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Anjiyografik SYNTAX skoru ile değerlendirilen koroner arter hastalığı ciddiyetinde kalsiyum-albumin oranının rolü

Yıl 2018, Cilt: 3 Sayı:3, 174 - 178, 30.11.2018
https://doi.org/10.25000/acem.450950

Öz

Amaç: Serum kalsiyum ve albumin seviyeleri
ile akut koroner sendromlar ve koroner arter hastalığı arasındaki ilişki birçok
çalışmada gösterilmiştir. Sunulan çalışmada, serum albumin, kalsiyum,
albumin-düzeltilmiş kalsiyum seviyeleri ve kalsiyum/albumin oranı (KAO) ile
aterosklerozun yaygınlık ve ciddiyetinin ilişkisi araştırılmıştır.

Yöntemler: Bu prospektif çalışmaya non-ST
elevasyonlu miyokard infarktüsü olan hastalar (NSTEMI, n=120) ve kontrol grubu
(n=109) dahil edildi. KAO ile koroner arter hastalığı yaygınlık ve ciddiyetinin
ilişkisini değerlendirmek için SYNTAX skoru kullanıldı.

Bulgular: NSTEMI hastalarında istatistiksel
anlamlı olmadan daha yüksek kalsiyum seviyeleri vardı (p=0.058). Buna rağmen
serum albumin-düzeltilmiş kalsiyum seviyeleri istatistiksel anlamlı olarak
NSTEMI grubunda daha yüksekti (p=0.001). Albumin seviyeleri ise gruplar
arasında farklılık göstermedi (p=0.093). KAO ve düzeltilmiş kalsiyum/albumin
oranı (dKAO), NSTEMI grubunda anlamlı olarak daha yüksekti (p=0.001). KAO (r=0.235,
p=0.010) ve dKAO (r=0.259, p=0.004) ile SYNTAX skoru arasında pozitif korelasyon
mevcut iken, albumin ile SYNTAX skoru (r=−0.259, p=0.004) arasında negatif
korelasyon görüldü.







Sonuç: Kalsiyum/albumin oranı, SYNTAX skoru ile
hesaplanan artmış koroner aterosklerotik yük ile ilişkili bulunmuştur.
Bulgularımızı doğrulamak için daha geniş çaplı çalışmalar gereklidir.

