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Evaluation of the Neutrophil-lymphocyte Ratio and Mean Platelet Volume in Hypertensive Patients with Coronary Artery Ectasia

Yıl 2020, Cilt: 23 Sayı: 1, 59 - 63, 01.04.2020

Öz

Introduction: Coronary artery ectasia (CAE) is associated with increased morbidity and mortality, and is known to also be associated with atherosclerosis. CAE is considered a variant of coronary artery disease, and is more common in patients with hypertension. We aimed to evaluate the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) in hypertensive patients with CAE.

Patients and Methods: The study was designed retrospectively in the cardiology unit of Bolu Abant Izzet Baysal University Medical Faculty Hospital between January 2017 and October 2019. A total of 7287 coronary angiographies were retrospectively analyzed to detect the incidence of ischemic heart disease. Diagnosis of CAE was made visually by two cardiologists who were blinded to the study aims. All included patients had a diagnosis of hypertension. After appropriate exclusions, hypertensive patients were divided into CAE and normal coronary artery groups, and the laboratory parameters of the two groups were compared.

Results: The neutrophil counts [4.2 (2.4-8.6) vs. 4.2 (2.0-6.7) u/mm3 , p= 0.015], red cell distribution width [15.7 (12.8-21.6) vs. 15.3 (13.2-18.6) %, p= 0.002], platelet distribution width [17.9 (15.5-23.0) vs. 17.5 (15.9-20.8) %, p= 0.001], NLR [2.1 (0.7-12.8) vs. 1.9 (0.8-4.5), p< 0.001], platelet-lymphocyte ratio [109.8 (63.0-321.8) vs. 100.9 (34.7-223.6), p= 0.001], MPV (8.4 ± 1.4 vs. 7.9 ± 1.0 fL, p< 0.001), and plateletcrit (0.19 ± 0.05 vs. 0.18 ± 0.4 %, p= 0.007) were significantly higher, and the lymphocytes counts [2.1 (0.5-4.2) vs. 2.2 (1.1-6.7) u/mm3 , p= 0.013] were significantly lower in hypertensive patients with CAE than in those without.

Conclusion: Hemogram parameters could be useful biomarkers for determining a thrombotic state and inflammatory response in hypertensive patients with CAE.

