçte birçok enflamatuar hücre ve mekanizma aktiftir. Enflamasyonun ciddiyeti ile ilişkili olabilecek biyobelirteçler; ortalama trombosit hacmi-lenfosit oranı (MPVLR) ve C-reaktif protein-albümin (CAR), nötrofil-lenfosit oranı (NLR) ve platelet-lenfosit oranı (PLR)’dir. Bu çalışmada bu parametreler ile safen ven grefti (SVG) hastalıkları arasındaki ilişkinin belirlenmesi amaçlanmıştır.

Yöntemler: Bu retrospektif çalışmaya stabil anjina pektorisli SVG hastalığı olan 314 hasta dahil edildi. Hastalar SVG hastalığının şiddetine göre iki gruba ayrıldı. SVG'de ciddi darlık olan 159 hasta ile darlık olmayan 156 hastayı CAR, NLR, PLR, MPVLR açısından karşılaştırdık.

Bulgular: SVG'de ≥%50 darlığı olan hastalarda CAR, MPVLR, NLR ve PLR anlamlı olarak daha yüksekti (sırasıyla 9.1 (4.2-16.8) p<0.001, 4.5(0.68) p<0.001, 2.4 (0.69) p=0.002, 153 (6) p=0.048). Bu veriler doğrultusunda SVG'de ≥%50 darlık olan grupta CAR ve MPVLR değerleri de istatistiksel olarak anlamlıydı (sırasıyla 3,2 (0,9-4,4) ve 9,1 (4,2-16,8); p<0,001 ve 3,64 (0,43) - 4,53(0,68); p<0.001).

Sonuç: C-reaktif protein-albümin ve MPVLR, SVG stenozunun ciddiyetini tahmin etmek için yararlı ve kolay erişilebilir bir belirteç olabilir.

Anahtar Kelimeler

C-reactive protein-albumin oranı, ortalama platelet hacmi- lenfosit oranı, nötrofil-lenfosit oranı, platelet-lenfosit oranı, safen ven greft hastalığı

