The relationship between canlph score and saphenous vein graft disease

Öz

Objective: The frequency and clinical presentation of saphenous vein graft disease (SVGD) is increasing so it is important to reveal the predisposing factors and identify the patients in the risk group. In this study; We aimed to evaluate the relationship between CRP/albumin ratio +neutrophil/lymphocyte ratio+ platelet/hemoglobin ratio (CANLPH) score and SVGD, which enables the evaluation of three biomarkers such as platelet/hemoglobin ratio (PHR), CRP/albumin ratio (CAR) and neutrophil/lymphocyte ratio (NLR). Method: Total of 754 patients who had coronary angiography in our hospital between January 2018 and January 2020 and had history of coronary artery bypass graft were included retrospectively. Patients with stenosis of at least ≥50 in SVGs constituted the SVGH group and without stenosis in SVGs the controls. CAR, NLR and PHR values were calculated and cut-off values were determined using the Youden index and scores were obtained as 0 or 1. The sum of these 3 scores was recorded as the CANLPH score. A p value of <0.05 was considered statistically significant. Results: The mean age of all patients was 66.0±8.6 (73% male). The patients in SVGD group (n=372) were more diabetic and had lower ejection fraction than controls (p=0.041 and p<0.001). The groups were similar in terms of PHR (p=0.690) but mean CAR (p=0.001) and NLR (p=0.003) were higher in SVGD group. In multivariate logistic regression analysis CANLPH, CAR, NLR, lower EF and higher glucose were independent predictors of SVGD. CANLPH score was better with an Area under curve (AUC) 0.663 and p<0.001, 95% confidence Interval (CI) :0.620-0.705. Conclusion: CANLPH score can be a laboratory biomarker for predicting SVGD.

Anahtar Kelimeler

• CANLPH score
• coronary artery bypass
• saphenous vein graft disease

CANLPH Skoru ile Safen Ven Greft Hastalığı Arasındaki İlişki

Öz

Amaç: Safen ven greft hastalığının (SVGH) sıklığı ve klinik prezentasyonu giderek artmaktadır, bu nedenle predispozan faktörlerin ortaya çıkarılması ve risk grubundaki hastaların belirlenmesi önemlidir. Bu çalışmanın amacı, SVGH ile CRP/albümin oranı (CAR), nötrofil/lenfosit oranı (NLR) ve trombosit/hemoglobin oranı (PHR) gibi üç biyobelirtecin değerlendirilmesini sağlayan CRP/Albümin+Nötrofil/Lenfosit+Trombosit/Hemoglobin (CANLPH) skoru arasındaki ilişkiyi araştırmaktır. Yöntem: Çalışmaya hastanemizde 1 Ocak 2018 - 1 Ocak 2020 tarihleri arasında koroner anjiyografi yapılmış ve koroner arter baypas greft (KABG) öyküsü olan toplam 754 hasta geriye dönük olarak dahil edilmiştir. SVG'lerinin en az birinde ve en az ≥%50 darlığı olan hastalar SVGH grubu ve SVG'lerde anlamlı darlığı bulunmayan hastalar kontrol grubu olarak dahil edildi. CAR, NLR ve PHR değerleri hastaların laboratuar verilerinden hesaplandı. You’den indeksi kullanılarak CAR, NLR ve PHR nin limit değerleri belirlendi ve puanlar 0 veya 1 olarak elde edildi. Bu üç skorun puanlarının toplamı ile grupların CANLPH skorları belirlendi. p<0.05 değeri istatistiksel olarak anlamlı kabul edildi. Bulgular: Hastaların yaş ortalaması 66.0±8.6 (%73 erkek) idi. SVGH grubunda (n=372), Diyabetes Mellitus (DM) oranı kontrol grubuna (n= 382) göre göre daha yüksekti ve hastaların ejeksiyon fraksiyonu (EF) daha düşüktü (p=0.041 ve p<0.001). Gruplar PHR düzeyleri açısından benzerdi ancak ortalama CAR ve NLR skorları SVGH grubunda daha yüksek saptandı. (p=0.690, p=0.001 ve p=0.003, sırasıyla). Çok değişkenli regresyon analizinde CANLPH, CAR, NLR, düşük EF ve yüksek glukoz seviyelerinin SVGH'nin bağımsız öngördürücüleri olduğu ve CANLPH skorunun, Eğri altındaki alan (EAA) 0.663 ve p<0.001, %95 güven aralığı (CI) :0.620-0.705 değerleri ile daha iyi olduğu saptandı. Sonuç: Basit ve kolay hesaplanabilen CANLPH skoru, SVGH 'yi öngördürmede bir laboratuvar biyobelirteci olarak kullanılabilir.

Anahtar Kelimeler

• CANLPH skoru
• koroner arter bypass greft
• safen ven greft hastalığı

Kaynakça

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