Non-diyabetik Hastalarda Koroner Plak Yükü ve Aterojenik Lipid İndeksleri

Öz

Amaç: Aterojenik lipid indeksleri ile koroner aterosklerotik yük arasındaki ilişkinin anjiyografik skorlama sistemleri kullanılarak non-diyabetik hastalarda değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Bu kesitsel çalışmaya, anjiyografik olarak doğrulanmış koroner arter hastalığı (KAH) bulunan 39 non-diyabetik hasta dahil edilmiştir. Koroner lezyonların şiddeti ve anatomik karmaşıklığı, Gensini ve SYNTAX skorlama sistemleri kullanılarak değerlendirilmiştir. Önceden kutanöz koroner girişim öyküsü, koroner arter baypas greftlemesi endikasyonu, ventrikül fonksiyon bozukluğu, anlamlı kapak hastalığı, atriyal fibrilasyon, sistemik inflamatuvar veya enfeksiyöz hastalık, böbrek fonksiyon bozukluğu, serebrovasküler hastalık veya lipid düşürücü tedavi kullanımı olan hastalar, koroner değerlendirmeye ve lipid indekslerine olası etkileri en aza indirmek amacıyla çalışma dışı bırakılmıştır. Trigliserit (TG), yüksek yoğunluklu lipoprotein kolesterol (HDL-K), çok düşük yoğunluklu lipoprotein kolesterol (VLDL-K), remnant kolesterol ve aterojenik oranlar (TG/HDL-K ve total kolesterol (TK)/HDL-K) dahil olmak üzere lipid parametreleri toplanmıştır. Lipid indeksleri ile anjiyografik skorlar arasındaki ilişkiler Spearman korelasyonu, lojistik regresyon ve ROC analizleri ile değerlendirilmiştir.
Bulgular:  Yüksek Gensini skoruna sahip hastalarda VLDL-K (39,6 ve 26,9 mg/dL, p=0,03), trigliserit (198 ve 133 mg/dL, p=0,03) düzeyleri ile TG/HDL-K (4.69 ve 2,71, p=0,011) ve TK/HDL-K oranları (4,74 ve 4,02, p=0,007) anlamlı olarak daha yüksekti; HDL-K ise daha düşüktü (45.1 ve 54.2 mg/dL, p=0.007). TG/HDL-K [olasılık oranı (OO) 1,51, %95 güven aralığı (GA) 1,03–2,20] ve TK/HDL-K (OR 4,30, %95 GA 1,34–13,79) çok değişkenli analiz sonrası daha yüksek Gensini kategorilerinin bağımsız belirleyicileri olarak kaldı. ROC analizleri, TG/HDL-K için AUC 0,76 ve TK/HDL-K için AUC 0,74 olmak üzere anlamlı ayırt edicilik göstermiştir. Sonuç: TG/HDL-K ve TK/HDL-K oranları, non-diyabetik hastalarda koroner aterosklerotik yük ve lezyon karmaşıklığı ile anlamlı ilişkiler göstermektedir. Bu basit ve kolay erişilebilir indeksler, stabil KAH hastalarında risk sınıflandırması için değerli olabilir.

Anahtar Kelimeler

• Ateroskleroz
• Dislipidemiler
• Non-Diyabetik
• Plak Yükü

Destekleyen Kurum

yok

Etik Beyan

The study was initiated with the approval of the Ankara University Medical Faculty Clinical Research Ethics Committee (date: 2024, decision no: İ08-788-25).

Teşekkür

Yazarlar, teknik desteklerinden dolayı Ankara Üniversitesi Kardiyoloji Bölümü personeline teşekkür eder.

CORONARY PLAQUE BURDEN AND ATHEROGENIC LIPID INDICES IN NON-DIABETIC PATIENTS

Öz

Objective: This study aimed to evaluate the association between atherogenic lipid indices and coronary atherosclerotic burden in non-diabetic patients using angiographic scoring systems.
Material and Methods: This cross-sectional study included 39 non-diabetic patients with angiographically confirmed coronary artery disease (CAD). The severity and anatomical complexity of coronary lesions were assessed using the Gensini and SYNTAX scoring systems. Patients with previous percutaneous coronary intervention, coronary artery bypass grafting eligibility, impaired ventricular function, significant valvular disease, atrial fibrillation, systemic inflammatory or infectious disease, renal dysfunction, cerebrovascular disease, or use of lipid-lowering therapy were excluded to minimize their potential effects on coronary assessment and lipid indices. Lipid parameters, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), very low-density lipoprotein cholesterol (VLDL-C), remnant cholesterol, and atherogenic ratios TG/HDL-C and (TC)/HDL-C), were collected. Associations between lipid indices and angiographic scores were evaluated using Spearman correlation, logistic regression, and ROC analyses.
Results: Patients with higher Gensini scores had significantly higher VLDL-C (39.6 vs. 26.9 mg/dL, p=0.03), triglyceride levels (198 vs. 133 mg/dL, p=0.03), TG/HDL-C ratio (4.69 vs. 2.71, p=0.011), and TC/HDL-C ratio (4.74 vs. 4.02, p=0.007), whereas HDL-C was lower (45.1 vs. 54.2 mg/dL, p=0.007). TG/HDL-C [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.03–2.20] and TC/HDL-C (OR 4.30, 95% CI 1.34–13.79) remained independent determinants of higher Gensini categories after multivariable analysis. ROC analyses demonstrated significant discriminative capacity for TG/HDL-C (AUC 0.76) and TC/HDL-C (AUC 0.74). Conclusion: TG/HDL-C and TC/HDL-C ratios were significantly associated with coronary atherosclerotic burden and lesion complexity in non-diabetic patients. These simple and readily accessible indices may be valuable for risk stratification in patients with stable CAD.

Anahtar Kelimeler

• Atherosclerosis
• Dyslipidemias
• Non-Diabetic
• Plaque Burden

Destekleyen Kurum

None

Etik Beyan

The study was initiated with the approval of the Ankara University Medical Faculty Clinical Research Ethics Committee (date: 2024, decision no: İ08-788-25).

Teşekkür

The authors thank the staff of the Ankara University Cardiology Department for their technical support.

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