Kronik Koroner Sendrom Tanısı Alan Hastalarda D Vitamini Eksikliği ile CHA2DS2-VASc Skoru Arasındaki İlişki

Abstract

Amaç: Kronik koroner sendrom (KKS) tanılı hasta grubunda D vitamini eksikliği ile CHA2DS2-VASc skoru arasındaki ilişkiyi tespit etmeyi amaçladık. Gereç ve Yöntem: Çalışmaya KKS tanısı konmuş ve koroner anjiografi uygulanmış ve kritik koroner arter darlığı saptanan 147 hasta retrospektif olarak alındı. Hastaların CHA2DS2-VASc skorları hesaplandı. Laboratuvar bulguları, D vitamin düzeyleri ve ekokardiyografi parametreleri kaydedildi. CHA2DS2-VASc skoruna göre; <3 ise düşük-orta skor grubu, skor ≥3 ise yüksek skor grubu olarak sınıflandırıldı. Bulgular: Ortalama yaş: 62.7±10.5 ve hastaların 80 (%54.4)’ i kadın idi. Yüksek skor grubundaki hastalar daha yaşlı idi (63.6±10.7, p<0.001). Vücut kitle indeksi (VKİ) ve diyabetes mellitus (DM) sıklığı yüksek skor grubunda daha fazlayken (p=0.003 ve p<0.001, sırasıyla), D vitamin düzeyi ve Ejeksiyon fraksiyonu ise anlamlı olarak daha düşüktü (p<0.001 ve p=0.02, sırasıyla). Çok değişkenli lojistik regresyon analizi yapıldığında, VKİ (Olasılık Oranı=1.383; %95 Güvenlik Aralığı=1.155-1.657), ve D vitamin düzeyinin (Olasılık Oranı=0.852; %95 Güvenlik Aralığı 0.776-0.935), yüksek CHA2DS2-VASc skorunu öngörme de bağımsız belirteçler olduğu izlendi. ROC analizi yapıldığında D vitamin düzeyi 23.6 ng/ml ‘‘kesim değeri’’ olarak alındığında %61 duyarlılık ve %84 özgüllük ile yüksek CHA2DS2-VASc skorunu belirlediği bulundu. Sonuç: Kronik koroner sendrom tansıyla koroner anjiyografi uygulanan hastalarda düşük D vitamini düzeyi ile yüksek CHA2DS2-VASc skoru arasında bağımsız bir ilişki olduğu tespit edildi.

Keywords

• Kronik Koroner Sendrom
• D Vitamin
• CHA2DS2-VASc Skoru

The Relationship Between Vitamin D Deficiency And CHA₂DS₂-VASc Score in Chronic Coronary Syndrome

Abstract

Objective: To assess the relationship between Vitamin D level and CHA2DS2-VASc score in patients with chronic coronary syndrome (CCS). Methods:A total of 147 participants with CCS who underwent coronary angiography and had critical coronary artery stenosis were retrospectively enrolled in the study. Patients’ CHA2DS2-VASc scores were measured. Laboratory parameters including vitamin D and echocardiographic findings were recorded. Participants were divided into two groups according to CHA2DS2-VASc score, CHA2DS2-VASc score <3 as low-moderate group and CHA2DS2-VASc score ≥3 as high group. Results: Mean age was 62.7±10.5 and 80 (54.4%) were female. Age was older in the group with high CHA2DS2-VASc score (63.6±10.7 vs 56.6±6.3, p<0.001). Body mass index (BMI) and diabetes mellitus (DM) frequency were higher in the high score group (p=0.003 and p<0.001, respectively), whilst ejection fraction and vitamin D level were lower (p=0.02 and p<0.001, respectively). In multivariate logistic regression analysis with forward selection, BMI (OR: 1.383, 95% CI: 1.155-1.657, p<0.001) and Vitamin D level (OR: 0.852, 95% CI: 0.776-0.935, p=0.001) were independently associated with high CHA2DS2-VASc score. A cut-off value of 23.6 ng/ml for vitamin D level predicted high CHA2DS2-VASc score, with 61% sensitivity and 84% specificity [AUC:0.755 (0.678-0.822), %95 CI, p<0.001] in receiver operating characteristic (ROC) curve analysis. Conclusion: In patients with CCS undergoing coronary angiography, it was determined an independent relationship between low vitamin D levels and high CHA2DS2-VASc score.

Keywords

• Chronic Coronary Syndrome
• Vitamin D
• CHA2DS2-VASc Score

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