Öz
Giriş: İnflamasyon ve oksidatif stres, ateroskleroz gelişiminde ve progresyonunda rol oynayan iki önemli faktördür. Monositin yüksek yoğunluklu lipoprotein kolesterole (HDL-K) oranlanmasıyla hesaplanan MHR değerlerinin artışı, inflamasyonda artış ve atreoskleroz gelişiminde hızlanma ile ilişkilendirilmektedir. Bu çalışma ile akut iskemik inme hastalarında inmenin ciddiyeti ve hastane içi ölüm ile MHR değerleri arasındaki ilişkiyi araştırmayı amaçladık.
Materyal ve Metot: Akut iskemik inme teşhisiyle hastaneye yatırılan ve tedavi edilen 183 hasta retrospektif olarak çalışmaya alındı. Demografik özellikleri, inme risk faktörleri, laboratuvar değerleri ve MHR değerleri kaydedildi. İnmenin ciddiyetini değerlendirmek için National Institutes of Health Stroke Skalası (NIHSS) kullanıldı. Hastane içi ölen hastalar kaydedildi.
Bulgular: Çalışmamızda 82 (%44,8) kadın, 101 (%55,2) erkek olmak üzere toplam 183 hasta vardı. Hastaların yaş ortalaması 68,24 ± 14,43 yıldı. Başvuru NIHSS değerlerine göre 157 (%85,8) hasta ağır disabilite, 26 (%14,2) hasta hafif disabilite grubuna ayrıldı. Ağır başvuru dizabilitesi olan grupta AF sıklığı ve MHR değerleri hafif disabilite grubuna göre anlamlı olarak daha yüksekti (sırasıyla p=0,01, p<0,01). Yine hastane içi ölen hastalarda AF sıklığı ve MHR değerleri taburcu edilen hastalara göre daha yüksekti (sırasıyla p=0,003, p=0,028).
Sonuç: Çalışmamızın sonucunda, inmenin ciddiyeti ve hastane içi ölüm ile artmış MHR değerleri arasında anlamlı ilişki mevcuttu.
Anahtar Kelimeler
Destekleyen Kurum
Çalışmayı destekleyen herhangi bir kurum ve kuruluş bulunmamaktadır. Yazarlar arasında çıkar çatışması yoktur.
Proje Numarası
Etik onayı: Çalışma için Selçuk Üniversitesi klinik araştırmalar etik kurulundan (toplantı sayısı: 2019/16 karar sayısı: 2019/352) onay alınmıştır.
Kaynakça
- Referanslar 1- Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ, 2020, 368, l6983. doi: 10.1136/bmj.l6983. 2- Bolayır A, Gökce SF et al. Monocyte/high density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol. Neurochir. Pol, 2018, 52(2), 150-55. 3- Schaftenaar F, Frodermann V et al. Atherosclerosis. Curr Opin Lipidol, 2016, 27(3), 209–15. 4- Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol 2012, 32(9), 2045–51. 5- Mestas J, Ley K. Monocyte-endothelial cell interactions in the development of atherosclerosis. Trends in cardiovascular medicine. 2008, 18(6), 228–32. 6- Woollard KJ, Geissmann F. Monocytes in atherosclerosis: subsets and functions. Nat Rev Cardiol. 2010, 7(2), 77–86. 7- Hafiane A, Genest J. High density lipoproteins: Measurement techniques and potential biomarkers of cardiovascular risk. BBA Clin. 2015, 31(3), 175-88. 8- Canpolat U, Cetin EH et al. Association of Monocyte-to-HDL Cholesterol Ratio with Slow Coronary Flow is Linked to Systemic Inflammation. Clinical and Applied Thrombosis/Hemostasis. 2016, 22(5), 476-82. 9- Kundi H, Kiziltunc E et al. Association of monocyte/ HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz, 2016, 41, 523–9. 10- Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pak J Med Sci. 2019, 35(4), 1081-6. 11- Brott T, Adams HP Jr et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 1989, 20(7), 864-70. 12- Lambert JM, Lopez EF et al. Macrophage roles following myocardial infarction. Int J Cardiol. 2008, 130(2), 147-58. 13- Choi S, Kim J et al. Monocyte count as a predictor of cardiovascular mortality in older Korean people. Age Ageing. 2017, 46(3), 433–8. 14- Grosse GM, Schulz-Schaeffer WJ et al. Monocyte subsets and related chemokines in carotid artery stenosis and ischemic stroke. Int J Mol Sci. 2016, 17(4), 433. 15- Karabacak M, Kahraman F et al. Increased plasma monocyte chemoattractant protein-1 levels in patients with isolated low high-density lipoprotein cholesterol. Scand J Clin Lab Invest. 