Akut İskemik İnme Geçiren Hastalarda Sol Atrial Appendaj Trombüs Oluşumu ve Monosit/HDL Oranı Arasındaki İlişki

Year 2023, Volume: 6 Issue: 2, 248 - 254, 30.06.2023

Süha Çetin Mustafa Gökhan Vural

https://doi.org/10.53446/actamednicomedia.1224287

Abstract

Amaç: Trombüs oluşumu ve enflamasyon arasında kuşkusuz bir bağlantı bulunmaktadır. Monsit/HDL oranı (MHO) bir enflamasyon göstergesi olup, birçok kardiyovasküler hastalıkla (örneğin: koroner arter hastalığı, akut koroner stent trombozu, koroner trombüs yükü, atriyal fibrilasyon (AF))ilişkilidir.
Yöntem: Akut iskemik inme teşhisi olan toplam 69 hasta retrospektif olarak bu çalışmaya dahil edildi. Demografik, klinik ve ekokardiyografik veriler hasta dosyalarından retrospektif olarak toplandı. MHO ve nötrofil/lenfosit oranları (NLO) mevcut olan laboratuvar bulgularından hesaplandı.
Bulgular: MHO ve NLO arasında anlamlı bir korelasyon mevcuttu r=0,6; p<0,001). 13 hastada sol atriyal appendaj trombüsü (APT) teşhisi konuldu (11 erkek; yaş 64,1±14,5); 14 hastada spontan eko kontrast (SEK) evre 3 veya 4 teşhisi mevcuttu (11 erkek; yaş 62,3±9,7); 42 hastanın ne sol APT ne de SEK görüntüsü mevcuttu (29 erkek; yaş 61,0±11,1). AF (p<0,001) haricinde 3 grup arasında demografik ve klinik bulgularda anlamlı bir fark yoktu. Monosit seviyesi trombüs negatif olan grupta diğer gruplara kıyasla daha düşüktü (p<0,001). MHO her grup için anlamlı bir fark gösterdi (p<0,001). Bu parametre sol APT ve SEK bulguları olan hastalarda anlamlı yüksekti.
Sonuç: Çalışmamız yükselmiş bir monosit/HDL oranının sol APT oluşumu ile ilişkili olduğunu gösterdi.

Keywords

Monosit/HDL oranı, sol atrial appendaj, atriyal fibrillasonyon

Association Between Left Atrial Appendage Thrombus Formation and Monocyte/HDL Ratio in Patients with Acute Ischemic Stroke

Abstract

Objective: There is an apparent link between thrombus formation and inflammation. Monocyte/HDL ratio (MHR) has been determined as an inflammatory marker and associated with many cardiovascular disorders like coronary artery disease, acute coronary stent thrombus, coronary thrombus burden and atrial fibrillation (AF). The purpose of this study was to elucidate the association between MHR and left atrial appendage thrombus formation (AATF) in patients with acute ischemic stroke.
Methods: A total of 69 patients with the diagnosis of acute ischemic stroke were retrospectively enrolled in the study. Demographic, clinical and echocardiographic data were collected retrospectively from the patients’ records. MHR and neutrophil/lymphocyte ratio (NLR) were calculated from the present laboratory data.
Results: There was a significant positive correlation between MHR and NLR (r=0.6; p<0.001). Thirteen patients had a left AATF (11 male; 64±14.5 years); 14 patients had spontaneous echo contrast (SEC) stage 3 or 4 (11 male; 62.3±9.7 years) and 42 patients (29 male; 61.0±11.1 years) did not have left AATF or SEC. There was no difference between the 3 groups in terms of baseline demographic or clinical findings except AF (p<0.001). Further, monocytes were significantly lower in the thrombus negative group compared to other groups (p<0.001). MHR was different in all three groups (p<0.001). This parameter was significantly increased in patients with left AATF and SEC finding.
Conclusion: Our study showed that an increased MHR is associated with left AATF.

Keywords

Monocyte/HDL ratio, left atrial appendage, atrial fibrillation

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