The relationship of coronary artery disease and indirect inflammatory markers

Abstract

Aim: Lipid and inflammatory molecules play important roles in the pathophysiology of atherosclerosis. Recently, a new biomarker called neutrophil/ high density lipoprotein cholesterol (HDL-K) (NHR) composed of neutrophil as a marker of inflammation, and HDL-K as an anti-atherosclerotic lipid have been found to be related with coronary artery disease (CAD). We aimed to find out the clinical pathologies associated with CAD that were related with NHR ratio. Material and Methods: We screened patients that were admitted to our cardiology outpatient clinic with the complaint of chest pain or dyspnea retrospectively. Our study included 226 patients with CAD and 267 patients without CAD, evaluated by myocardial perfusion scintigraphy, multislice computed tomography or coronary angiography (74.8% male, mean age 64.22 ± 6.35; 49.8% male, mean age 61.92 ± 7.32). We calculated the cut-off value of NHR ratio that is related with CAD. Then we evaluated the factors related with increased NHR ratio. Results: We detected higher NHR ratios in CAD (+) group than in CAD (-) group (0.111(0.040-0.420) vs. 0.092(0.030-0.260), p<0.001). A cutoff value of ≥0.106 for the NHR ratio was estimated to evaluate CAD, which had a sensitivity of 61.5% and specificity of 61.4%, AUC: 0.670 with 95% CI (0.623–0.717). We determined that male gender, diabetes mellitus, CAD, peripheral artery disease (PAD) were independent predictors of NHR ≥0.106. Conclusion: Male gender, diabetes mellitus, CAD and PAD were found to be independent predictors of increased NHR ratio. NHR ratio may be used in the evaluation of atherosclerotic cardiovascular diseases

Keywords

• coronary artery disease
• inflammation
• high density lipoprotion cholesterol

Koroner arter hastalığı ile indirekt inflamatuar belirteçlerin ilişkisi

Abstract

Amaç: Ateroskleroz patofizyolojisinde lipit ve inflamatuar moleküller önemli rol oynar. Yakın zamanda yapılan çalışmalarda inflamatuar bir gösterge olan nötrofil sayısı ile yüksek dansiteli lipoproteinden (HDL-K) oluşan nötrofil/HDL-K (NHR) oranının koroner arter hastalığı (KAH) ile ilişkisi gösterilmiştir. Biz de çalışmamızda NHR oranın KAH ile bağlantılı hangi klinik patolojilerle ilişkili olduğunu bulmayı amaçladık. Gereç ve Yöntemler: 01.Eylül.2019-31.Aralık.2019 tarihleri arasında göğüs ağrısı veya nefes darlığı şikayetleri ile kardiyoloji polikliniğimize başvuran hastalar retrospektif olarak tarandı. Miyokart perfüzyon sintigrafisi (MPS), çok kesitli bilgisayarlı tomografi (ÇKBT) veya koroner anjiyografi (KAG) ile değerlendirilen, KAH olan 226 hasta ve KAH olmayan 267 hasta çalışmamıza dahil edildi (%74,8 erkek, ortalama yaş 64,22 ± 6,35; %49,8 erkek, ortalama yaş 61,92 ± 7,32). KAH (+) ve KAH (-) grupları arasında NHR oranı karşılaştırıldı. ROC (Receiver Operating Characteristics) analizi ile KAH ile ilişkili NHR oranının cut-off değeri hesaplandı. Daha sonra yüksek NHR oranı ile ilişkili klinik faktörler değerlendirildi. Bulgular: KAH (+) grupta KAH (-) gruba göre daha yüksek NHR oranları saptandı (0,111 (0,040-0,420) vs. 0,092 (0,030- 0,260), p<0,001) (Tablo 1). NHR oranının 0,106 ve üzerinde olması %61,5 duyarlılık, %61,4 özgüllükle KAH ile ilişkili tespit edildi (EAA: 0,670; %95 GA: 0,623-0,717, p<0,001). Erkek cinsiyet, diyabet, KAH, periferik arter hastalığının (PAH) NHR ≥0,106 ile bağımsız ilişkili olduğu saptandı. Sonuç: Çalışmamızda erkek cinsiyet, diyabetes mellitus (DM), KAH ve PAH’ ın yüksek NHR oranının bağımsız öngördürücüleri olduğu bulundu. Nefes darlığı ve göğüs ağrısı şikayetleri ile kardiyoloji polikliniğine başvuran hastalarda aterosklerotik kardiyovasküler hastalıkların değerlendirilmesinde, lipit profili ve kan sayımından elde edilen parametrelerden kolaylıkla hesaplanabilen NHR oranının da katkı sağlayabileceğini düşünmekteyiz.

Keywords

• koroner arter hastalığı
• inflamasyon
• yüksek dansiteli lipoprotein kolesterol

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