Kararsız Angina Pektorisli Hastalarda Ciddiyetin Yeni Bir Belirteci Olarak Trombosit Lenfosit Oranı: Randomize Kontrollü Çift Kör Çalışma

Year 2021, Volume: 11 Issue: 3, 398 - 403, 01.12.2021

Mustafa Bolatkale Ahmet Çağdaş Acara

Abstract

Amaç: Akut Koroner Sendrom (AKS), ST segment yükselmeli miyokard enfarktüsünden kararsız angina pektorise (UAP) kadar geniş bir klinik durum yelpazesini kapsar. UAP, Acil Servis kliniğinde herhangi bir biyobelirteçle tespit edilemez. Trombosit lenfosit oranı (PLR), kardiyak bozukluklarda aşırı trombotik aktiviteyi ve enflamasyonu belirlemek için potansiyel bir işaret olarak gösterilmiştir. Syntax skoru (SXscore), sadece lezyon şiddetini ve kompleksitesini ölçmekle kalmayan, aynı zamanda AKS’li hastalarda mortalite dahil olmak üzere agır kardiyovasküler sonuçları öngören koroner anjiyografiye dayalı anatomik bir skorlama sistemidir. Bu çalışmanın amacı, UAP’lı hastalarda trombosit lenfosit oranı ile SXscore karşılaştırılarak bu hastalarda PLR’nin prediktif değerini ortaya koymaktır.
Materyal ve Metot: Çalışma grubu, acil servise başvuran UAP tanısı alan hastalar ve acil servise’de UAP tanıs alan yetişkin hastalardan oluşturuldu. Kontrol grubu, kronik hastalığı olmayan sağlıklı yetişkinlerden oluşmuştur. Çalışma grubunda AKS şüphesi olan hastalara koroner anjiografi uyguladık ve her hasta için Syntax Skoru hesaplandı. Çalışma ve kontrol grubu arasında PLR seviyeleri karşılaştırıldı ve çalışma grubunun PLR seviyeleri ile Syntax skorları karşılaştırıldı.
Bulgular: Ortalama PLR düzeyleri UAP grubunda 122,89±52,44 ve kontrol grubunda 104,21±22,85 idi (p: 0,005). PLR düzeyi 113,98 olduğunda %55,8 duyarlılığa, %66,7 özgülüğe sahip olarak bulundu ve SXscore ile negatif korelasyon gösterdiği görülüldü (r=- 0,325; p: 0,004).
Sonuç: UAP ile başvuran hastalarda PLR seviyelerinin önemli ölçüde arttığı görüldü. PLR, UAP’ın ciddiyetinin tahmininde yeni bir belirteç olarak düşünülebilir. Ancak koroner vasküler hasarın değerlendirilmesinde etkisiz olduğu görülmüştür.

Keywords

syntax score;, platelet-lymphocyte oranı;, unstable angina pektoris

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