Kaynakça

  • 1. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367:1747–57.
  • 2. Sianos G, Morel MA, Kappetein AP,Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention. 2005;1:219–27.
  • 3. Caixeta A, Genereux P, Palmerini T, Lansky AJ, Mehran R, Dangas GD, et al. Prognostic utility of the SYNTAX score in patients with single versus multivessel disease undergoing percutaneous coronary intervention (from the Acute Catheterization and Urgent Intervention Triage StrategY [ACUITY] trial). Am J Cardiol. 2014;113:203-10.
  • 4. Palmerini T, Genereux P, Caixeta A, Cristea E, Lansky A, Mehran R, et al. Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial. J Am Coll Cardiol. 2011;57:2389–97.
  • 5. Kurtul A, Murat SN, Yarlioglues M, Duran M, Ocek AH, Koseoglu C, et al. Usefulness of Serum Albumin Concentration to Predict High Coronary SYNTAX Score and In-Hospital Mortality in Patients With Acute Coronary Syndrome. Angiology. 2016;67:34–40.
  • 6. Nelson JJ, Liao D, Sharrett AR, Folsom AR, Chambless LE, Shahar E, et al. Serum albumin level as a predictor of incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000;151:468–77.
  • 7. Dziedzic T, Slowik A, Szczudlik A. Serum albumin level as a predictor of ischemic stroke outcome. Stroke. 2004;35:156-58.
  • 8. Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, Tang WW, Methvin A, Smith AL, et al.; for the Health ABC Study. Serum albumin concentration and heart failure risk: the Health, Aging, and Body Composition Study. Am Heart J. 2010;160:279–85.
  • 9. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–54.
  • 10. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340:115–26.
  • 11. Gresele P, Deckmyn H, Huybrechts E, Vermylen J. Serum albumin enhances the impairment of platelet aggregation with thromboxane synthase inhibition by increasing the formation of prostaglandin D2. Biochem Pharmacol. 1984;33:2083–88.
  • 12. Zoellner H, Hofler M, Beckmann R, Hufnagl P, Vanyek E, Bielek E, et al. Serum albumin is a specific inhibitor of apoptosis in human endothelial cells. J Cell Sci. 1996;109:2571–80.
  • 13. Roche M, Rondeau P, Singh NR, Tarnus E, Bourdon E. The antioxidant properties of serum albumin. FEBS Letters. 2008;582:1783–87.
  • 14. Moore EW. Ionized calcium in normal serum, ultrafiltrates and whole blood determined by ion-exchange calcium electrodes. J Clin Invest. 1970;49:318–34.
  • 15. Lu X, Wang Y, Meng H, Chen P, Huang Y, Wang Z, et al. Association of admission serum calcium levels and inhospital mortality in patients with acute ST-elevated myocardial infarction: an eight-year, single-center study in China. PLoS One. 2014;9:e99598.
  • 16. Yan SD, Liu XJ, Peng Y, Xia TL, Liu W, Tsauo JY, et al. Admission Serum Calcium Levels Improve the GRACE Risk Score Prediction of Hospital Mortality in Patients With Acute Coronary Syndrome. Clin Cardiol. 2016;39:516–23.
  • 17. P.Kusumakumari, K.Ashalata, S.VijayaBabu, M.Nagamani, K.Lakshmi Kumari. Serum Calcium as a Risk Factor In Myocardial Infarction-A Study In A Population Of North Coastal Andhra Pradesh, India. J Dent Med Sci. 2015;14:31–3.
  • 18. Jin Y, He L, Wang Q, Chen Y, Ren X, Tang H, et al. Serum calcium levels are not associated with coronary heart disease. Vasc Health Risk Manag. 2013;9:517–20.
  • 19. Djoussé L, Rothman KJ, Cupples LA,Arnett DK, Ellison RC; NHLBI Family Heart Study.Relation Between Serum Albumin and Carotid Atherosclerosis The NHLBI Family Heart Study. Stroke. 2003;34:53–7.
  • 20. Folsom AR, Ma J, Eckfeldt JH,Nieto FJ, Metcalf PA, Barnes RW. Low serum albumin: association with diabetes mellitus and other cardiovascular risk factors but not with prevalent cardiovascular disease or carotid artery intima-media thickness: the Atherosclerosis Risk in Communities (ARIC) Study Investigators. Ann Epidemiol. 1995;5:186–91.
  • 21. Law MR, Morris JK, Wald NJ, Hale AK. Serum albumin and mortality in the BUPA study. British United Provident Association. Int J Epidemiol. 1994;23:38–41.
  • 22- Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989;2:358–67.
  • 23. Bushinsky DA, Monk RD. Electrolyte quintet: calcium. Lancet. 1998;352:306–11.
  • 24. Ross R, Glomset JA. The pathogenesis of atherosclerosis (second of two parts). NEngl J Med. 1976;295:420–25.
  • 25. Thim T, Hagensen MK, Bentzon JF, Falk E. From vulnerable plaque to atherothrombosis. J Intern Med. 2008;263:506–16.
  • 26. Danesh J, Collins R, Apleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998;279:1477-82.
  • 27. Thomson SP, Gibbons RJ, Smars PA, Suman VJ, Pierre RV, Santrach PJ, et al. Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction. Ann Intern Med. 1995;122:335–41.
  • 28. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17:432–7.
  • 29. Goldwasser P, Feldman J. Association of serum albumin and mortality risk. J Clin Epidemiol. 1997;50:693–703.
  • 30. Weijenberg MP, Feskens EJ, Souverijn JH, Kromhout D. Serum albumin, coronary heart disease risk, and mortality in an elderly cohort. Epidemiology. 1997;8:87–92.
  • 31. Oduncu V, Erkol A, Karabay CY, Kurt M, Akgün T, Bulut M, et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013;24:88–94.
  • 32. Celik IE, Yarlioglues M, Kurtul A, Duran M, Koseoglu C, Oksuz F, et al. Preprocedural Albumin Levels and Risk of InStent Restenosis After Coronary Stenting With Bare-Metal Stent. Angiology. 2016;67:478–83.
  • 33. Lind L, Skarfors E, Berglund L, Lithell H, Ljunghall S. Serum calcium: a new, independent, prospective risk factor for myocardial infarction in middle aged men followed for 18 years. J Clin Epidemiol. 1997;50:967–73.
  • 34. Lind L, Jakobsson S, Lithell H, Wengle B, Ljunghall S. Relation of serum calcium concentration to metabolic risk factors for cardiovascular disease. BMJ. 1988;297:960–3.
  • 35. Jorde R, Sundsfjord J, Fitzgerald P,Bønaa KH. Serum calcium and cardiovascular risk factors and diseases: the Tromso study. Hypertension. 1999;34:484–90.
  • 36. Levy J, Stern Z, Gutman A,Naparstek Y, Gavin JR 3rd, Avioli LV. Plasma calcium and phosphate levels in an adult non insulin-dependent population. Calcif Tissue Int. 1986;39:316-8.
  • 37. Grandi NC, Brenner H, Hahmann H, Wüsten B, März W, Rothenbacher D, et al. Calcium, phosphate and the risk of cardiovascular events and all-cause mortality in a population with stable coronary heart disease. Heart. 2012;98:926-33.

