Plateletkrit ve Trombosit Dağılım Genişliği Koroner Arter Ektazisinin Bağımsız Öngördürücüsüdür

Abstract

Giriş: Koroner arter ektazisi (KAE), koroner arterlerin anormal genişlemesi ile karakterize edilir. Ortalama trombosit hacmi (OTH), trombosit dağılım genişliği (TDG), plateletkrit (PKT) dahil olmak üzere trombosit hacmi endeksleri ve trombosit sayısı trombosit aktivasyonunun göstergeleridir. Bu çalışmada KAE’li hastalarda trombosit hacmi endeksleri incelendi.

Hastalar ve Yöntem: Çalışmaya, izole KAE’si olan 51 (38 erkek; ortalama yaş: 52 + 9.9 yıl) hasta ve koroner arterleri normal olan 50 (39 erkek; ortalama yaş: 54 + 11.3 yıl) sağlıklı birey dahil edildi. Başvuruda trombosit hacmi endeksleri otomatik tam kan sayımı parçası olarak ölçüldü.

Bulgular: Trombosit sayımı, OTH, PKT ve TDG, KAE grubunda kontrol grubuna göre daha yüksekti (p< 0.05). Çok değişkenli lojistik regresyon analizinde, TDG (Odds oranı: 0.22, %95 güven aralığı: 0.06-0.73, p= 0.013) ve PKT’nin (Odds oranı: 3.41, %95 güven aralığı: 1.66-6.98, p≤ 0.001) KAE’nin bağımsız öngördürücüleri olduğu gösterildi.

Sonuç: Bu çalışma, PKT ve TDG’nin KAE’nin bağımsız belirleyicileri olduğunu göstermektedir.

Keywords

• Koroner arter ektazisi,koroner arter hastalığı,ortalama trombosit hacmi,trombosit dağılım genişliği

Plateletcrit and Platelet Distribution Width as Independent Predictors of Coronary Artery Ectasia

Abstract

Introduction: Coronary artery ectasia (CAE) is characterised by an abnormal dilatation of the coronary arteries. Platelet volume indices, including the mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) and platelet count, are indicators of platelet activation. In this study, we investigated platelet volume indices in patients with CAE.

Patients and Methods: The study group included 51 patients (38 men; mean age: 52 ± 9.9 years) with isolated CAE and 50 individuals with normal coronary arteries (39 men; mean age: 54 ± 11.3 years). Admission platelet volume indices were measured as part of the automated complete blood count.

Results: Platelet count, MPV, PCT and PDW were higher in CAE than in the control group (p< 0.05). Multivariate analysis revealed PDW (odds ratio: 0.22, 95% confidence interval: 0.06-0.73, p= 0.013) and PCT (odds ratio: 3.41, 95% confidence interval: 1.66-6.98, p≤ 0.001) as independent predictors of CAE.

Conclusion: This study demonstrates that PCT and PDW are independent predictors of CAE.

Keywords

• Coronary artery ectasia,coronary artery disease,mean platelet volume,platelet distribution width

References

1. 1. Hartnell GG, Parnell BM, Pridie RB. Coronary artery ectasia, its prevalence and clinical significance in 4993 patients. Br Heart J 1985;54:392-5.
2. 2. Valente S, Lazzeri C, Giglioli C, Sani F, Romano SM, Margheri M, et al. Clinical expression of coronary artery ectasia. J Cardiovasc Med (Hagerstown) 2007;8:815-20.
3. 3. Li JJ, Nie SP, Qian XW, Zeng HS, Zhang CY. Chronic inflammatory status in patients with coronary artery ectasia. Cytokine 2009;46:61-4.
4. 4. Giannoglou GD, Antoniadis AP, Chatzizisis YS, Damvopoulou E, Parcharidis GE, Louridas GE. Prevalence of ectasia in human coronary arteries in patients in northern Greece referred for coronary angiography. Am J Cardiol 2006;98:314-8.
5. 5. Kruger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms (‘‘dilated coronopathy’’). J Am Coll Cardiol 1999;34:1461-70.
6. 6. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177-90.
7. 7. Shah B, Oberweis B, Tummala L, Amoroso NS, Lobach I, Sedlis SP, et al. Mean platelet volume and long-term mortality in patients undergoing percutaneous coronary intervention. Am J Cardiol 2013;111:185-9.
8. 8. Martin JF, Shaw T, Heggie J, Penington DG. Measurement of the density of human platelets and its relationship to volume. Br J Haematol 1983;54:337-52.

