Stabil koroner arter hastalığında koroner kollateral dolaşımın bir prediktörü olarak pan-immün inflamasyon değeri (PIV)

Year 2025, Volume: 6 Issue: 3, 219 - 223, 18.06.2025

Mehmet Nail Bilen , Ömer Genç

https://doi.org/10.47582/jompac.1625998

Abstract

Amaç: Bu çalışma, stabil koroner arter hastalığı (KAH) olan hastalarda koroner kollateral dolaşım (KKD) ile Pan-immün-enflamasyon değeri (PIV) dahil olmak üzere çeşitli klinik ve laboratuvar parametreleri arasındaki ilişkiyi değerlendirmeyi amaçladı.
Yöntemler: Hastalar, Rentrop derecelendirme sistemine göre iki gruba ayrıldı: iyi gelişmiş KKD’yi temsil eden grup 1 (Rentrop dereceleri 2–3) ve zayıf KKD’yi gösteren grup 2 (Rentrop dereceleri 0–1). Gruplar arasında demografik özellikler ve PIV, beyaz kan hücresi (WBC) sayısı, nötrofil sayısı, trombosit sayısı ve yüksek yoğunluklu lipoprotein (HDL) düzeyleri gibi laboratuvar parametreleri karşılaştırıldı. PIV'nin zayıf KKD’yi öngörme gücünü değerlendirmek için ROC analizi yapıldı. Zayıf KKD’nin bağımsız belirleyicilerini saptamak için lojistik regresyon analizi kullanıldı.
Bulgular: Yaş, cinsiyet dağılımı, hipertansiyon, diyabet ve sigara kullanım prevalansı açısından iki grup arasında anlamlı bir fark bulunmadı (p > 0,05). Grup 2'de WBC düzeyleri (9,5 ± 3,3 vs. 8,8 ± 3,1, p = 0,04), nötrofil sayıları (5,5 [4,6–6,9] vs. 4,9 [4,0–6,0], p = 0,001), trombosit sayıları (268,8 ± 82,5 vs. 247,2 ± 80,3, p = 0,023) ve ortanca PIV değerleri (347,5 [260,3–666,9] vs. 331,2 [175,4–491,1], p = 0,003) anlamlı olarak daha yüksekti. Buna karşılık, HDL düzeyleri grup 2’de anlamlı şekilde daha düşüktü (38,8 ± 8,4 mg/dL vs. 42,0 ± 11,7 mg/dL, p = 0,007). ROC analizi, zayıf KKD'yi öngörmede PIV/100'ün sınırlı bir ayırt edici güce sahip olduğunu gösterdi (AUC: 0,601, %95 CI: 0,543–0,657) ve >168 optimal eşik değeriyle (duyarlılık: %94,59, özgüllük: %22,82, p = 0,002) zayıf KKD’yi tahmin ettiği belirlendi. Lojistik regresyon analizi, PIV/100’ün zayıf KKD için bağımsız bir belirleyici olduğunu ortaya koydu (OR: 1,1, %95 CI: 1,02–1,23, p = 0,044), ancak HDL düzeyleri anlamlı bir öngörücü değeri göstermedi (p = 0,94).
Sonuç: Bu çalışma, sistemik enflamasyon ve bağışıklık yanıtının, PIV ile yansıtıldığı şekilde, koroner kollateral dolaşım gelişimindeki rolünü vurgulamaktadır. Yüksek PIV değerleri ve ilişkili enflamatuvar belirteçler, zayıf KKD ile ilişkilendirilmiştir. Bu bulgular, PIV’nin KKD değerlendirilmesinde ve stabil KAH hastalarında terapötik yaklaşımları yönlendirmede potansiyel bir biyobelirteç olarak kullanılabileceğini düşündürmektedir.
Anahtar Kelimeler: Koroner Kollateral Dolaşım (KKD), Pan-immün-enflamasyon değeri (PIV), Stabil Koroner Arter Hastalığı (KAH).

Keywords

Koroner Kollateral Dolaşımı , Pan immün indeks , Stabil Koroner Arter Hastalığı

Pan-immune inflammation value as a determinant of coronary collateral circulation in patients with chronic coronary syndrome and chronic total occlusion

Abstract

Aims: This study aimed to investigate the association between coronary collateral circulation (CCC) pan-immune-inflammation value (PIV) in patients with chronic coronary syndrome (CCS) and chronic total occlusion (CTO).
Methods: The study included 297 patients with CCS who underwent coronary angiography and had CTO in at least one major coronary artery. Patients with CTO were categorized into two groups based on Rentrop grading: group 1 (grades 2–3, well developed CCC) and group 2 (grades 0–1, poor CCC).
Results: Patients with poor CCC had higher WBC levels (p=0.04), neutrophil counts (p=0.001), platelet counts (p=0.023), and median PIV values (p=0.003) compared to patients with well-developed CCC. Logistic regression identified PIV (per hundred units) as an independent predictor of poor CCC (OR=1.10, 95% [CI=1.02–1.23], p=0.044). Receiver operating characteristic (ROC) analysis demonstrated that a cut-off value of 168 for PIV predicted poor CCC slightly better compared to other markers, with 94.6% sensitivity and 22.8% specificity (area under the curve=0.601, 95% CI=0.543–0.657, p=0.002).
Conclusion: These findings indicate that PIV may serve as an independent predictor of CCC development.

Keywords

Coronary collateral circulation , pan-immune-inflammation value , chronic coronary syndrome , chronic total occlusion

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