Yüksek SYNTAXII skoru olan koroner arter hastalarında plazma aterojenik indeksinin rolü

Abstract

Amaç: Koroner arter hastalığına (KAH) göre aterojenik plazma indeksinin (AIP) en iyi tanısal eşik değerini ve bunun SYNTAX II (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) skoru (SSII) ile ilişkisini değerlendirmeye çalıştık. Gereç ve Yöntemler: Araştırma, koroner anjiyografi uygulanan, ST segment yükselmesiz miyokard enfarktüsü (NSTEMI) olan ve en az iki bağımsız kardiyolog tarafından ilk koroner anjiyografiye dayalı olarak SSII'nin hesaplandığı ardışık 280 hastayı kapsamıştır. Hastalar düşük SSII (<23, n=116) ve yüksek SSII (≥23, n=164) olarak iki gruba ayrıldı. AIP, trigliseritin yüksek yoğunluklu lipoprotein-kolesterol oranına logaritmik dönüştürülmesiyle hesaplandı. Bulgular: Çalışma grupları arasında yaş, cinsiyet, sigara kullanımı, hipertansiyon, aile öyküsü, diyabet, serum üre, C-reaktif protein, hemoglobin düzeyi, sol ventriküler ejeksiyon fraksiyonu ve AIP açısından bazı farklılıklar belirledik (P<.05), bu da yüksek SSII ile AIP arasında pozitif bir bağlantı bulunduğunu göstermektedir (r=0,343; p<0,001; istatistiksel olarak anlamlı p<0,05). Çok değişkenli lojistik regresyon analizi sonucunda AIP'nin KAH ve yüksek SSII için bağımsız bir risk faktörü olduğu belirlendi. Ayrıca 0,54 ng/ml ve üzerindeki AIP değerlerinin koroner arter hastalığının ciddiyetini %62,8 duyarlılık ve %60,5 özgüllükle tahmin edebildiğini bulduk (eğri altında kalan alan:0,676, %95 güven aralığı, %0,613 – 0,739; p <0,001). Sonuç: Yüksek SSII'li hastalarda AIP oranlarının düşük SSII'li hastalara göre arttığı tespit edildi. Ayrıca yüksek SSII'li grupta AIP'nin KAH ve yüksek SSII ile anlamlı derecede bağımsız olarak ilişkili olduğu görüldü. Bu bulgular ışığında, bir biyobelirteç olarak AIP, KAH'ın önlenmesine yardımcı olabilir.

Keywords

• Plazmanın aterojenik indeksi
• SYNTAX II skoru
• akut koroner sendrom.

Supporting Institution

no

The role of atherogenic index of plasma in coronary artery patients with high SYNTAXII score

Abstract

Aim: We tried to evaluate the best diagnostic threshold value of the atherogenic index of plasma (AIP) with respect to coronary artery disease (CAD) and its relationship with SYNTAX II (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score (SSII). Material and Methods: The research encompassed 280 consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing coronary angiography, through which SSII was calculated based on initial coronary angiography by at least two independent cardiologists. The patients were separated into two groups low SSII (<23, n=116) and high SSII (≥23, n=164), while AIP was calculated by logarithmic conversion of triglyceride to high-density lipoprotein-to-cholesterol ratio. Results: We determined some differences between the study groups in point of age, gender, smoking, hypertension, family history, diabetes mellitus, serum urea, C-reactive protein, hemoglobin level, left ventricular ejection fraction, and AIP (P <.05), which indicates a positive connection found between high SSII and AIP (r=0.343; p<0.001; statistically significant p<.05). As a result of multivariate logistic regression analysis, AIP was determined to be an independent risk factor for CAD and high SSII. In addition, we found that AIP values of 0.54 ng/ml and above could estimate the severity of coronary artery disease with 62.8% sensitivity and 60.5% specificity (area under the curve:0.676, %95 confidence interval, 0.613 – 0.739%; p<0.001). Conclusion: AIP ratios were detected to be increased in patients with high SSII in comparison to those with low SSII. In addition, AIP was significantly independently connected with CAD and high SSII in the group with high SSII. In light of these findings, AIP, as a biomarker, may help prevent CAD.

Keywords

• Atherogenic index of plasma
• SYNTAX score II
• acute coronary syndrome.

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