Stent Restenozunu Öngördürmede Eozinofil-Lenfosit Oranının Kullanışlılığı

Year 2016, Volume: 43 Issue: 2, 299 - 304, 01.06.2016

Mehmet Zihni Bilik Mehmet Ata Akıl Halit Acet Murat Yüksel Mustafa Oylumlu Nihat Polat Adem Aktan Sait Alan

Abstract

Amaç: Stent içi restenoz (SR), perkütan koroner girişimin
(PKG) önemli komplikasyonlarından biridir. Eozinofil
ile SR arasındaki ilişkiyi ortaya çıkaran çok sayıda çalışma
olmasına rağmen, literatürde eozinofil-lenfosit oranı
(ELO)’nın SR gelişimi ile ilişkisi hakkında veri bulunmamaktadır.
Bu çalışmada, hastaların başvuru ELO değerlerinin
SR ile ilişkisini araştırmayı amaçladık.
Yöntemler: Çalışmaya, daha önce koroner stent takılmış
olup hastanemize stabil angina nedeniyle başvuran ve
tekrar koroner anjiyografisi yapılan 314 hasta dahil edildi.
Hastaların verileri retrospektif olarak incelendi. Anjiyografik
olarak SR tespit edilen 197 kişi hasta grubuna alındı,
stentleri açık olan 117 hasta ise kontrol grubuna dahil
edildi.
Bulgular: Yaş, cinsiyet, hipertansiyon, diabetes mellitus,
LDL-kolesterol, HDL-kolesterol, platelet sayısı, platelet-lenfosit
oranı (PLO), hemoglobin düzeyleri ve sol ventrikül
ejeksiyon fraksiyonu (LVEF) ölçümleri bakımından
gruplar arasında anlamlı bir fark yoktu. Başvuruda bakılmış
olan kan beyaz küre sayısı (WBC), nötrofil, eozinofil,
C-reaktif protein (CRP), ELO ve nötrofil-lenfosit oranı
(NLO) değerleri SR grubunda kontrol grubuna göre istatistiksel
olarak anlamlı şekilde daha yüksek lenfosit değerleri
daha düşüktü. Tüm hastalar ELO düzeylerine göre
iki gruba ayrıldığında, yüksek-ELO grubunda düşük-ELO
grubuna kıyasla daha sık SR görüldü. Başvuru ELO değerinin
≥0,745 olması durumunda, SR’u %64 sensitivite
ve %61 spesifite ile öngördürebildiği saptandı.
Sonuç: Bu çalışmada ELO değerleri kontrol grubuna kıyasla
SR grubunda anlamlı olarak daha yüksek bulundu.
Çalışmadan elde ettiğimiz bulgular ışığında kolay ve ucuz
bir yöntem olan ELO, SR açısından yüksek riskli hastaların
belirlenmesine yardımcı olabilir ve yüksek ELO, SR
için bir öngördürücü olarak kullanılabilir.

Keywords

Koroner restenoz, stentler, eozinofiller, lenfositler

Usefulness of Eosinophil-Lymphocyte Ratio to Predict Stent Restenosis

Abstract

Objective: Stent restenosis (SR) is an important compli­cation of percutaneous coronary intervention. There are many studies explored the relation of eosinophils with SR, however, there is no data about relationship between eo­sinophil-lymphocyte ratio (ELR) and SR. In this study we aimed to investigate the relationship between the value of ELR on admission and SR. Methods: The study was included 314 patients who had been applied a coronary stent implantation and they were admitted to cardiology clinic with stabile angina and un­derwent repeat coronary angiography. The data obtained from patients were analyzed retrospectively. The patient group was consisted of 197 patients who were diagnosed as SR, and the control group was consisted of 117 pa­tients whose stents were patent angiographically. Results: The groups were similar in terms of age, gender, hypertension, diabetes mellitus, LDL-C, HDL-C, platelet count, platelet-lymphocyte ratio (PLR), hemoglobin and left ventricle ejection fraction (LVEF). White blood cell (WBC), neutrophil, eosinophil, C-reactive protein (CRP), ELR and neutrophil-lymphocyte ratio (NLR) on admission were higher in the SR group compared to the controls. All patients were categorized into two groups according to ELR values and SR was more frequent in the high ELR group compared to low ELR group. An ELR value of ≥0.745 predicted SR with 64% sensitivity and 61% specif­ity. Conclusion: In this study ELR was found statistically higher in SR patients compared to the controls. Accord­ing to our data ELR as an inexpensive and easy method, may contribute to determination of high risk patients and increased ELR can be used as a predictor of SR.

Keywords

Coronary restenosis, stents, eosinophils, lymphocytes

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