Role of calcium–albumin ratio in severity of coronary artery disease assessed by angiographic SYNTAX score

Yıl 2018, Cilt: 3 Sayı:3, 174 - 178, 30.11.2018
https://doi.org/10.25000/acem.450950

Öz

Aim: Numerous studies have reported a
relationship between serum calcium or albumin levels and acute coronary
syndromes and coronary artery disease. The present study investigated the
relation between serum albumin, calcium or albumin-corrected calcium levels or
calcium/albumin ratio (CAR) and extensiveness and severity of atherosclerosis.

Methods: This prospective study included
patients with non-ST elevation myocardial infarction (NSTEMI, n=120) and a
control group (n=109). We used the SYNTAX score to evaluate the association
between CAR and severity and extent of coronary artery disease.

Results: There were higher, but statistically
nonsignificant, levels of calcium in patients with NSTEMI (p=0.058). However,
serum albumin-corrected calcium levels were significantly higher in NSTEMI
group (p=0.001). Yet, albumin levels did not differ between the groups
(p=0.093). CAR and corrected calcium–albumin ratio (cCAR) were significantly
higher in NSTEMI group (p=0.001). A positive correlation existed between CAR (r=0.235,
p=0.010), cCAR (r=0.259, p=0.004), and SYNTAX score, whereas albumin and SYNTAX
score (r=−0.259, p=0.004) showed a negative correlation.







Conclusion: Calcium/albumin ratio has been
found to be associated with an increased coronary atherosclerotic burden as
calculated by SYNTAX score. Further large-scale studies are warranted to
confirm our findings.

