Kararlı Anjina Pektorisli Hastalarda Koroner Arter Lezyon Şiddetinin Eritrosit Dağılım Genişliği ve Ayak Bileği-Kol Basınç İndeksi ile İlişkisi

Year 2018, , 311 - 319, 29.06.2018

Kayıhan Karaman , Barış Aygüç Arif Arısoy , Metin Karayakalı , Samet Yılmaz Serhat Karaman , Cemal Aslan Ataç Çelik

https://doi.org/10.31832/smj.415819

Abstract

Amaç: Ayak bileği-kol basınç indeksi (AKİ), noninvaziv ve
ucuz bir metod olup yaşlı popülasyonda periferik arter hastalığının (PAH)
tanımlanması için kullanılır. PAH’nın bir göstergesi olarak AKİ, koroner arter
hastalığını (KAH) tahmin etmek için yaygın bir şekilde kullanılmaktadır.
Eritrosit dağılım genişliği (EDG) dolaşımdaki eritrositlerin boyutlarındaki
değişkenliğin bir ölçüsüdür. EDG’deki artışlar hem kararlı hem de kararsız
haldeki KAH ile ilişkilidir. Bu çalışmada, kararlı anjina pektoris (KAP)
hastalarında EDG ve AKİ belirteçlerinin SYNTAX skoru (SS) kullanılarak koroner
lezyon şiddeti üzerine prediktif bilgi sağlayıp sağlayamayacağını araştırmayı
amaçladık.

Gereç ve Yöntemler: Çalışmaya 109 KAP hastası dahil
edildi. Hastalar önce 40 hasta normal koroner arterler ve 69 hasta KAH grubuna
ayrılarak değerlendirildi. Sonrasında KAH hasta grubu, KAH şiddetini
anjiyografik olarak derecelendiren SS’na göre iki ayrı alt gruba (SS 1-22
(n=32) ve SS >22 (n=37) ayrılarak incelendi. p<0.05 anlamlı kabul edildi.

Bulgular: Çok değişkenli regresyon analizi EDG ve AKİ’nin
KAH varlığının bağımsız birer prediktörü olduğunu gösterdi (sırasıyla; OR:
6,209, p= 0,001 ve OR: -2,342, p<0,001). Fakat aynı analiz AKİ’nin KAH
şiddetini öngörmede EDG’den daha iyi olduğunu gösterdi (sırasıyla; OR: 1,568,
p= 0,215 ve OR: -1,540, p<0,001).

Sonuçlar: Koroner arter hastalığı varlığında EDG’nin
anlamlı derecede arttığı, AKİ’nin anlamlı derecede azaldığı görülmüştür. KAH
varlığını öngörmede EDG ve AKİ’nin kullanışlı birer değişken olduğu tespit
edilmiştir. AKİ, KAH’ın şiddetini tahmin etmede EDG'den daha güçlü bir
öngördürücüdür.

Keywords

Bilek-brakiyal indeksi, eritrosit dağılım genişliği, SYNTAX skoru, anjina pektoris

The Relationship between Red Cell Distribution Width and Ankle-Brachial Pressure Index of the Coronary Artery Lesion Severity in Patients with Stable Angina Pectoris

Abstract

Objective:
Ankle-brachial pressure index (ABI) is a noninvasive and inexpensive method
used to identify peripheral arterial disease (PAD) in the elderly population.
As a marker of PAD, ABI is widely used to predict coronary artery disease
(CAD). Red cell distribution width (RDW) is a measure of the variability in the
size of erythrocytes in circulation. Increases in RDW are associated with both
stable and unstable CAD. In this study, we aimed to investigate whether RDW and
ABI markers could provide predictive information on coronary lesion complexity
using SYNTAX score (SS) in patients with stable angina pectoris
(SAP).

Materials and Methods:
One hundred SAP patients were included in the study. Patients were divided into
40 patients with normal coronary arteries and 69 patients with CAD.
Subsequently, the CAD patient group was examined by separating two subgroups
(SS 1-22 (n=32) and SS >22 (n=37)) according to the SS that rated CAD severity
as angiography. p <0.05 was considered significant.

Results: Multivariate
regression analysis showed that RDW and ABI were independently predictors of
CAD (OR: 6,209, p=0.001 and OR: -2,342, p<0.001, respectively). However, the
same analysis showed that ABI was better than RDW in predicting the severity of
CAD (OR: 1,568, p=0,215 and OR: -1,540, p<0.001).

Conclusions: In the
presence of CAD has been shown that RDW increases significantly and ABI
decreases significantly. It has also been found that RDW and ABI are useful
variables for predicting the presence of CAD. ABI is a strong predictor of the
severity of CAD than RDW.

Keywords

Ankle-brachial index, red cell distribution width, SYNTAX score, angina pectoris

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