Monosit Sayısının Yüksek Yoğunluklu Lipoprotein Kolesteroel Oranı ve Ortalama Trombosit Hacmi, Karotis Arter Stenozunun Ciddiyeti ile İlişkili Olabilir

Yıl 2021, Cilt: 12 Sayı: 1, 52 - 59, 30.04.2021

Veysel Atilla Ayyıldız Mevlüt Serdar Kuyumcu

Öz

Amaç: Karotis arter darlığının patofizyolojisi tam olarak anlaşılamamıştır. Araştırmalar, ortalama trombosit hacminin (MPV) trombosit aktivasyonu için potansiyel bir belirteç olduğunu ve ateroskleroz patofizyolojisinde anahtar bir faktör olduğunu göstermiştir. Son zamanlarda, monosit sayısının HDL'ye (MHR) oranı, hastalarda kardiyovasküler olayların bir prediktörü olarak tanımlanmıştır. Bu bulgular ışığında çalışmanın amacı, MPV ve MHR'nin CAD şiddeti ile olası ilişkisini araştırmaktır.
Materyal-metot: Hastalar üç gruba ayrıldı: CAD≥%60 (40 hasta), CAD<% 60 (40 hasta) ve karotis aterosklerotik hastalığı olmayan (40 kişi). Hastaların demografik özellikleri, klinik özellikleri ve laboratuvar parametreleri gruplar arasında karşılaştırıldı.
Bulgular: Kontrol grubunda MPV ve MHR seviyeleri CAD <60 grubuna göre daha düşük, CAD <60 grubunda CAD ≥60 grubuna göre daha düşüktü (p <0,001, p <0,001). Yüksek MPV (OR = 6.050;% 95 CI: 2.946-12.427; p <0.001) ve MHR (OR = 1.107;% 95 CI: 1.045 -1.159; p <0.001) seviyeleri çoklu lineer regresyon analizinden sonra ≥% 60 karotis arter darlığı için bağımsız prediktör olarak tespit edildi. Korelasyon analizinde MPV ile karotis arter darlığı oranı arasında pozitif korelasyon bulundu (p <0,001, r = 0,680).
Sonuç: Çalışmamızda MPV ve MHR ile karotis arter hastalığı arasında potansiyel bir ilişki tespit edildi. Çalışmamız, karotis arter ateroskleroz patofizyolojisinin anlaşılmasına ve buna yönelik tedavilerin geliştirilmesine katkı sağlayabilir.

Anahtar Kelimeler

Karotis arter darlığı, ortalama trombosit hacmi, monosit-yüksek yoğunluklu lipoprotein oranı

Destekleyen Kurum

Destekleyen kurum yoktur.

Proje Numarası

Mevcut değil

Monocyte count to high-density lipoprotein cholesterol ratio and mean platelet volume may be related to the severity of carotid artery stenosis.

Öz

Objective: The pathophysiology of carotid artery stenosis (CAD) is not fully understood. Research has showed that mean platelet volume (MPV) is a potential marker for platelet activation and is a key factor in atherosclerosis pathophysiology. Recently, the ratio of monocyte count to HDL (MHR) has been identified as a predictor of cardiovascular events in patients. In the light of these findings, the goal of study was to evaluate the potential association of MPV and MHR with the severity of CAD.
Material-Method: Patients had divided into three groups: CAD≥ 60% (40 patients), CAD <60% (40 patients) and no carotid atherosclerotic disease (40 individuals). Patients' demographic characteristics, clinical features and laboratory findings were compared between groups.
Results: MPV and MHR leves were lower in the control group than CAD <60 group and lower in CAD <60 group than CAD ≥60 group (p <0.001, p <0.001). Higher MPV (OR= 6.050; 95% CI: 2.946-12.427; p <0.001) and MHR (OR= 1.107; 95% CI: 1.045-1.159; p <0.001) levels were detected as independent predictor for ≥60% carotid artery stenosis after multiple linear regression analysis. In the correlation analysis, a positive correlation was found between MPV and the rate of carotid artery stenosis (p<0.001, r=0.680).
Conclusion: In our study, a potential relationship between MPV and MHR with carotid artery disease was determined. Our study may make contributions to understanding the carotid artery atherosclerosis pathophysiology and developing treatments for it.

Anahtar Kelimeler

Carotid artery stenosis, mean platelet volume, monocyte-to-high-density lipoprotein cholesterol ratio