Kaynakça

  • 1. Tony H, Meng K, Wu B, Zeng Q. Among ectasia patients with coexisting coronary artery disease, timi frame count correlates with ectasia size and markis type iv is the commonest. Cardiol Res Pract 2015;2015:282170.
  • 2. Mavrogeni S. Coronary artery ectasia: from diagnosis to treatment. Hellenic J Cardiol 2010;51:158-63.
  • 3. Ozcan OU, Gulec S. Coronary artery ectasia. Cor et Vasa 2013;55:e242-7.
  • 4. Saglam M, Karakaya O, Barutcu I, Esen AM, Turkmen M, Kargin R, et al. Identifying cardiovascular risk factors in a patient population with coronary artery ectasia. Angiology 2007;58:698-703.
  • 5. Harikrishnan S, Sunder K, Tharakan J, Titus T, Bhat A, Sivasankaran S, et al. Coronary artery ectasia: angiographic, clinical profile and follow-up. Indian Heart J 2000;52:547-53.
  • 6. Yang JJ, Yang X, Chen ZY, Wang Q, He B, Du LS, et al. Prevalence of coronary artery ectasia in older adults and the relationship with epicardial fat volume by cardiac computed tomography angiography. J Geriatr Cardiol 2013;10:10.
  • 7. HGWAPL B, Jegavanthan A, Kogulan T, Karunaratne R, Hewaratne U, Kodithuwakku N, et al. Coronary angiographic and clinical characteristics of patients with coronary artery ectasia; an experience from sri lanka. IJRS 2019;10:33429-33.
  • 8. Sanyal S, Caccavo N. Is nitroglycerin detrimental in patients with coronary artery ectasia? A case report. Tex Heart Inst J 1998;25:140.
  • 9. Brunetti ND, Salvemini G, Cuculo A, Ruggiero A, De Gennaro L, Gaglione A, et al. Coronary artery ectasia is related to coronary slow flow and inflammatory activation. Atherosclerosis 2014;233:636-40.
  • 10. Dahhan A. Coronary artery ectasia in atherosclerotic coronary artery disease, inflammatory disorders, and sickle cell disease. Cardiovascular therapeutics 2015;33:79-88.
  • 11. Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, et l. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the lancet commission on hypertension. Lancet (London, England) 2016;388:2665-712.
  • 12. Agita A, Alsagaff MT. Inflammation, immunity, and hypertension. Acta Med Indones 2017;49:158-65.
  • 13. Rashid S, Gul U, Ali M, Sadiq T, Kiyani AM. Coronary artery ectasia: clinical and angiographic features. J Coll Physicians Surg Pak 2018;28:824-8.
  • 14. Tandon V, Tandon AA, Kumar M, Mosebach CM, Balakumaran K. Coronary artery aneurysms: Analysis of comorbidities from the national inpatient sample. Cureus 2019;11:e4876.
  • 15. Falaschetti E, Mindell J, Knott C, Poulter N. Hypertension management in england: a serial cross-sectional study from 1994 to 2011. Lancet (London, England) 2014;383:1912-9.
  • 16. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary arterial ectasia. AJC 1976;37:217-22.
  • 17. Sabatine MS, Morrow DA, Cannon CP, Murphy SA, Demopoulos LA, DiBattiste PM, et al. Relationship between baseline white blood cell count and degree of coronary artery disease and mortality in patients with acute coronary syndromes: a tactics-timi 18 substudy. JACC 2002;40:1761-8.
  • 18. Rudiger A, Burckhardt OA, Harpes P, Müller SA, Follath F. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med 2006;24:451-4.
  • 19. Bedel C, Selvi F. Association of platelet to lymphocyte and neutrophil to lymphocyte ratios with in-hospital mortality in patients with type a acute aortic dissection. BJCVS 2020;34:694-8.
  • 20. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in asian population. Intern Archiv Med 2012;5:2.
  • 21. Isik T, Ayhan E, Uyarel H, Tanboga IH, Kurt M, Uluganyan M, et al. Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasia. Turk Kardiyol Dern Ars 2013;41:123-30.
  • 22. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133:628-32.
  • 23. Gürel OM, Demircelik MB, Bilgic MA, Yilmaz H, Yilmaz OC, Cakmak M, et al. Association between red blood cell distribution width and coronary artery calcification in patients undergoing 64-multidetector computed tomography. Korean Circ J 2015;45:372-7.
  • 24. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: Its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost 2004;10:175-8.
  • 25. Erhart S, Beer JH, Reinhart WH. Influence of aspirin on platelet count and volume in humans. Acta Haematol 1999;101:140-4.
  • 26. Akpinar I, Sayin MR, Gursoy YC, Karabag T, Kucuk E, Buyukuysal MC, et al. Plateletcrit. A platelet marker associated with saphenous vein graft disease. Herz 2014;39:142-8.
  • 27. Coban E, Ozdogan M, Yazicioglu G, Akcit F. The mean platelet volume in patients with obesity. Int J Clin Pract 2005;59:981-2.
  • 28. Akpinar I, Sayin MR, Gursoy YC, Aktop Z, Karabag T, Kucuk E, et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon. J Cardiol 2014;63:112-8.
  • 29. Uğur M, Ayhan E, Bozbay M, Çiçek G, Ergelen M, Işık T, et al. The independent association of plateletcrit with long-term outcomes in patients undergoing primary percutaneous coronary intervention. J Crit Care 2014;29:978-81.
  • 30. Akkaya E, Gul M, Ugur M. Platelet to lymphocyte ratio: a simple and valuable prognostic marker for acute coronary syndrome. Int J Cardiol 2014;177:597-8.

Koroner Arter Ektazi Olan Hipertansif Hastalarda Nötrofil-Lenfosit Oranının ve Ortalama Trombosit Hacminin Değerlendirilmesi

Yıl 2020, Cilt: 23 Sayı: 1, 59 - 63, 01.04.2020

Öz

Giriş: Artmış morbidite ve mortalite ile ilişkili olan koroner arter ektazi (KAE), ateroskleroz ile ilişkilidir ve koroner arter hastalığının bir varyantı olarak kabul edilir. KAE hipertansiyonu olan hastalarda daha yaygındır. Bu çalışmada, hipertansif KAH olan hastalarda nötrofil-lenfosit oranını (NLR) ve ortalama trombosit hacmini (MPV) değerlendirmek amaçlanmıştır.