Kaynakça

• 1. Lee MS, Park SJ, Kandzari DE et al. Saphenous vein graft intervention. JACC Cardiovasc Interv. 2011;4:831-43. DOI: 10.1016/j.jcin.2011.05.014.
• 2. Allaire E, Clowes AW. Endothelial cell injury in cardiovascular surgery: the intimal hyperplastic response. Ann Thorac Surg. 1997;63:582-91 DOI: 10.1016/s0003-4975(96)01045-4.
• 3. Wiedemann D, Kocher A, Bonaros N et al. Perivascular administration of drugs and genes as a means of reducing vein graft failure. Curr Opin Pharmacol. 2012;12:203-16. DOI: 10.1016/j.coph.2012.02.012.
• 4. Motwani JG, Topol EJ. Aortocoronary saphenous vein graft disease: pathogenesis, predisposition, and prevention. Circulation. 1998;97:916-31. DOI: 10.1161/01.cir.97.9.916.
• 5. Kaya MG. Enflamasyon ve koroner arter hastalığı: Yeni biyobelirteç olarak nötrofil/lenfosit oranı [Inflammation and coronary artery disease: as a new biomarker neutrophil/lymphocyte ratio]. Turk Kardiyol Dern Ars. 2013;41:191-2. DOI: 10.5543/tkda.2013.84484.
• 6. Kurtul A, Murat SN, Yarlioglues M et al. Association of platelet-to-lymphocyte ratio with severity and complexity of coronary artery disease in patients with acute coronary syndromes. Am J Cardiol. 2014;114:972-8. DOI: 10.1016/j.amjcard.2014.07.005.
• 7. Besli F, Ilter A, Gungoren F. The Link Between Mean Platelet Volume to Lymphocyte Ratio and Complexity of Coronary Artery Disease. Angiology. 2018;69:358-9. DOI: 10.1177/0003319717743315.
• 8. Ornek E, Kurtul A. Relationship of mean platelet volume to lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris. Coron Artery Dis. 2017;28:492-7. DOI: 10.1097/MCA.0000000000000530.
• 9. Tanriverdi Z, Gungoren F, Tascanov MB, Besli F, Altiparmak IH. Comparing the Diagnostic Value of the C-Reactive Protein to Albumin Ratio With Other Inflammatory Markers in Patients With Stable Angina Pectoris. Angiology. 2020;71:360-5. DOI: 10.1177/0003319719897490.
• 10. Yayla C, Gayretli Yayla K. C-Reactive Protein to Albumin Ratio in Patients With Saphenous Vein Graft Disease. Angiology. 2021 Mar 8:3319721998863. DOI: 10.1177/0003319721998863.
• 11. Sahn D.J, Maris A, Kisslo J. For the committee on M-mode standardization of the American Society of Echocardiography Recommendation regarding quantitation in M-mode echocardiographic measurements. Circulation 1978;58:1072-83. DOI: 10.1161/01.cir.58.6.1072.
• 12. Cankurt T, Celik İE, Ozturk S, Maden O. Inflammatory Conditions in Acute Coronary Syndrome Patients Treated with Percutaneous Coronary Intervention of Saphenous Vein Graft. Int J Angiol. 2020;29:237-44. DOI: 10.1055/s-0040-1714751.
• 13. Yavuz F, Kilic S, Kaplan M, Yıldırım A, Kucukosmanoglu M, Dogdus M. Impact of Atherogenic Indexes in Saphenous Vein Graft Stenosis. Arq Bras Cardiol. 2020;115:538-44. DOI: 10.36660/abc.20190683.
• 14. Qiao S, Gao W, Guo S. Neutrophil-Lymphocyte Ratio (NLR) for Predicting Clinical Outcomes in Patients with Coronary Artery Disease and Type 2 Diabetes Mellitus: A Propensity Score Matching Analysis. Ther Clin Risk Manag. 2020;16:437-43. DOI: 10.2147/TCRM.S244623.
• 15. Wada H, Dohi T, Miyauchi K et al. Neutrophil to Lymphocyte Ratio and Long-Term Cardiovascular Outcomes in Coronary Artery Disease Patients with Low High-Sensitivity C-Reactive Protein Level. Int Heart J. 2020;61:447-53. DOI: 10.1536/ihj.19-543.
• 16. Umei TC, Kishimoto Y, Aoyama M et al. High Plasma Levels of Legumain in Patients with Complex Coronary Lesions. J Atheroscler Thromb. 2020;27:711-7. DOI: 10.5551/jat.52027.
• 17. Kalyoncuoglu M, Durmus G. Relationship between C-reactive protein-to-albumin ratio and the extent of coronary artery disease in patients with non-ST-elevated myocardial infarction. Coron Artery Dis. 2020;31:130-6. DOI: 10.1097/MCA.0000000000000768.
• 18. Collet JP, Kerneis M, Hulot JS et al. Point-of-care genetic profiling and/or platelet function testing in acute coronary syndrome. Thromb Haemost. 2016;115:382-91. DOI: 10.1160/TH15-05-0394.
• 19. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinicaluse? A multidisciplinary review. Ann Med 2012;44:805–16. DOI: 10.3109/07853890.2011.653391.
• 20. Gary T, Pichler M, Belaj K et al. Lymphocyte-to-monocyte ratio: a novel marker for critical limb ischemia in PAOD patients. Int J Clin Pract. 2014;68:1483-7. DOI: 10.1111/ijcp.12495.
• 21. Qiu Z, Jiang Y, Jiang X et al. Relationship Between Platelet to Lymphocyte Ratio and Stable Coronary Artery Disease: Meta-Analysis of Observational Studies. Angiology. 2020;71:909-15. DOI: 10.1177/0003319720943810.
• 22. Azab B, Zaher M, Weiserbs KF et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol. 2010;106:470-6. DOI: 10.1016/j.amjcard.2010.03.062.
• 23. Soeki T, Sata M. Inflammatory biomarkers and atherosclerosis. Int Heart J. 2016;57:134-9. DOI: 10.1536/ihj.15-346.
• 24. Keramat S, Karahan O, Patel M, Fazeli B. Acute phase reactant proteins in Buerger's disease: Is it a systemic disease? Vascular. 2023 Jun;31(3):473-476. doi: 10.1177/17085381211069715.
• 25. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448-54. DOI: 10.1056/NEJM199902113400607.
• 26. Karahan O, Acet H, Ertaş F, et al. The relationship between fibrinogen to albumin ratio and severity of coronary artery disease in patients with STEMI. Am J Emerg Med. 2016 Jun;34(6):1037-42. DOI: 10.1016/j.ajem.2016.03.003. 
• 27. Karabağ Y, Çağdaş M, Rencuzogullari I et al. Relationship between C-reactive protein/albumin ratio and coronary artery disease severity in patients with stable angina pectoris. J Clin Lab Anal. 2018;32:e22457. DOI: 10.1002/jcla.22457.