9. 9. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010;14:28-32.
10. 10. Bain BJ, Bates I. Basic haematological techniques. In: Lewis SM, Bain BJ, Bates I (eds). Dacie and Lewis Practical Haematology, 9th ed. Edinburgh: Churchill Livingstone; 2001:19-46.
11. 11. Akpinar I, Sayin MR, Gursoy YC, Karabag T, Kucuk E, Buyukuysal MC, et al. Plateletcrit. A platelet marker associated with saphenous vein graft disease. Herz 2014;39:142-8.
12. 12. Huczek Z, Kochman J, Filipiak KJ, Horszczaruk GJ, Grabowski M, Piatkowski, et al. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol 2005;46:284-90.
13. 13. Murat SN, Duran M, Kalay N, Gunebakmaz O, Akpek M, Doger C, et al. Relation between mean platelet volume and severity of atherosclerosis in patients with acute coronary syndromes. Angiology 2013;64:131-6.
14. 14. Demir S, Avsar MK, Karakaya Z, Selcuk M, Tosu AN, Abal G, et al. Increased mean platelet volume is associated with coronary artery ectasia. Postepy Kardiol Interwencyjnej 2013;9:241-5.
15. 15. Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation 1983;67:134-8.
16. 16. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary artery ectasia. Am J Cardiol 1976;37:217-22.
17. 17. Mavrogeni S. Coronary artery ectasia: from diagnosis to treatment. Hellenic J Cardiol 2010;51:158-63.
18. 18. Díaz-Zamudio M, Bacilio-Pérez U, Herrera-Zarza MC, Meave-González A, Alexanderson-Rosas E, Zambrana-Balta GF, et al. Coronary artery aneurysms and ectasia: role of coronary CT angiography. Radiographics 2009;29:1939-54.
19. 19. Senaran H, Ileri M, Altinbas A, Koşar A, Yetkin E, Oztürk M, et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001;24:405-8.
20. 20. Demopoulos V, Olympios C, Fakiolas C, Pissimissis EG, Economides NM, Adamopoulou E, et al. The natural history of aneurysmal coronary artery disease. Heart 1997;78:136-41.
21. 21. Swanton RH, Lea TM, Coltarte DJ, Jenkins BS, Webb-Peploe MM, Williams BT. Coronary artery ectasia, a variant of occlusive coronary arteriosclerosis. Br Heart J 1978;40:393-400.
22. 22. Boles U, Eriksson P, Zhao Y, Henein MY. Coronary artery ectasia: remains a clinical dilemma. Coron Artery Dis 2010;21:318-20.
23. 23. Furman MI, Benoit SE, Barnard MR, Valeri CR, Borbone ML, Becker RC, et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery disease. J Am Coll Cardiol 1998;31:352-8.
24. 24. Ault KA, Cannon CP, Mitchell J, McCahan J, Tracy RP, Novotny WF, et al. Platelet activation in patients after an acute coronary syndrome: results from the TIMI-12trial: thrombolysis in myocardial infarction. J Am Coll Cardiol 1999;33:634-9.
25. 25. Klinger MH, Jelkmann W. Role of blood platelets in infection and inflammation. J Interferon Cytokine Res 2002;22:913-22.
26. 26. Alexandrakis MG, Passam FH, Moschandrea IA, Christophoridou AV, Pappa CA, Coulocheri SA, et al. Levels of serum cytokines and acute phase proteins in patients with essential and cancer-related thrombocytosis. Am J Clin Oncol 2003;26:135-40.
27. 27. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-tolymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:e67688.
28. 28. Dogan A, Aksoy F, Icli A, Arslan A, Varol E, Uysal BA, et al. Mean platelet volume is associated with culprit lesion severity and cardiac eventsin acute coronary syndromes without ST elevation. Blood Coagul Fibrinolysis 2012;23:324-30.
29. 29. Valkila EH, Salenius JP, Koivula TA. Platelet indices in patients with occlusivecarotid artery disease. Angiology 1994;45:361-5.
30. 30. Becchi C, Al Malyan M, Fabbri LP, Marsili M, Boddi V, Boncinelli S. Mean platelet volume trend in sepsis: is it a useful parameter. Minerva Anestesiol 2006;72:749-56.
31. 31. Kostrubiec M, Łabyk A, Pedowska-Włoszek J, Hrynkiewicz-Szyma´nska A, Pacho S, Jankowski K, et al. Mean platelet volume predictsearly death in acute pulmonary embolism. Heart 2010;96:460-5.
32. 32. Cil H, Yavuz C, Islamoglu Y, Tekbas EÖ, Demirtas S, Atilgan ZA, et al. Platelet count and mean platelet volume in patientswith in-hospital deep venous thrombosis. Clin Appl Thromb Hemost 2012;18:650-3.
33. 33. Duran M, Gunebakmaz O, Uysal OK, Ocak A, Yilmaz Y, Arinc H, et al. The relation between mean platelet volume and coronary collateralvessels in patients with acute coronary syndromes. J Cardiol 2013;61:295-8.
34. 34. Akpinar I, Sayin MR, Gursoy YC, Aktop Z, Karabag T, Kucuk E, et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon. J Cardiol 2014 ;63:112-8.
35. 35. Uğur M, Ayhan E, Bozbay M, Çiçek G, Ergelen M, Işık T, et al. The independent association of plateletcrit with long-term outcomes in patients undergoing primary percutaneous coronary intervention. J Crit Care 2014;29:978-81.