Hastalar ve Yöntem: Çalışma Ocak 2017-Ekim 2019 tarihleri arasında Bolu Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi kardiyoloji ünitesinde retrospektif olarak tasarlandı. Çalışmada 7287 koroner anjiyografi iskemik kalp hastalığını saptamak için retrospektif olarak incelendi. KAE tanısı görsel olarak iki kör kardiyolog tarafından konuldu. Çalışmaya dahil edilen tüm hastalarda hipertansiyon tanısı vardı. Uygun dışlamalar sonrasında hipertansif hastalar KAE ve normal koroner arter gruplarına ayrıldı. Bu iki grubun laboratuvar parametreleri karşılaştırıldı.

Bulgular: Nötrofil sayısı [4.2 (2.4-8.6) vs. 4.2 (2.0-6.7) u/mm3 , p= 0.015], RDW [15.7 (12.8-21.6) vs. 15.3 (13.2-18.6) %, p= 0.002], PDW [17.9 (15.5-23.0) vs. 17.5 (15.9-20.8) %, p= 0.001], NLR [2.1 (0.7-12.8) vs. 1.9 (0.8-4.5), p< 0.001], PLR [109.8 (63.0-321.8) vs. 100.9 (34.7-223.6), p= 0.001], MPV (8.4 ± 1.4 vs. 7.9 ± 1.0 fL, p< 0.001) ve PCT (0.19 ± 0.05 vs. 0.18 ± 0.4 %, p= 0.007) KAE olan hipertansif hastalarda anlamlı olarak daha yüksekti. KAE olan hipertansif hastalarda lenfosit sayısı [2.1 (0.5-4.2) vs. 2.2 (1.1-6.7) u/mm3 , p= 0.013] anlamlı derecede düşüktü.

Sonuç: Hemogram parametreleri, KAE olan hipertansif hastalarda trombotik bir durumun ve inflamatuvar yanıtın belirlenmesinde bir biyobelirteç olarak daha yararlı olabilir.

