Alyuvar dağılım genişliği ile izole koroner ektazi arasındaki ilişki

Year 2021, , 385 - 390, 22.12.2021

Dilay Karabulut , Cennet Yıldız , Umut Karabulut , Gülçin Şahingöz Erdal , Nihan Turhan , İbrahim Faruk Aktürk , Müge Bilge , Ersan Oflar Gülsüm Bingöl , Nilgün Işıksaçan

https://doi.org/10.18663/tjcl.1008342

Abstract

Amaç: İzole koroner arter ektazisi (CAE), koroner arterin anormal genişlemesidir ve iskemiye neden olabilir. RDW, çeşitli kardiyovasküler bozukluklarda araştırılmıştır ve yakın zamanda,hastalarda olumsuz sonuçların öngörücü bir biyobelirteçi olabileceği öne sürülmüştür. Artmış RDW'nin,her ikisi de inflamasyonla ilişkili olduğu için, izole CAE ile de ilişkili olacağını varsaydık.
Gereç ve Yöntemler: İzole CAE'li 69 hasta ve anjiyografik olarak normal 71 hasta olmak üzere 140 denek üzerinde çalışıldı. Temel klinik özellikler ve RDW dahil laboratuvar bulguları iki grup arasında karşılaştırıldı.
Bulgular: RDW düzeyi izole CAE'de normal kontrollere göre anlamlı derecede yüksekti (14,36±1,61 'a 13,59±1,57,
p=0,005). Ek olarak, izole CAE'de glomerüler filtrasyon hızı ve kreatinin, yüksek yoğunluklu lipoprotein ve düşük yoğunluklu lipoprotein seviyeleri normal kontrollere göre anlamlı derecede düşüktü (76,43±19,64'e karşı 100,36±18,3 ,0,9±0 ,28 'e karşı 0,74±0,25, 43,39±10,09'e karşı 48,4±13,67, 121,36±32,05 'e karşı 143,70±55,33 ,sırası ile p=0,001, p=0,001, p=0,01, p=0,004).ROC eğrisi analizinde, 13,5'lik bir RDW değeri, izole CAE'nin varlığının veya yokluğunun ayrımında etkili bir kesme noktası olarak tanımlandı ([AUC]: 0,71, CI %95, 0,62-0,80, p<0,001).
Sonuç: Verilerimiz, RDW'nin izole CAE varlığını saptamak için yararlı bir belirteç olabileceğini göstermiştir

Keywords

Alyuvar, Dağılım, Genişliği, Koroner, Ektazi

The relationship between red blood cell distribution width and isolated coronary ectasia

Abstract

Aim: Isolated coronary artery ectasia (CAE) is an abnormal dilatation of the coronary artery which cause ischemia. RDW has been investigated in several cardiovascular disorders and has also been recently proposed as a predictive biomarker of adverse outcomes in patients with these conditions. We hypothesized that increased RDW would be associated with isolated CAE because both are associated with inflammation.
Material and Methods: We studied 140 subjects, including 69 patients with isolated CAE, 71 patients with angiographically normal controls. Baseline clinical characteristics and laboratory findings, including RDW, were compared among two groups.
Results: The level of RDW was significantly higher in isolated CAE than normal controls (14,36±1,61vs 13,59±1.57, p=0.005). In addition, the levels of glomerular filtration rate and creatinin, high density lipoprotein and low density lipoprotein were significantly lower in isolated CAE than normal controls (76,43±19,64 vs 100,36±18,3 and 0,9±0,28 vs 0,74±0,25, 43,39±10,09 vs 48,4±13,67, 121,36±32,05 vs 143,70±55,33 p=0,001, p=0,001, p=0,01, p=0,004 respectively). In a ROC curve analysis, a RDW value of 13,5 was identified as an effective cut off point for the discrimination of the presence or absence of isolated CAE (Area Under curve [AUC]: 0.71, CI 95%, 0.62-0.80, p<0,001).
Conclusion: Our data suggested that RDW may be a useful marker to predict CAE

