Trigliserid/yüksek yoğunluklu lipoprotein kolesterol oranı ile koroner lezyonların fonksiyonel önemi arasındaki ilişki

Abstract

AMAÇ Yapılan çalışmalarda trigliseridlerin (TG) kardiyovasküler hastalık (KVH) için bağımsız bir risk faktörü olduğunu gösterilmektedir. Düşük, yüksek yoğunluklu lipoprotein kolesterel (HDL-K) ile karakterize dislipideminin KAH belirtileriyle ilişkili olduğu gösterilmiştir. Yapılan çalışmalarda TG/HDL-K oranının, koroner hastalığın derecesi ile güçlü şekilde ilişkili parametreler olduğu saptanmıştır Bu çalışmada, TG/HDL-K oranının orta koroner arter lezyonlarının fonksiyonel önemi ile ilişkili olup olmadığını araştırmayı amaçladık. GEREÇ ve YÖNTEM Anjiyografik olarak orta derecede koroner darlık (kantitatif koroner analizde %40-70) nedeniyle fraksiyonel akım rezervi (FAR) ölçümü yapılan 72'i erkek, 30'sı kadın olmak üzere 102 ardışık hasta çalışmaya dahil edildi. FAR değerinin ≤ 0.80 olması hemodinamik anlamlılık için kabul edildi. BULGULAR Çalışmaya dahil edilen 102 hasta arasında, 52'sinin (%50.9) önemli fonksiyonel darlık olduğu belirlendi. Grup II'nin sol ventrikül ejeksiyon fraksiyonu, grup I'e göre daha düşüktü (60 (55-62.5) vs. 55(50-60), p = 0.006). Grup II'de erkek hasta oranı daha yüksekti ancak iki grup arasındaki fark anlamlı değildi (sırasıyla %68 ve %77, p = 0.072). Tek değişkenli ve çoklu lojistik regresyon analizi, TG/HDL-K'nin (OR = 1.278, %95 CI = 1.078-1.514, p = 0.005) önemli fonksiyonel darlığın bağımsız belirleyicilerinden olduğunu gösterdi. ROC analizi, TG/HDL-K değerinin 3.89 olduğunu ve hemodinamik olarak önemli koroner arter darlığını tahmin etmede %64 spesifiklik ve %61.5 duyarlılık sağladığını ortaya koydu. SONUÇ Yükselmiş TG/HDL-K değerleri, anjiyografik olarak orta düzey koroner arter darlığının fonksiyonel önemi ile ilişkilendirilmiştir

Keywords

• Koroner Arter Hastalığı
• Trigliserid
• Fraksiyonel Akım Rezervi

The relationship between triglyceride/high-density lipoprotein cholesterol ratio and the functional significance of coronary lesions

Abstract

Aims: Have shown that triglycerides (TG) are an independent risk factor for cardiovascular disease (CVD). Dyslipidemia characterized by low high-density lipoprotein cholesterol (HDL-C) has been shown to be associated with symptoms of coronary artery disease (CAD). In studies, the TG/HDL-C ratio has been found to be strongly associated with parameters indicative of the severity of coronary disease. In this study, we aimed to investigate whether the TG/HDL-C ratio is associated with the functional significance of moderate coronary artery lesions. Methods: A total of 102 consecutive patients, 72 male and 30 female, who underwent measurement of fractional flow reserve (FFR) due to moderate coronary stenosis (quantitative coronary analysis 40-70%) on angiography were included in the study. An FFR value ≤0.80 was accepted for hemodynamic significance. Results: Among the 102 patients included in the study, it was determined that 52 (50.9%) had significant functional stenosis. Left ventricular ejection fraction of Group II was lower than Group I (60 (55-62.5) vs. 55(50-60), p=0.006). The male patient ratio was higher in Group II, but the difference between the two groups was not significant (68% and 77%, respectively, p=0.072). Univariate and multivariate logistic regression analysis showed that TG/HDL-C (OR=1.278, 95% CI=1.078-1.514, p=0.005) was an independent determinant of significant functional stenosis. ROC analysis revealed that the TG/HDL-C value was 3.89 and provided 64% specificity and 61.5% sensitivity in predicting hemodynamically significant coronary artery stenosis. Conclusion: Elevated TG/HDL-C values are associated with the functional significance of angiographically moderate coronary artery stenosis.

Keywords

• Coronary Artery Disease
• Triglyceride
• Fractional Flow Reserve
• HDL-C

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