Diagnostic performance of whole blood viscosity indices in predicting the presence and severity of coronary artery disease

Yıl 2024, Cilt: 5 Sayı: 1, 48 - 56, 29.02.2024

Ahmet Kıvrak , Alp Yıldırım

https://doi.org/10.47582/jompac.1424294

Öz

Aims: Growing evidence suggests that blood viscosity plays a crucial role in both the development and acceleration of atherosclerosis. In this study, aimed to investigate the diagnostic performance of the mean platelet volume-age-total protein-hematocrit (MAPH) score, a new index for blood viscosity, in predicting the presence and severity of CAD in patients with suspected coronary artery disease (CAD).
Methods: We retrospectively evaluated 431 patients who underwent coronary angiography. SYNTAX score (SS) were divided into 3 groups; low group (<22), intermediate group (22-32) and, high group (≥32). Low (LSR) and and high (HSR) shear rates were derived using values of total protein and hematocrit. The MAPH score was calculated based on the threshold values of mean platelet volume, age, total protein, and hematocrit for predicting CAD.
Results: The median LSR (60.7 vs. 43.1, p<0.001), mean HSR (17.3±1.3 vs. 16.2±1.2, p<0.001), and mean MAPH score (2.7±0.8 vs. 1.6±0.5, p<0.001) were higher in the CAD group compared to the non-CAD group. These indices of blood viscosity were found to be higher in the intermediate-high SS group compared to the low SS group. The threshold value of MAPH score for predicting CAD was >2 (sensitivity=78.2%, specificity=70.0%). It also had a graduated threshold value (>3, sensitivity=71.1%, specificity=62.5%) in distinguishing intermediate-high SS than low SS groups. In predicting both the presence and severity of CAD, the MAPH score exhibited superior diagnostic performance relative to the levels of LSR and HSR.
Conclusion: In patients with suspected CAD, a gradual increase in the MAPH score demonstrated significant diagnostic performance in distinguishing both the presence and severity of CAD. In these patients, the MAPH score may serve as a potential screening tool and can be utilized for risk stratification.

Anahtar Kelimeler

Blood viscosity, coronary artery disease, MAPH score, microcirculation, SYNTAX score

Etik Beyan

The study was performed in accordance with the Declaration of Helsinki, and was approved by the Diskapi Yildirim Beyazit Training and Research Hospital Clinical Research Ethics Committee.

Proje Numarası

Date: 12.09.2022, Decision No: 146/03

Koronari arter hastalığının varlığını ve şiddetini tahmin etmede tam kan viskozite indekslerinin tanısal performansı

Öz

Amaç: Artan kanıtlar, kan viskozitesinin aterosklerozun hem gelişiminde hem de hızlanmasında önemli bir rol oynadığını göstermektedir. Bu çalışmada, şüpheli KAH'li hastalarda KAH'ın varlığını ve şiddetini tahmin etmede MAPH skorunun, yeni bir kan viskozitesi indeksi olan tanısal performansını incelemeyi amaçladık.
Metot: Koroner anjiyografi geçiren 431 hasta retrospektif olarak değerlendirildi. SYNTAX skoru (SS), 3 gruba ayrıldı; düşük grup (<22), orta grup (22-32) ve yüksek grup (≥32). HSR ve LSR, total protein ve hematokrit değerleri kullanılarak türetilmiştir. MAPH skoru, KAH'ı tahmin etmek için yaş, ortalama trombosit hacmi, total protein ve hematokritin eşik değerleri temel alınarak hesaplandı.
Bulgular: KAH grubunda, KAH olmayan gruba göre medyan LSR (60.7'ye karşı 43.1, p<0.001), ortalama HSR (16.2±1.2'ye karşı 17.3±1.3, p<0.001) ve ortalama MAPH skoru (1.6±0.5'e karşı 2.7±0.8, p<0.001) daha yüksekti. Kan viskozitesi indeksleri, düşük SS grubuna kıyasla orta-yüksek SS grubunda daha yüksek bulundu. KAH'ı tahmin etmek için MAPH skorunun eşik değeri >2 idi (duyarlılık=78.2%, özgüllük=70.0%). Ayrıca, düşük SS gruplarından orta-yüksek SS gruplarını ayırt etmede dereceli eşik değeri vardı (>3, duyarlılık=71.1%, özgüllük=62.5%). Hem KAH'ın varlığını hem de şiddetini tahmin etmede, MAPH skoru LSR ve HSR seviyelerine göre üstün tanısal performans sergiledi.
Sonuç: Şüpheli KAH'li hastalarda, MAPH skorundaki kademeli artış, hem KAH'ın varlığını hem de şiddetini ayırt etmede önemli bir tanısal performans gösterdi. Bu hastalarda, MAPH skoru potansiyel bir tarama aracı olarak hizmet verebilir ve risk stratifikasyonu için kullanılabilir.

Anahtar Kelimeler

Kan viskozitesi, koroner arter hastalığı, MAPH skoru, mikrosirkülasyon, syntax skoru

Proje Numarası

Date: 12.09.2022, Decision No: 146/03

Kaynakça

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