Keywords

Red, cell, distribution, width, coronary, ectasia

References

• 1. Swaye PS, Fisher LD, Litwin P, et al. Aneurysmal coronary artery disease. Circulation. 1983; 67: 134-8.
• 2. Pinar Bermudez E, Lopez Palop R, Lozano Martinez-Luengas I, et al. [Coronary ectasia: prevalence, and clinical and angiographic characteristics]. Rev Esp Cardiol. 2003; 56: 473-9.
• 3. Valente S, Lazzeri C, Giglioli C, et a. Clinical expression of coronary artery ectasia. J Cardiovasc Med (Hagerstown) 2007; 8: 815–20.
• 4. Giannoglou GD, Antoniadis AP, Chatzizisis YS, Damvopoulou E, Parcharidis GE, Louridas GEet al. Prevalence of ectasia in human coronary arteries in patients in northern Greece referred for coronary angiography. Am J Cardiol 2006; 98: 314–8.
• 5. Li JJ. Inflammation in coronary artery diseases. Chin Med J (Engl). 2011; 124: 3568-75.
• 6. Saigo K, Jiang M, Tanaka C, et al. Usefulness of automatic detection of fragmented red cells using a hematology analyzer to diagnose thrombotic microangiopathy. Clin Lab Haematol 2002; 24: 347–51.
• 7. Tonelli M, Sacks F, Arnold M, et al.Recurrent Events Trial I: Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation 2008, 117: 163–8.
• 8. Felker GM, Allen LA, Pocock SJ, et al. Investigators C: Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol 2007; 50: 40–7.
• 9. Ye Z, Smith C, Kullo IJ. Usefulness of red cell distribution width to predict mortality in patients with peripheral artery disease. Am J Cardiol 2011; 107: 1241–5.
• 10. Ani C, Ovbiagele B. Elevated red blood cell distribution width predicts mortality in persons with known stroke. J Neurol Sci 2009; 277: 103–8.
• 11. Qing P, Luo SH, Guo YL, et al. Evaluation of red blood cell distribution width in patients with cardiac syndrome X. Dis Markers 2013; 34: 333–9.
• 12. Luo SH, Jia YJ, Nie SP, et al. Increased red cell distribution width in patients with slow coronary flow syndrome. Clinics (Sao Paulo) 2013; 68: 732–7.
• 13. Lippi G, Targher G, Montagnana M, et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med. 2009; 133: 628-2.
• 14. Lappe JM, Horne BD, Shah SH, et al. Red cell distribution width, C-reactive protein, the complete blood count, and mortality in patients with coronary disease and a normal comparison population. Clin Chim Acta. 2011; 412: 2094-9.
• 15. Satran A, Bart BA, Henry CR, et al. Increased prevalence of coronary artery aneurysms among cocaine users. Circulation 2005; 111: 2424–9.
• 16. Li JJ, He JG, Nan JL, et al. Is systemic inflammation responsible for coronary artery ectasia? Int J Cardiol 2008; 130: 69–70.
• 17. Harikrishnan S, Sunder KR, Tharakan J, et al. Coronary artery ectasia: angiographic, clinical profile and follow-up. Indian Heart J. 2000; 52: 547-53.
• 18. Li JJ,Nie SP,QianXW,et al. Chronic inflammatory status in patients with coronary artery ectasia. Cytokine. 2009; 46: 61-4.
• 19. Turhan H, Erbay AR, Yasar AS, et al. Comparison of C-reactive protein levels in patients with coronary artery ectasia versus patients with obstructive coronary artery dis- ease. Am J Cardiol. 2004; 94: 1303-6.
• 20. Finkelstein A, Michowitz Y, Abashidze A, et al. Temporal association between circulating proteolytic, inflammatory and neurohormonal markers in patients with coron- ary ectasia. Atherosclerosis. 2005; 179: 353-9.
• 21. Aydin M, Tekin IO, Dogan SM, et al. The levels of tumor necrosis factor-alpha and interleukin-6 in patients with isolated coronary artery ectasia. Mediators Inflamm.2009; 2009: 106145.
• 22. Mavrogeni SI, Manginas A, Papadakis E, et al. Coronary flow evaluation by TIMI frame count and magnetic resonance flow velocity in patients with coronary artery ectasia. J Cardiovasc Magn Reson. 2005; 7: 545-50.
• 23. Balin M, Celik A, Kobat MA. The association between soluble lectin-like oxidized low-density lipoprotein receptor-1 levels and patients with isolated coronary artery ectasia. J Thromb Thrombolysis. 2012; 33: 239-45.
• 24. Dogdu O, Koc F, Kalay N, et al. Assessment of red cell distribution width (RDW) in patients with coronary artery ectasia. Clin Appl Thromb Hemost. 2012; 18: 211-4.
• 25. Antoniadis A.P, Chatzizisis Y.S, Giannoglou G.D. Pathogenetic mechanisms of coronary ectasia. Int J Cardiol 2008; 130: 335-43.
• 26. Pierce CN, Larson DF. Inflammatory cytokine inhibition of erythropoiesis in patients implanted with a mechanical circulatory assist device. Perfusion 2005; 20: 83–90.
• 27. Marinkovic D, Zhang X, Yalcın S,et al. Foxo3 is required for the regulation of oxidative stress in erythropoiesis. J Clin Invest. 2007; 117: 2133–44.
• 28. Kajinami K, Kasashima S, Oda Y, et al.Coronary ectasia in familial hypercholesterolemia: histo- pathologic study regarding matrix metalloproteinases. Mod Pathol. 1999; 12: 1174-80.
• 29. Sezen Y, Bas M, Polat M, et al. The relationship between oxidative stress and coronary artery ectasia Cardiol J 2010; 17: 488-94.
• 30. Saglam M, Karakaya O, Barutcu I, et al. Identifying Cardiovascular Risk Factors in a Patient Population With Coronary Artery Ectasia. Angiology, 2007; 58: 698–703.