2015, 75(4), 327-32. 16- Navab M, Ananthramaiah GM et al. The oxidation hypothesis of atherogenesis: the role of oxidized phospholipids and HDL. J Lipid Res, 2004, 45, 993-1007. 17- Barter PJ, Nicholls S et al. Antiinflammatory properties of HDL. Circ Res 2004, 95, 764-72. 18- Mineo C, Deguchi H et al. Endothelial and antithrombotic actions of HDL. Circ Res, 2006, 98, 1352-64. 19- Li XP, Zhao SP et al. Protective effect of high density lipoprotein on endothelium dependent vasodilatation. Int J Cardiol. 2000, 73, 231-6. 20- Barter PJ, Baker PW et al. Effect of high-density lipoproteins on the expression of adhesion molecules in endothelial cells. Curr Opin Lipidol, 2002, 13, 285-8. 21- Sacco RL, Benson RT et al. High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study. J Am Med Assoc, 2001, 285, 2729-35. 22- Yeh PS, Yang CM et al. Low levels of high-density lipoprotein cholesterol in patients with atherosclerotic stroke: a prospective cohort study. Atherosclerosis, 2013, 228(2), 472-7. 23- Kanbay M, Solak Y et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014, 46(8), 1619-25. 24- Kundi H, Gok M et al. Relationship between monocyte to HDL-C ratio and the severity of isolated coronary artery ectasia. Am J Cardiol, 2015, 116(11), 1685–9. 25- Canpolat U, Aytemir K et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace, 2015, 17(12), 1807–15. 26- Li N, Ren L et al. Relationship between monocyte to HDL cholesterol ratio and concomitant cardiovascular disease in Chinese Han patients with obstructive sleep apnea. Cardiovasc Diagn Ther. 2019, 9(4), 362-370. 27- Wang HY, Shi WR et al. Assessing the performance of monocyte to high-density lipoprotein ratio for predicting ischemic stroke: insights from a population-based Chinese cohort. Lipids Health Dis. 2009, 18(1), 127. 28- Liu H, Liu K et al. Monocyte-to-High-Density Lipoprotein Ratio Predicts the Outcome of Acute Ischemic Stroke. J Atheroscler Thromb. 2020 Jan 16. doi: 10.5551/jat.51151.
Öz
Objective: Inflammation and oxidative stress are two important factors that play a role in the development and progression of atherosclerosis.The increase in MHR values calculated by the ratio of monocyte to high density lipoprotein cholesterol (HDL-C) is associated with an increase in inflammation and acceleration in the development of atherosclerosis. We aimed to investigate the severity of stroke in patients with acute ischemic stroke and the relationship between in-hospital death and MHR values with this study.
Materials and Methods: 183 patients hospitalized and treated with the diagnosis of acute ischemic stroke were retrospectively included in the study. Demographic features, stroke risk factors, laboratory parameters, and MHR values were recorded.The National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of the stroke. Patients who died in hospital were recorded.
Results: In our study, there were 183 patients, 82(44,8%) female and 101(55,2%) male. The mean age of the patients was 68.24 ± 14.43 years. According to the initial NIHSS values, 157(85,8%) patients were divided into severe disability, and 26(14,2%) patients were divided into mild disability. The frequency of AF and MHR were significantly higher in the group with severe disability compared to the mild disability group (p=0,01, p<0,01, respectively). Also, the frequency of AF and MHR were higher in patients who died in hospitals compared to the patients discharged (p=0,003, p=0,028, respectively).
Conclusion: As a result of our study, there was a significant relationship between the severity of stroke and in-hospital death and increased MHR values.
Anahtar Kelimeler
Proje Numarası
Etik onayı: Çalışma için Selçuk Üniversitesi klinik araştırmalar etik kurulundan (toplantı sayısı: 2019/16 karar sayısı: 2019/352) onay alınmıştır.
