Aort Kapak Sklerozunun Öngörülmesinde Yeni Hematolojik İnflamatuar Parametrelerin Önemi

Öz

Giriş: İnflamatuvar süreç, aort kapak sklerozunun (AKS) ilerlemesinde kritik rol oynar. Bu çalışma, AKS hastalarında hematolojik ve biyokimyasal inflamatuar belirteçleri değerlendirmeyi amaçlamaktadır.
Yöntemler: Bu çalışma retrospektif, tek merkezli olup, Haziran 2021 ile Eylül 2021 arasında ekokardiyogram yapılan ardışık 557 hasta dahil edildi. Çalışma popülasyonu AKS varlığına göre iki gruba ayrıldı. Gruplar C-reaktif protein, Nötrofil-lenfosit oranı (NLR), trombosit-lenfosit oranı (PLR) ve monosit-HDL kolesterol oranı (MHR), değerleri açısından karşılaştırıldı.
Bulgular: Çalışmaya alınan hastaların ortalama yaşı 63 ± 10 yıl olarak bulundu. AKS izlenen hastalarda C-reaktif protein (CRP), NLR, PLR ve MHR anlamlı olarak daha yüksekti. NLR için en iyi kesme değerleri 1.4 (duyarlılık %84, özgüllük %74), PLR için 116 (duyarlılık %75, özgüllük %54) ve MHR için 9,5 (duyarlılık %78, özgüllük %75) olarak tespit edildi. CRP (OR: 1.246, %95 CI: 1.117 – 1.389; p < 0,001), NLR (OR: 2.10, %95 GA: 1.456 – 3,032; p < 0.001) ve MHR (OR: 1,227, %95 CI: 1,125 – 1,339; p < 0.001) AKS nun bağımsız öngördücüleri olarak bulundu. İlaveten veriler kategorik değişken olarak analiz edildiğinde, NLR > 1,4 değeri (OR: 4,825, %95 GA: 2,430 – 9,583; p < 0.001) ve MHR > 9,5 değeri (OR: 13,937, %95 GA: 7,464 – 26,023; p < 0,001) AKS için bağımsız öngördürücü olarak bulundu.
Sonuç: Artan CRP seviyeleri, NLR ve MHR, AKS için bağımsız öngördücüler olarak tespit edildi. Hematolojik inflamatuar biyobelirteçler, AKS varlığının öngörülmesi için uygun maliyetli ve faydalı parametreler olarak önemlidir.

Anahtar Kelimeler

• aort kapak sklerozu
• C-reaktif protein
• monosit sayısı ile yüksek yoğunluklu lipoprotein kolesterol oranı
• nötrofil-lenfosit oranı
• trombosit-lenfosit oranı

The Significance of Novel Hematologic Inflammatory Parameters in Predicting Aortic Valve Sclerosis

Abstract

Aim: Inflammatory process plays a critical role in the progression of aortic valve sclerosis (AVS). This study aims to evaluate the haematological and biochemical inflammatory markers in AVS patients.
Methods: A retrospective observational study was included consecutive 557 patients who underwent an echocardiogram between June 2021 and September 2021. The study population was divided into two groups according to the presence of AVS. The groups were compared in terms of C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-HDL cholesterol ratio (MHR).
Results: The mean age was 63 ± 10 years. C-reactive protein (CRP), NLR, PLR and MHR were significantly higher in patients with AVS. The best cut-off values of the NLR were 1.4 (a sensitivity of 84%, a specificity of 74%), PLR was 116 (a sensitivity of 75%, a specificity of 54%), and MHR was 9.5 (a sensitivity of 78%, a specificity of 75%). CRP (OR: 1.246, 95% CI: 1.117 – 1.389; p < 0.001), NLR (OR: 2.10, 95% CI: 1.456 – 3.032; p < 0.001), and MHR (OR: 1.227, 95% CI: 1.125 – 1.339; p < 0.001) were independent predictors of the AVS when NLR and MHR analysed as a continuous variable. Using a cut off level of NLR > 1.4 (OR: 4.825, 95% CI: 2.430 – 9.583; p < 0.001) and MHR > 9.5 (OR: 13.937, 95% CI: 7.464 – 26.023; p < 0.001) were independent predictors of the AVS.
Conclusion: Increased CRP levels, NLR and MHR were found to be independent predictors for AVS. Hematological inflammatory biomarkers are cost effective and helpful approach for prediction of AVS presence.

Keywords

• aortic valve sclerosis
• C-reactive protein
• monocyte count to high-density lipoprotein cholesterol ratio
• neutrophil-to-lymphocyte ratio
• platelet-to lymphocyte ratio

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