Akut Non-ST Elevasyonlu Miyokard Enfarktüslü Hastalarda Zayıf Koroner Koleteral Fonksiyonu İle İlişkili Klinik Ve Hematolojik Bulgular

Yıl 2016, Cilt: 8 Sayı: 1, 20 - 26, 01.03.2016

Mehmet Ileri

Öz

Amaç: Bu çalışmanın amacı akut non-ST elevasyonlu miyokard infarktüsü NSTEMI geçirmekte olan hastalarda kötü koroner koleteral dolaşım KKD varlığıyla ilişkili klinik ve hematolojik bulguları araştırmaktır.Metod: Bu çalışma prospektif olarak, NSTEMI geçirmekte olan ve semptomların başlangıcından itibaren 24 saat içinde koroner bakım ünitesine başvurmuş ve 48 saat içinde koroner anjiyografi yapılan ardışık 224 hastayı kapsamaktadır. Koroner koleteral gelişiminin derecelendirilmesinde Cohen-Rentrop metodu kullanıldı. Bulgular: Kötü grade 0 ve 1 ve iyi grade 2 ve 3 KKD grupları sırasıyla 145 ve 79 hasta içermekteydi. Kötü KKD’I olan hastalar iyi KKD’ı olanlarla karşılaştırıldıklarında belirgin derecede yüksek WBC, nötrofil sayıları ve nötrofil/lenfosit oranına NLO sahiptiler sırasıyla 9.01±0.95 vs 7.57±0.35, p

Anahtar Kelimeler

koroner koleteral dolaşım, non-ST elevasyonlu miyokard infarktüsü

Clinical and Hematological Parameters Associated With Poor Coronary Collateral Function In Acute Non–ST Elevation Myocardial Infarction

Öz

Aim:The aim of this study was to investigate the clinical and hematological findings associated with poor coronary collateral circulation CCC in patients with acute non-ST elevation myocardial infarction NSTEMI .Methods: This study included prospectively 224 consecutive patients with NSTEMI admitted to coronary care unit within 24 hours of symptom onset and had coronary angiography within 48 hours of hospitalization. Coronary collateral development was graded according to the Cohen-Rentrop method. Results: Poor grade 0 and 1 and good grade 2 and 3 CCC groups consisted of 145 and 79 patients respectively. Patients with poor CCC had significantly higher WBC count, neutrophil count and neutrophil to lymphocyte ratio NLR compared to those with good CCC 9.01±0.95 vs 7.57±0.35, p