Kaynakça

  • 1. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet. 2006;367:1747–57.
  • 2. Sianos G, Morel MA, Kappetein AP,Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention. 2005;1:219–27.
  • 3. Caixeta A, Genereux P, Palmerini T, Lansky AJ, Mehran R, Dangas GD, et al. Prognostic utility of the SYNTAX score in patients with single versus multivessel disease undergoing percutaneous coronary intervention (from the Acute Catheterization and Urgent Intervention Triage StrategY [ACUITY] trial). Am J Cardiol. 2014;113:203-10.
  • 4. Palmerini T, Genereux P, Caixeta A, Cristea E, Lansky A, Mehran R, et al. Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial. J Am Coll Cardiol. 2011;57:2389–97.
  • 5. Kurtul A, Murat SN, Yarlioglues M, Duran M, Ocek AH, Koseoglu C, et al. Usefulness of Serum Albumin Concentration to Predict High Coronary SYNTAX Score and In-Hospital Mortality in Patients With Acute Coronary Syndrome. Angiology. 2016;67:34–40.
  • 6. Nelson JJ, Liao D, Sharrett AR, Folsom AR, Chambless LE, Shahar E, et al. Serum albumin level as a predictor of incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol. 2000;151:468–77.
  • 7. Dziedzic T, Slowik A, Szczudlik A. Serum albumin level as a predictor of ischemic stroke outcome. Stroke. 2004;35:156-58.
  • 8. Gopal DM, Kalogeropoulos AP, Georgiopoulou VV, Tang WW, Methvin A, Smith AL, et al.; for the Health ABC Study. Serum albumin concentration and heart failure risk: the Health, Aging, and Body Composition Study. Am Heart J. 2010;160:279–85.
  • 9. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340:448–54.
  • 10. Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med. 1999;340:115–26.
  • 11. Gresele P, Deckmyn H, Huybrechts E, Vermylen J. Serum albumin enhances the impairment of platelet aggregation with thromboxane synthase inhibition by increasing the formation of prostaglandin D2. Biochem Pharmacol. 1984;33:2083–88.
  • 12. Zoellner H, Hofler M, Beckmann R, Hufnagl P, Vanyek E, Bielek E, et al. Serum albumin is a specific inhibitor of apoptosis in human endothelial cells. J Cell Sci. 1996;109:2571–80.
  • 13. Roche M, Rondeau P, Singh NR, Tarnus E, Bourdon E. The antioxidant properties of serum albumin. FEBS Letters. 2008;582:1783–87.
  • 14. Moore EW. Ionized calcium in normal serum, ultrafiltrates and whole blood determined by ion-exchange calcium electrodes. J Clin Invest. 1970;49:318–34.
  • 15. Lu X, Wang Y, Meng H, Chen P, Huang Y, Wang Z, et al. Association of admission serum calcium levels and inhospital mortality in patients with acute ST-elevated myocardial infarction: an eight-year, single-center study in China. PLoS One. 2014;9:e99598.
  • 16. Yan SD, Liu XJ, Peng Y, Xia TL, Liu W, Tsauo JY, et al. Admission Serum Calcium Levels Improve the GRACE Risk Score Prediction of Hospital Mortality in Patients With Acute Coronary Syndrome. Clin Cardiol. 2016;39:516–23.
  • 17. P.Kusumakumari, K.Ashalata, S.VijayaBabu, M.Nagamani, K.Lakshmi Kumari. Serum Calcium as a Risk Factor In Myocardial Infarction-A Study In A Population Of North Coastal Andhra Pradesh, India. J Dent Med Sci. 2015;14:31–3.
  • 18. Jin Y, He L, Wang Q, Chen Y, Ren X, Tang H, et al. Serum calcium levels are not associated with coronary heart disease. Vasc Health Risk Manag. 2013;9:517–20.
  • 19. Djoussé L, Rothman KJ, Cupples LA,Arnett DK, Ellison RC; NHLBI Family Heart Study.Relation Between Serum Albumin and Carotid Atherosclerosis The NHLBI Family Heart Study. Stroke. 2003;34:53–7.
  • 20. Folsom AR, Ma J, Eckfeldt JH,Nieto FJ, Metcalf PA, Barnes RW. Low serum albumin: association with diabetes mellitus and other cardiovascular risk factors but not with prevalent cardiovascular disease or carotid artery intima-media thickness: the Atherosclerosis Risk in Communities (ARIC) Study Investigators. Ann Epidemiol. 1995;5:186–91.
  • 21. Law MR, Morris JK, Wald NJ, Hale AK. Serum albumin and mortality in the BUPA study. British United Provident Association. Int J Epidemiol. 1994;23:38–41.
  • 22- Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989;2:358–67.
  • 23. Bushinsky DA, Monk RD. Electrolyte quintet: calcium. Lancet. 1998;352:306–11.
  • 24. Ross R, Glomset JA. The pathogenesis of atherosclerosis (second of two parts). NEngl J Med. 1976;295:420–25.
  • 25. Thim T, Hagensen MK, Bentzon JF, Falk E. From vulnerable plaque to atherothrombosis. J Intern Med. 2008;263:506–16.
  • 26. Danesh J, Collins R, Apleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA. 1998;279:1477-82.
  • 27. Thomson SP, Gibbons RJ, Smars PA, Suman VJ, Pierre RV, Santrach PJ, et al. Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction. Ann Intern Med. 1995;122:335–41.
  • 28. Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17:432–7.
  • 29. Goldwasser P, Feldman J. Association of serum albumin and mortality risk. J Clin Epidemiol. 1997;50:693–703.
  • 30. Weijenberg MP, Feskens EJ, Souverijn JH, Kromhout D. Serum albumin, coronary heart disease risk, and mortality in an elderly cohort. Epidemiology. 1997;8:87–92.
  • 31. Oduncu V, Erkol A, Karabay CY, Kurt M, Akgün T, Bulut M, et al. The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention. Coron Artery Dis. 2013;24:88–94.
  • 32. Celik IE, Yarlioglues M, Kurtul A, Duran M, Koseoglu C, Oksuz F, et al. Preprocedural Albumin Levels and Risk of InStent Restenosis After Coronary Stenting With Bare-Metal Stent. Angiology. 2016;67:478–83.
  • 33. Lind L, Skarfors E, Berglund L, Lithell H, Ljunghall S. Serum calcium: a new, independent, prospective risk factor for myocardial infarction in middle aged men followed for 18 years. J Clin Epidemiol. 1997;50:967–73.
  • 34. Lind L, Jakobsson S, Lithell H, Wengle B, Ljunghall S. Relation of serum calcium concentration to metabolic risk factors for cardiovascular disease. BMJ. 1988;297:960–3.
  • 35. Jorde R, Sundsfjord J, Fitzgerald P,Bønaa KH. Serum calcium and cardiovascular risk factors and diseases: the Tromso study. Hypertension. 1999;34:484–90.
  • 36. Levy J, Stern Z, Gutman A,Naparstek Y, Gavin JR 3rd, Avioli LV. Plasma calcium and phosphate levels in an adult non insulin-dependent population. Calcif Tissue Int. 1986;39:316-8.
  • 37. Grandi NC, Brenner H, Hahmann H, Wüsten B, März W, Rothenbacher D, et al. Calcium, phosphate and the risk of cardiovascular events and all-cause mortality in a population with stable coronary heart disease. Heart. 2012;98:926-33.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orjinal Makale
Yazarlar

Yakup Alsancak 0000-0001-5230-2180

Serkan Sivri 0000-0001-8995-0480

Serdal Baştuğ 0000-0002-9991-7307

Engin Bozkurt

Yayımlanma Tarihi 30 Kasım 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 3 Sayı:3

Kaynak Göster

Vancouver Alsancak Y, Sivri S, Baştuğ S, Bozkurt E. Role of calcium–albumin ratio in severity of coronary artery disease assessed by angiographic SYNTAX score. Arch Clin Exp Med. 2018;3(3):174-8.