Kararlı Koroner Arter Hastalığı Olan Hastalarda Nitratların Oluşturduğu Baş Ağrısının Aterosklerotik Yükü Öngörmedeki Değeri

Year 2016, Volume: 19 Issue: 1, 12 - 16, 04.04.2016

Hakan Erkan , Gülhanım Kırış Levent Korkmaz İsmail Gökhan Çavuşoğlu Şükrü Çelik

Abstract

Giriş:
Damarlarda genişlemeye yol açan nitratlar
antianginal tedavinin köşetaşı ilaçlarından biridir. Nitratların en sık
karşılaşılan yan etkisi beyin arterlerinin genişlemesi ile bağlantılı oluşan baş
ağrısıdır. Nitratlara karşı damar genişletici cevap aterosklerozlu hastalarda
anlamlı olarak azalmıştır. Bu çalışmanın amacı kararlı koroner arter hastalığı
olan hastalarda nitratların indüklediği baş ağrısı (NİB) ile sistemik ve
koroner aterosklerotik yük arasındaki ilişkiyi belirlemektir.

Hastalar
ve Yöntem: NİB olan kırk hasta (grup I:
61.2 ± 8.56 yıl, 32 erkek) ve NİB olmayan atmış iki hasta (63.5 ± 8.45 yıl, 41
erkek) çalışmaya kaydedildi. Sistemik aterosklerotik yük karotis intima-media
kalınlığı (KİMK) ve kalp-ayak bileği damar indeksi (KADİ) ile değerlendirildi.
Koroner aterosklerotik yük, Gensini skoru ile değerlendirildi.

Bulgular:
KİMK ve KADİ grup ll’de grup I’e göre anlamlı
olarak daha büyüktü. (0.8 ± 0.20 karşı 0.6 ± 0.20 ve 9.5 ± 1.00 karşı 8.4 ±
1.20 p< 0.001, sırasıyla). Gensini skoruda grup ll’de grup l’den daha
yüksekti. [ortanca 32 (16.7-45.2) karşı 12.5 (5.2-19.2) p< 0.001].
Multivariate analizde baş ağrısı KİMK, KADİ ve Gensini skorunun bağımsız
belirleyicisi olarak bulundu (p< 0.001 ).

Sonuç: NİB olan hastalar NİB olmayanlarla
karşılaştırıldığında KİMK, KADİ ve Gensini skoru ile belirlenmiş düşük seviyede
sistemik ve koroner ateroskleroz yüke sahiptir.

Keywords

Nitrat, baş ağrısı, ateroskleroz

Predictive Value of Nitrate-Induced Headache on Atherosclerotic Burden in Patients with Stable Coronary Artery Disease

Abstract

Introduction:
Nitrates, which lead to vasodilation in vessels, is
one of the cornerstone drugs of antianginal therapy. The most frequently
encountered side effect of nitrates is headache, which is linked to
vasodilation of the cerebral arteries. Vasodilator response to nitrates is
significantly reduced in patients with atherosclerosis. The aim of present
study was to assess the relationship between nitrate-induced headache (NIH) and
systemic and coronary atherosclerotic burden in patients with stable coronary
artery disease.

Patients
and Methods: Overall, 40 patients with NIH (group I: 61.2
± 8.56 years, 32 males) and 62 patients without headache (group II: 63.5 ± 8.45
years, 41 males) were included in the study. Systemic atherosclerotic burden
was evaluated by carotid intima-media thickness (CIMT) and cardio-ankle vascular
index (CAVI). Coronary atherosclerotic burden was assessed by the Gensini
score.

Results: CIMT
and CAVI were significantly greater in group II than in group I (0.8 ± 0.20 vs.
0.6 ± 0.20 and 9.5 ± 1.0 vs. 8.4 ± 1.2, respectively; p< 0.001). The Gensini
score was also higher in group II than in group I [median 32 (16.7-45.2) vs
12.5 (5.2-19.2); p< 0.001]. In multivariate analysis, headache was found as
an independent determinant of CIMT, CAVI, and Gensini score (p< 0.001).

Conclusion: Patients with NIH had a low
level systemic and coronary atherosclerotic burden, evaluated by CIMT, CAVI,
and Gensini score, compared with those without NIH.

Keywords

Nitrates, headache, atherosclerosis

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