Kaynakça

  • 1. Tony H, Meng K, Wu B, Zeng Q. Among ectasia patients with coexisting coronary artery disease, timi frame count correlates with ectasia size and markis type iv is the commonest. Cardiol Res Pract 2015;2015:282170.
  • 2. Mavrogeni S. Coronary artery ectasia: from diagnosis to treatment. Hellenic J Cardiol 2010;51:158-63.
  • 3. Ozcan OU, Gulec S. Coronary artery ectasia. Cor et Vasa 2013;55:e242-7.
  • 4. Saglam M, Karakaya O, Barutcu I, Esen AM, Turkmen M, Kargin R, et al. Identifying cardiovascular risk factors in a patient population with coronary artery ectasia. Angiology 2007;58:698-703.
  • 5. Harikrishnan S, Sunder K, Tharakan J, Titus T, Bhat A, Sivasankaran S, et al. Coronary artery ectasia: angiographic, clinical profile and follow-up. Indian Heart J 2000;52:547-53.
  • 6. Yang JJ, Yang X, Chen ZY, Wang Q, He B, Du LS, et al. Prevalence of coronary artery ectasia in older adults and the relationship with epicardial fat volume by cardiac computed tomography angiography. J Geriatr Cardiol 2013;10:10.
  • 7. HGWAPL B, Jegavanthan A, Kogulan T, Karunaratne R, Hewaratne U, Kodithuwakku N, et al. Coronary angiographic and clinical characteristics of patients with coronary artery ectasia; an experience from sri lanka. IJRS 2019;10:33429-33.
  • 8. Sanyal S, Caccavo N. Is nitroglycerin detrimental in patients with coronary artery ectasia? A case report. Tex Heart Inst J 1998;25:140.
  • 9. Brunetti ND, Salvemini G, Cuculo A, Ruggiero A, De Gennaro L, Gaglione A, et al. Coronary artery ectasia is related to coronary slow flow and inflammatory activation. Atherosclerosis 2014;233:636-40.
  • 10. Dahhan A. Coronary artery ectasia in atherosclerotic coronary artery disease, inflammatory disorders, and sickle cell disease. Cardiovascular therapeutics 2015;33:79-88.
  • 11. Olsen MH, Angell SY, Asma S, Boutouyrie P, Burger D, Chirinos JA, et l. A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations: the lancet commission on hypertension. Lancet (London, England) 2016;388:2665-712.
  • 12. Agita A, Alsagaff MT. Inflammation, immunity, and hypertension. Acta Med Indones 2017;49:158-65.
  • 13. Rashid S, Gul U, Ali M, Sadiq T, Kiyani AM. Coronary artery ectasia: clinical and angiographic features. J Coll Physicians Surg Pak 2018;28:824-8.
  • 14. Tandon V, Tandon AA, Kumar M, Mosebach CM, Balakumaran K. Coronary artery aneurysms: Analysis of comorbidities from the national inpatient sample. Cureus 2019;11:e4876.
  • 15. Falaschetti E, Mindell J, Knott C, Poulter N. Hypertension management in england: a serial cross-sectional study from 1994 to 2011. Lancet (London, England) 2014;383:1912-9.
  • 16. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary arterial ectasia. AJC 1976;37:217-22.
  • 17. Sabatine MS, Morrow DA, Cannon CP, Murphy SA, Demopoulos LA, DiBattiste PM, et al. Relationship between baseline white blood cell count and degree of coronary artery disease and mortality in patients with acute coronary syndromes: a tactics-timi 18 substudy. JACC 2002;40:1761-8.
  • 18. Rudiger A, Burckhardt OA, Harpes P, Müller SA, Follath F. The relative lymphocyte count on hospital admission is a risk factor for long-term mortality in patients with acute heart failure. Am J Emerg Med 2006;24:451-4.
  • 19. Bedel C, Selvi F. Association of platelet to lymphocyte and neutrophil to lymphocyte ratios with in-hospital mortality in patients with type a acute aortic dissection. BJCVS 2020;34:694-8.
  • 20. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in asian population. Intern Archiv Med 2012;5:2.
  • 21. Isik T, Ayhan E, Uyarel H, Tanboga IH, Kurt M, Uluganyan M, et al. Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasia. Turk Kardiyol Dern Ars 2013;41:123-30.
  • 22. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133:628-32.
  • 23. Gürel OM, Demircelik MB, Bilgic MA, Yilmaz H, Yilmaz OC, Cakmak M, et al. Association between red blood cell distribution width and coronary artery calcification in patients undergoing 64-multidetector computed tomography. Korean Circ J 2015;45:372-7.
  • 24. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: Its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost 2004;10:175-8.
  • 25. Erhart S, Beer JH, Reinhart WH. Influence of aspirin on platelet count and volume in humans. Acta Haematol 1999;101:140-4.
  • 26. Akpinar I, Sayin MR, Gursoy YC, Karabag T, Kucuk E, Buyukuysal MC, et al. Plateletcrit. A platelet marker associated with saphenous vein graft disease. Herz 2014;39:142-8.
  • 27. Coban E, Ozdogan M, Yazicioglu G, Akcit F. The mean platelet volume in patients with obesity. Int J Clin Pract 2005;59:981-2.
  • 28. Akpinar I, Sayin MR, Gursoy YC, Aktop Z, Karabag T, Kucuk E, et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon. J Cardiol 2014;63:112-8.
  • 29. Uğur M, Ayhan E, Bozbay M, Çiçek G, Ergelen M, Işık T, et al. The independent association of plateletcrit with long-term outcomes in patients undergoing primary percutaneous coronary intervention. J Crit Care 2014;29:978-81.
  • 30. Akkaya E, Gul M, Ugur M. Platelet to lymphocyte ratio: a simple and valuable prognostic marker for acute coronary syndrome. Int J Cardiol 2014;177:597-8.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırmalar
Yazarlar

Mehmet İnanır Bu kişi benim 0000-0003-1784-3584

Gökhan Alıcı Bu kişi benim 0000-0002-1443-4307

Emrah Acar Bu kişi benim 0000-0003-4573-8386

Hayati Eren Bu kişi benim 0000-0002-2159-064X

Müjgan Gürler Bu kişi benim 0000-0001-9532-8241

Sait Alan Bu kişi benim 0000-0002-5090-7247

Yayımlanma Tarihi 1 Nisan 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 23 Sayı: 1

Kaynak Göster

Vancouver İnanır M, Alıcı G, Acar E, Eren H, Gürler M, Alan S. Evaluation of the Neutrophil-lymphocyte Ratio and Mean Platelet Volume in Hypertensive Patients with Coronary Artery Ectasia. Koşuyolu Heart Journal. 2020;23(1):59-63.