Nötrofil Lenfosit ve Platelet Lenfosit Oranlarının Göğüs Ağrısı Olan Hastalarda Kanada Kardiyovasküler Cemiyeti Angina Sınıflaması ile Olan İlişkisi

Yıl 2016, Cilt: 16 Sayı: 1, 0 - 0, 04.03.2016

Emrah Ipek , Erhan Yıldırım Mahir Cengiz Selami Demirelli , Emrah Ermiş Bingül Dilekçi Şahin Mustafa Yolcu

https://doi.org/10.17098/amj.29893

Öz

Amaç: Bu çalışmada polikliniğe başvuran ve göğüs ağrısı olan hastalarda nötrofil lenfosit (NLO) ve platelet lenfosit oranlarının (PLO) Kanada Kardiyovasküler Cemiyeti (KKC) anjina sınıflaması ile ilişkisi incelenmiştir.

Materyal ve Metot: Çalışma hastaları polikliniğimize göğüs ağrısı ile başvuran hastaları içermektedir. Çalışma grupları, kardiyak olmayan göğüs ağrısı ve atipik anjina (grup 1), KKC sınıf 1 ve sınıf 2 (grup 2), KKC sınıf 3 ve sınıf 4 (grup 3) hastalardan oluşmuştur.

Bulgular: NLO koroner arter hastalığının yaygınlığı ve anjina derecesi ile pozitif korelasyon göstermiştir. (p<0,001). NLO’nun grup 1’deki hastaları grup 2+3’tekilerden ve grup 1+2’deki hastaları grup 3’deki hastalardan ayırt edebilme gücü ROC analizi ile test edilmiştir. NLO’nun grup 1’i grup 2+3’ten ve grup 1+2’yi grup 3’ten ayırt etmedeki yeterliliğini gösteren eğri altında kalan (EAA) değerleri sırası ile 0,714 ve 0,698 (p<0,001) bulunmuştur. PLO gruplar arasında anlamlı farklılık göstermemiştir (p> 0,05)

Sonuç: NLO, ucuz ve pratik bir enflamatuar belirteç olup poliklinik koşullarında hastaların KKC anjina dereceleri ile ilişkili bulunuştur.

muştur.

Anahtar Kelimeler

nötrofil/lenfosit oranı, platelet/lenfosit oranı, koroner arter hastalığı, KKC angina sınıflaması

Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio and Their Relationship with Canadian Cardiovascular Society Angina Classification in Patients with Chest Pain

Öz

Objectives: We examined the association between neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with the Canadian Cardiovascular Society (CCS) angina grade of patients in outpatient setting.

Materials and Methods: The study population included patients with chest pain who had admitted to our outpatient clinic. The study group consisted of noncardiac chest pain and atypical angina (group 1), CCS class 1 and class 2 angina (group 2) and CCS class 3 and class 4 (group 3) patients.

Results: The neutrophil lymphocyte ratio was positively correlated with extent of CAD and angina grade (p<0.001). To test the power of neutrophil lymphocyte ratio for distinguishing group 1 and group 2+3, and group 1+2 and group 3, ROC analysis was performed. The NLR had AUC values of 0.714 and 0.698 (p<0.001), which demonstrate its sufficiency to distinguish patients in group 1 from individuals in group 2+3 and patients in group 1+2 from individuals in group 3, respectively. The platelet lymphocyte ratio did not differ among groups (p>0.05).

Conclusion: The NLR is a cheap and practical inflammatory marker and is associated with CCS angina grade of patients in outpatient setting.

Anahtar Kelimeler

neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, coronary artery disease, CCS angina classification

Kaynakça

• Libby P, Ridker PM, Hansson GK. Inflammation in atherosclerosis: from pathophysiology to practice. J Am Coll Cardiol 2009;23:2129-38.
• Kaya A, Kurt M, Tanboga IH, et al. Relation of Neutrophil to Lymphocyte Ratio With the Presence and Severity of Stable Coronary Artery Disease. Clin Appl Thromb Hemost 2014;5:473-7.
• Hatmi ZN, Saeid AK, Broumand MA, Khoshkar SN, Danesh ZF. Multiple inflammatory prognostic factors in acute coronary syndromes: a prospective inception cohort study. Acta Med Iran 2010;1:51-7.
• Angela Papa, Michele Emdin, Claudio Passino, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil–lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clinica Chimica Acta 2008; 1-2:27–31.
• Guasti L, Dentali F, Castiglioni L, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost 2011;4:591-9.
• Uthamalingam S, Patvardhan EA, Subramanian S, et al. Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol 2011; 3:433-8.
• Thaulow E, Erikssen J, Sandvik L, Stormorken H, Cohn PF. Blood platelet count and function are related to total and cardiovascular death in apparently healthy men. Circulation 1991;2:613–7.
• Nikolsky E, Grines CL, Cox DA, et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol 2007; 8:1055–61.
• Ommen SR, Hammill SC, Gibbons RJ. The relative lymphocyte count predicts death in patients receiving implantable cardioverter defibrillators. Pacing Clin Electrophysiol 2002;10:1424–8.
• Arruda-Olson AM, Reeder GS, Bell MR, Weston SA, Roger VL. Neutrophilia predicts death and heart failure after myocardial infarction: a community-based study. Circ Cardiovasc Qual Outcomes 2009;6:656–62.
• Campeau L. Letter: Grading of angina pectoris. Circulation 1976;3:522-3.
• Campeau L. The Canadian Cardiovascular Society grading of angina pectoris revisited 30 years later. Can J Cardiol 2002;4:371-9.
• Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988;78:486-502.
• Gibbons RJ, Chatterjee K, Daley J, et al. ACC/AHA/ACP–ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). Circulation 1999;99:2829–48.
• Sönmez O, Ertaş G, Bacaksız A et al. Relation of neutrophil-to-lymphocyte ratio with the presence and complexiety of coronary artery disease: an observational study. Anadolu Kardiyol Derg 2013;13:662-7.
• Yildiz A, Yuksel M, Oylumlu M et al. The Utility of the Platelet-Lymphocyte Ratio for Predicting No Reflow in Patients With ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb Hemost 2015;21: 223-8.
• Acar G, Kalkan ME, Avci A et al. The Relation of Platelet-Lymphocyte Ratio and Coronary Collateral Circulation in Patients With Stable Angina Pectoris and Chronic Total Occlusion. Clin Appl Thromb Hemost 2013 (doi: 10.1177/1076029613508599).
• Sunbul M, Gerin F, Durmus E et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2014;36:217-21.
• Lee S, Choe JW, Kim HK, Sung J. High-sensitivity C-reactive protein and cancer. J Epidemiol 2011;21:161-8. 20. Okyay GU, Inal S, Oneç K, et al. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail 2013;35:29-36.
• Okyay GU, Inal S, Oneç K, et al. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail 2013;35:29-36.
• Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-7.
• Horne BD, Anderson JL, John JM et al. Intermountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005; 45:1638-43.
• Sahin DY, Elbasan Z, Gur M, et al. Neutrophil to Lymphocyte Ratio Is Associated With the Severity of Coronary Artery Disease in Patients With ST-Segment Elevation Myocardial infarction. Angiology 2013;64:423-9.
• Sari I, Sunbul M1, Mammadov C, et al. Relation of neutrophil to lymphocyte and platelet to lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography. Kardiol Pol 2015 (doi: 10.5603/KP.a2015.0098).
• Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012; 34:326-34.
• Gary T, Pichler M, Belaj K et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PloS On 2013;8:e67688.
• Asher V, Lee J, Innamaa A, Bali A. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol 2011;13:499-503.