Kaynakça
- Referanslar 1- Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ, 2020, 368, l6983. doi: 10.1136/bmj.l6983. 2- Bolayır A, Gökce SF et al. Monocyte/high density lipoprotein ratio predicts the mortality in ischemic stroke patients. Neurol. Neurochir. Pol, 2018, 52(2), 150-55. 3- Schaftenaar F, Frodermann V et al. Atherosclerosis. Curr Opin Lipidol, 2016, 27(3), 209–15. 4- Libby P. Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol 2012, 32(9), 2045–51. 5- Mestas J, Ley K. Monocyte-endothelial cell interactions in the development of atherosclerosis. Trends in cardiovascular medicine. 2008, 18(6), 228–32. 6- Woollard KJ, Geissmann F. Monocytes in atherosclerosis: subsets and functions. Nat Rev Cardiol. 2010, 7(2), 77–86. 7- Hafiane A, Genest J. High density lipoproteins: Measurement techniques and potential biomarkers of cardiovascular risk. BBA Clin. 2015, 31(3), 175-88. 8- Canpolat U, Cetin EH et al. Association of Monocyte-to-HDL Cholesterol Ratio with Slow Coronary Flow is Linked to Systemic Inflammation. Clinical and Applied Thrombosis/Hemostasis. 2016, 22(5), 476-82. 9- Kundi H, Kiziltunc E et al. Association of monocyte/ HDL-C ratio with SYNTAX scores in patients with stable coronary artery disease. Herz, 2016, 41, 523–9. 10- Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pak J Med Sci. 2019, 35(4), 1081-6. 11- Brott T, Adams HP Jr et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 1989, 20(7), 864-70. 12- Lambert JM, Lopez EF et al. Macrophage roles following myocardial infarction. Int J Cardiol. 2008, 130(2), 147-58. 13- Choi S, Kim J et al. Monocyte count as a predictor of cardiovascular mortality in older Korean people. Age Ageing. 2017, 46(3), 433–8. 14- Grosse GM, Schulz-Schaeffer WJ et al. Monocyte subsets and related chemokines in carotid artery stenosis and ischemic stroke. Int J Mol Sci. 2016, 17(4), 433. 15- Karabacak M, Kahraman F et al. Increased plasma monocyte chemoattractant protein-1 levels in patients with isolated low high-density lipoprotein cholesterol. Scand J Clin Lab Invest. 2015, 75(4), 327-32. 16- Navab M, Ananthramaiah GM et al. The oxidation hypothesis of atherogenesis: the role of oxidized phospholipids and HDL. J Lipid Res, 2004, 45, 993-1007. 17- Barter PJ, Nicholls S et al. Antiinflammatory properties of HDL. Circ Res 2004, 95, 764-72. 18- Mineo C, Deguchi H et al. Endothelial and antithrombotic actions of HDL. Circ Res, 2006, 98, 1352-64. 19- Li XP, Zhao SP et al. Protective effect of high density lipoprotein on endothelium dependent vasodilatation. Int J Cardiol. 2000, 73, 231-6. 20- Barter PJ, Baker PW et al. Effect of high-density lipoproteins on the expression of adhesion molecules in endothelial cells. Curr Opin Lipidol, 2002, 13, 285-8. 21- Sacco RL, Benson RT et al. High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study. J Am Med Assoc, 2001, 285, 2729-35. 22- Yeh PS, Yang CM et al. Low levels of high-density lipoprotein cholesterol in patients with atherosclerotic stroke: a prospective cohort study. Atherosclerosis, 2013, 228(2), 472-7. 23- Kanbay M, Solak Y et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014, 46(8), 1619-25. 24- Kundi H, Gok M et al. Relationship between monocyte to HDL-C ratio and the severity of isolated coronary artery ectasia. Am J Cardiol, 2015, 116(11), 1685–9. 25- Canpolat U, Aytemir K et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace, 2015, 17(12), 1807–15. 26- Li N, Ren L et al. Relationship between monocyte to HDL cholesterol ratio and concomitant cardiovascular disease in Chinese Han patients with obstructive sleep apnea. Cardiovasc Diagn Ther. 2019, 9(4), 362-370. 27- Wang HY, Shi WR et al. Assessing the performance of monocyte to high-density lipoprotein ratio for predicting ischemic stroke: insights from a population-based Chinese cohort. Lipids Health Dis. 2009, 18(1), 127. 28- Liu H, Liu K et al. Monocyte-to-High-Density Lipoprotein Ratio Predicts the Outcome of Acute Ischemic Stroke. J Atheroscler Thromb. 2020 Jan 16. doi: 10.5551/jat.51151.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sinirbilim |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Proje Numarası | Etik onayı: Çalışma için Selçuk Üniversitesi klinik araştırmalar etik kurulundan (toplantı sayısı: 2019/16 karar sayısı: 2019/352) onay alınmıştır. |
| Yayımlanma Tarihi | 31 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 7 Sayı: 4 |
