Primer hiperparatiroidizmde subklinik koroner ateroskleroz prevalansı artar mı? primer hiperparatiroidili hastalarda koroner akım rezervi ve plazma aterojenik indeks

Abstract

Amaç: Koroner akım rezervi (CFR), erken evre koroner arter hastalığının (KAH) bir belirtisidir. Plazma aterojenik indeksi (PAI), ateroskleroz ve kardiyovasküler mortalite ile ilişkilidir. Bu nedenle amacımız primer hiperparatiroidizm (PHPT) hastalarında KFR ve PAI'yi belirlemek ve PAI'nin erken evre KAH'ın tespitinde kullanılıp kullanılamayacağını araştırmaktı. Yöntemler: Örneklemi 44 PTHT hastası ve 33 sağlıklı gönüllü oluşturdu. CFR'yi hiperemik diyastolik tepe hızının başlangıç diyastolik tepe hızına oranı olarak tanımladık. PAI değerleri log 10 trigliserit (TRG) / yüksek yoğunluklu lipoprotein (HDL) formülü ile hesaplandı. Sonuç: PAI ve CFR açısından gruplar karşılaştırıldığında PTHT hastalarında PAI düzeyleri anlamlı olarak yüksek, CFR düzeyleri ise anlamlı olarak düşüktü (sırasıyla p<0.01, p=0.01). Korelasyon analizi, CFR'nin PAI ve TRG ile negatif korelasyon gösterdiğini ortaya çıkardı (PAI- p<0,0001 r=-0,537). Çok değişkenli lojistik regresyon analizi, yalnızca yüksek PAI düzeyinin (OR: 151,6, %95 güven aralığı (CI): 4,1-5480, p=0,006) PHPT hastalarında CFR'deki azalmanın bağımsız bir öngörücüsü olduğunu gösterdi. Sonuç: PAI ve CFR değerleri arasında bağımsız bir korelasyon bulduk. Dolayısıyla PAI, yüksek advers kardiyovasküler olay riskiyle karşı karşıya olan PHPT hastalarının belirlenmesinde yararlı olabilir ve aynı zamanda subklinik aterosklerozun erken tanısına da olanak sağlayabilir.

Keywords

• Primer hiperparatiroidizm
• Plazma aterojenik indeks
• Ateroskleroz
• Koroner akış rezervi

Does the prevalence of subclinical coronary atherosclerosis increase in primary hyperparathyroidism; coronary flow reserve and plasma aterogenic index in patients with primary hyperparathyroidism?

Abstract

Aims: The coronary flow reserve (CFR) is a sign of early-stage coronary artery disease (CAD). Plasma atherogenic index (PAI) is related to atherosclerosis and cardiovascular mortality. Therefore, our aim was to determine CFR and PAI in patients with primary hyperparathyroidism (PHPT) and investigate whether PAI can be used in the detection of early-stage CAD. Methods: The sample was comprised of 44 patients with PTHT and 33 healthy volunteers. We defined CFR as the ratio of the hyperemic diastolic peak velocity to the baseline diastolic peak velocity. PAI values were calculated with the formula of log 10 triglyceride (TRG)/high-density lipoprotein (HDL). Results: The comparison of the groups for PAI and CFR demonstrated that PAI levels were significantly higher while CFR levels were significantly lower in the PTHT patients (p<0.01, p=0.01, respectively). The correlation analysis revealed that CFR was negatively correlated with PAI and TRG (PAI- p<0.0001 r=-0.537). The multivariate logistic regression analysis showed that only a high PAI level (OR: 151.6, 95% confidence interval (CI): 4.1-5480, p=0.006) was an independent predictor of reduction in CFR in PHPT patients. Conclusion: Overall, we found an independent correlation between PAI and CFR values. Hence, PAI may be useful in identifying PHPT patients facing a high risk of adverse cardiovascular events and may also allow early diagnosis of subclinical atherosclerosis.

Keywords

• Primary hyperparathyroidism
• plasma atherogenic index
• atherosclerosis
• coronary flow reserve

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