Value of Alkaline Phosphatase in Predicting the Extent and Severity of Coronary Artery Disease in Acute Myocardial Infarction

Yıl 2017, Cilt: 20 Sayı: 2, 91 - 97, 01.08.2017

Celal Kilit

Öz

Introduction:
The
serum alkaline phosphatase (ALP) level has been shown to be a prognostic factor
in stable coronary artery disease (CAD) and acute myocardial infarction (AMI)
by its promoting effect on vascular calcification. The objectives of this study
were to investigate serum ALP levels and to determine their value in predicting
the extent and severity of CAD in patients with AMI.

Patients
and Methods: A total of 200 patients with AMI were included in this
study. Patients with serum ALP levels higher than 120 mg/dL were classified as
elevated ALP group. The extent and severity of CAD was assessed using Gensini
score and number of vessel disease. Patients with a Gensini score greater than
40 were included in advanced CAD group.

Results: There was
no relationship between the ALP level and the Gensini score in study
population. Patients were grouped according to the Gensini score (Gensini
scores ≤ 40 and > 40). There was no difference between the groups in terms
of ALP levels. However, ALP levels were significantly higher in diabetic
patients and in patients with non—ST-segment elevation myocardial infarction
(NSTEMI). Parathormone levels and neutrophil counts were significantly higher
in the advanced CAD group.

Conclusion: ALP levels do not indicate
the extent and severity of CAD in patients with AMI. However, these levels are
higher in diabetic patients and in patients with NSTEMI than in patients with
ST-segment elevation myocardial infarction. Higher parathormone levels and
neutrophil counts are related to the extent and severity of CAD in patients
with AMI.

Anahtar Kelimeler

Alkaline phosphatase, coronary angiography, myocardial infarction, coronary artery disease, parathyroid hormone

Akut Miyokart İnfarktüsünde Koroner Arter Hastalığının Yaygınlığını ve Ciddiyetini Tahmin Etmede Alkalen Fosfatazın Değeri

Öz

Giriş: Serum alkalen fosfataz (ALP) seviyesi, vasküler kalsifikasyon üzerine olan
tetikleyici etkisinden dolayı akut miyokart infarktüsü (AMİ)’nde ve stabil
koroner arter hastalığı (KAH)’nda prognostik bir faktör olarak gösterilmiştir.
Çalışmanın amacı, AMİ hastalarında serum ALP seviyelerini araştırmak ve KAH’ın
yaygınlığı ve ciddiyetini tahmin etmedeki değerini saptamaktır.

Hastalar ve
Yöntem: Bu çalışmaya AMİ geçiren toplam 200 hasta dahil edildi.
Serum ALP düzeyleri 120 mg/dL’den yüksek olanlar, yükselmiş ALP grubu olarak
tanımlandı. KAH’ın yaygınlığı ve ciddiyeti, Gensini skoru ve hasta damar sayısı
ile değerlendirildi. Gensini skoru 40’ın üzerinde olan hastalar, ilerlemiş KAH
grubuna dahil edildi.

Bulgular: Çalışma popülasyonunda ALP düzeyi ve Gensini skoru arasında ilişki yoktu.
Hastalar Gensini skorlarına göre gruplandırıldı (Gensini skoru ≤ 40 ve Gensini
skoru > 40). Gruplar arasında ALP düzeyi açısından fark yoktu. Bununla
birlikte, ALP düzeyleri diyabetik hastalarda ve 
ST elevasyonsuz miyokart infarktüsü (NSTEMİ) olan hastalarda anlamlı
derecede daha yüksekti. Parathormon düzeyleri ve nötrofil sayıları, ilerlemiş
KAH grubunda anlamlı olarak yüksek bulundu.

Sonuç: ALP düzeyi, AMİ’li
hastalarda KAH yaygınlığı ve ciddiyetini göstermemektedir. Bununla birlikte ALP
düzeyleri, diyabetik hastalarda ve ST elevasyonlu miyokart infarktüsü (STEMİ)
hastalarıyla kıyaslandığında NSTEMİ hastalarında daha yüksektir. Yüksek
parathormon düzeyi ve nötrofil sayısı, AMİ’de KAH yaygınlığı ve ciddiyeti ile
ilişkilidir.

Anahtar Kelimeler

Alkalen fosfataz, koroner anjiyografi, miyokart infarktüsü, koroner arter hastalığı, paratiroid hormon

Kaynakça

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