Proje Numarası

Mevcut değil

Kaynakça

• 1. Atherosclerosis and the role of inflammation. Archives of the Turkish Society of Cardiology. 2009;37(80):1-6.
• 2. Güleç S. [Global risk and objectives in cardiovascular diseases]. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2009;37 Suppl 2:1-10.
• 3. Başarici I. [Determination of TIMI frame counts and slow coronary flow/ Relationship between the slow coronary flow and carotid artery intima-media thickness]. Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology. 2007;7(3):333-4; author reply 4.
• 4. Aboyans V, Ricco JB, Bartelink MEL, Björck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): European heart journal. 2018;39(9):763-816.
• 5. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2003;9(3):177-90.
• 6. Yaşar AS, Bilen E, Yüksel IO, Arslantaş U, Karakaş F, Kirbaş O, et al. Association between admission mean platelet volume and coronary patency after thrombolytic therapy for acute myocardial infarction. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2010;38(2):85-9.
• 7. Gu Lcan AR, Karakaş MS, Akdemir B, Uçar M, Altekin RE, Yılmaz HS. [Relation between mean platelet volume and subclinical atherosclerosis in patients with metabolic syndrome]. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2014;42(1):22-8.
• 8. Yüksel Kalkan G, Gür M, Baykan AO, Uçar H, Elbasan Z, Şahin DY, et al. Mean platelet volume is associated with aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Anatol J Cardiol. 2015;15(9):753-8.
• 9. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol. 2004;44(2):415-22.
• 10. Korkmaz L, Korkmaz AA, Akyüz AR, Ağaç MT, Acar Z, Kırış A, et al. Association between mean platelet volume and coronary artery calcification in patients without overt cardiovascular disease: an observational study. Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology. 2012;12(1):35-9.
• 11. Aşkın L, Çetin M, Türkmen S, Taşolar H, Aktürk E. The relationship between monocyte/high-density lipoprotein ratio and Selvester QRS score in patients with STEMI. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2018;46(4):260-7.
• 12. Tosheska Trajkovska K, Topuzovska S. High-density lipoprotein metabolism and reverse cholesterol transport: strategies for raising HDL cholesterol. Anatol J Cardiol. 2017;18(2):149-54.
• 13. Onat A. High density lipoprotein cholesterol in coronary artery patients: is it as low as expected? Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology. 2006;6(1):92-3; author reply 3.
• 14. Biswas SK. Does the Interdependence between Oxidative Stress and Inflammation Explain the Antioxidant Paradox? Oxidative Medicine and Cellular Longevity. 2016;2016:5698931.
• 15. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. International urology and nephrology. 2014;46(8):1619-25.
• 16. Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of Monocyte-to-HDL Cholesterol Ratio with Slow Coronary Flow is Linked to Systemic Inflammation. Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2016;22(5):476-82.
• 17. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. European heart journal. 2016;37(29):2315-81.
• 18. Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, et al. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999;30(9):1751-8.
• 19. Kuyumcu A, Kuyumcu MS. Akdeniz Diyeti ve Karotis Arter Hastalığı Arasındaki İlişki. SDÜ Sağlık Bilimleri Dergisi. 2019;10(2):99-104.
• 20. Pafili K, Penlioglou T, Mikhailidis DP, Papanas N. Mean platelet volume and coronary artery disease. Current opinion in cardiology. 2019;34(4):390-8.
• 21. Vivekananthan DP, Patel VB, Moliterno DJ. Glycoprotein IIb/IIIa antagonism and fibrinolytic therapy for acute myocardial infarction. Journal of interventional cardiology. 2002;15(2):131-9.
• 22. Kristensen SD. The platelet-vessel wall interaction in experimental atherosclerosis and ischaemic heart disease with special reference to thrombopoiesis. Danish medical bulletin. 1992;39(2):110-27.
• 23. Ihara A, Kawamoto T, Matsumoto K, Shouno S, Hirahara C, Morimoto T, et al. Relationship between platelet indexes and coronary angiographic findings in patients with ischemic heart disease. Pathophysiology of haemostasis and thrombosis. 2006;35(5):376-9.
• 24. Celebi OO, Canbay A, Celebi S, Sahin D, Aydoğdu S, Diker E. [The effect of admission mean platelet volume on TIMI frame count measured after fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction]. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2009;37(5):307-11.
• 25. Karakaş MS, Altekin RE, Baktır AO, Küçük M, Cilli A, Yalçınkaya S. Association between mean platelet volume and severity of disease in patients with obstructive sleep apnea syndrome without risk factors for cardiovascular disease. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2013;41(1):14-20.
• 26. Nurkalem Z, Alper AT, Orhan AL, Zencirci AE, Sari I, Erer B, et al. Mean platelet volume in patients with slow coronary flow and its relationship with clinical presentation. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2008;36(6):363-7.
• 27. Demirkol S, Balta Ş, Arslan Z, Küçük U, Ünlü M. [Noninvasive markers such as mean platelet volume in clinical practice]. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2013;41(6):575.
• 28. Varol E. Decreased mean platelet volume in Gilbert's syndrome: role of oxidative stress. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis. 2013;24(6):673.
• 29. Varol E, Akcay S, Icli A, Yucel H, Ozkan E, Erdogan D, et al. Mean platelet volume in patients with prehypertension and hypertension. Clinical hemorheology and microcirculation. 2010;45(1):67-72.
• 30. Moghadam RH, Shahmohammadi A, Asgari N, Azizi K, Mansour SM, Roozbahani M. Comparison of mean platelet volume levels in coronary artery ectasia and healthy people: systematic review and meta-analysis. Blood research. 2018;53(4):269-75.
• 31. Tuncel T, Uysal P, Hocaoglu AB, Erge DO, Karaman O, Uzuner N. Change of mean platelet volume values in asthmatic children as an inflammatory marker. Allergologia et immunopathologia. 2012;40(2):104-7.
• 32. Nicholls SJ, Dusting GJ, Cutri B, Bao S, Drummond GR, Rye KA, et al. Reconstituted high-density lipoproteins inhibit the acute pro-oxidant and proinflammatory vascular changes induced by a periarterial collar in normocholesterolemic rabbits. Circulation. 2005;111(12):1543-50.
• 33. Kunitake ST, Jarvis MR, Hamilton RL, Kane JP. Binding of transition metals by apolipoprotein A-I-containing plasma lipoproteins: inhibition of oxidation of low density lipoproteins. Proceedings of the National Academy of Sciences of the United States of America. 1992;89(15):6993-7.