Anahtar Kelimeler

coronary collateral circulation, non-ST elevation myocardial infarction

Kaynakça

• Habib GB, Heibig J, Forman SA, Brown BG, Roberts R, Terrin ML et al. Influence of coronary collateral vessels on myocardial infarct size in humans. Results of phase I thrombolysis in myocardial infarction (TIMI) trial. The TIMI Investigators. 1991 Mar; 83(3): 739-46.
• Steg PG, Kerner A, Mancini GB, Reynolds HR, Carvalho AC, Fridrich V et al. OAT Investigators. Impact of collateral flow to the occluded infarct-related artery on clinical outcomes in patients with recent myocardial infarction: a report from the randomized occluded artery trial. Circulation 2010; 121(25): 2724-30.
• Giugliano RP, Braunwald E. The year in non-ST-segment elevation acute coronary syndrome. J Am Coll Cardiol 2011; 58(22): 2342-54.
• Rentrop KP, Cohen M, Blanke H, Phillips RA. Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects. J Am Coll Cardiol 1985; 5(3): 587-92.
• de Marchi SF, Gloekler S, Meier P, Traupe T, Steck H, Cook S et al. Determinants of preformed collateral vessels in the human heart without coronary artery disease. Cardiology 2011; 118(3): 198-206.
• Piek JJ, van Liebergen RA, Koch KT, Peters RJ, David GK. Clinical, angiographic and hemodynamic predictors of recruitable collateral flow assessed during balloon angioplasty coronary occlusion. J Am Coll Cardiol 1997; 29(2): 275-82.
• Pohl T, Seiler C, Billinger M, Herren E, Wustmann K, Mehta H et al. Frequency distribution of collateral flow and factors influencing collateral channel development. Functional collateral channel measurement in 450 patients with coronary artery disease. J Am Coll Cardiol 2001; 38(7): 1872-8.
• Kerner A, Gruberg L, Goldberg A, Roguin A, Lavie P, Lavie L et al. Relation of C-reactive protein to coronary collaterals in patients with stable angina pectoris and coronary artery disease. Am J Cardiol. 2007; 99(4): 509-12.
• Duran M, Ornek E, Murat SN, Turfan M, Vatankulu MA, Ocak A et al. High levels of serum uric acid impair development of coronary collaterals in patients with acute coronary syndrome. Angiology 2012; 63(6): 472-5.
• Lev EI, Kleiman NS, Birnbaum Y, Harris D, Korbling M, Estrov Z. Circulating endothelial progenitor cells and coronary collaterals in patients with non-ST segment elevation myocardial infarction. J Vasc Res 2005; 42(5): 408-14.
• Bahrmann P, Rach J, Desch S, Schuler GC, Thiele H. Incidence and distribution of occluded culprit arteries and impact of coronary collaterals on outcome in patients with non-ST elevation myocardial infarction and early invasive treatment strategy. Clin Res Cardiol 2011; 100(5): 457-67.
• Seiler C, Stoller M, Pitt B, Meier P. The human coronary collateral circulation: development and clinical importance. Eur Heart J 2013; 34(34): 2674-82.
• Seiler C. The human coronary collateral circulation. Eur J Clin Invest 2010; 40(5): 465-76.
• Kerner A, Gruberg L, Goldberg A, Roguin A, Lavie P, Lavie L et al. Relation of C-reactive protein to coronary collaterals in patients with stable angina pectoris and coronary artery disease. Am J Cardiol 2007; 99(4): 509-12.
• Kadı H, Ceyhan K, Karayakalı M, Koç F, Celik A, Onalan O. [The relationship between coronary collateral circulation and blood high-sensitivity C-reactive protein levels]. Turk Kardiyol Dern Ars 2011; 39(1): 23-8.
• Seiler C, Pohl T, Billinger M, Meier B. Tumor necrosis factor alpha concentration and collateral flow in patients with coronary artery disease and normal systolic left ventricular function. Heart 2003; 89(1): 96-7.
• Heil M, Ziegelhoeffer T, Wagner S, Fernández B, Helisch A, Martin S et al. Collateral artery growth (arteriogenesis) after experimental arterial occlusion is impaired in mice lacking CC- chemokine receptor-2. Circ Res 2004; 94(5): 671-7.
• Kocaman SA, Arslan U, Tavil Y, Okuyan H, Abaci A, Cengel A. Increased circulating monocyte count is related to good collateral development in coronary artery disease. Atherosclerosis 2008; 197(2): 753-6.
• van der Hoeven NW, Teunissen PF, Werner GS, Delewi R, Schirmer SH, Traupe T et al. Tijssen JG, Piek JJ, Seiler C, van Royen N. Clinical parameters associated with collateral development in patients with chronic total coronary occlusion. Heart 2013; 99(15): 1100-5.
• Kalkan M, Sahin M, Kalkan A, Güler A, Taş M, Bulut M et al. The relationship between the neutrophil-lymphocyte ratio and the coronary collateral circulation in patients with chronic total occlusion. Perfusion 2014; 29(4): 360-366.
• Furman MI, Gore JM, Anderson FA, Budaj A, Goodman SG, Avezum A et al. GRACE Investigators. Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE). Am Heart J 2004; 147(1): 42-8.
• Uysal OK, Turkoglu C, Sahin DY, Duran M, Yıldırım A, Elbasan Z et al. The Relationship Between Neutrophil-to-Lymphocyte Ratio and Coronary Collateral Circulation. Clin Appl Thromb Hemost 2015; 21(4): 329-33.
• Nacar AB, Erayman A, Kurt M, Buyukkaya E, Karakaş MF, Akcay AB et al. The relationship between coronary collateral circulation and neutrophil/lymphocyte ratio in patients with coronary chronic total occlusion. Med Princ Pract 2015; 24(1): 65-9.
• Ayhan S, Ozturk S, Erdem A, Ozlu MF, Memioglu T, Ozyasar M et al. Hematological parameters and coronary collateral circulation in patients with stable coronary artery disease. Exp Clin Cardiol 2013; 18(1): e12-5.
• Akın F, Ayça B, Çelik Ö, Şahin C. Predictors of poor coronary collateral development in patients with stable coronary artery disease: neutrophil-to-lymphocyte ratio and platelets. Anatol J Cardiol 2015; 15(3): 218-23.
• Sun Z, Shen Y, Lu L, Zhang RY, Pu LJ, Zhang Q et al. Clinical and angiographic features associated with coronary collateralization in stable angina patients with chronic total occlusion. J Zhejiang Univ Sci B 2013; 14(8): 705-12.
• Rocic P. Why is coronary collateral growth impaired in type II diabetes and the metabolic syndrome? Vascul Pharmacol 2012; 57(5-6): 179-86.