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Kararlı Anjina Pektorisli Hastalarda Koroner Arter Lezyon Şiddetinin Eritrosit Dağılım Genişliği ve Ayak Bileği-Kol Basınç İndeksi ile İlişkisi

Yıl 2018, , 311 - 319, 29.06.2018
https://doi.org/10.31832/smj.415819

Öz

Amaç: Ayak bileği-kol basınç indeksi (AKİ), noninvaziv ve
ucuz bir metod olup yaşlı popülasyonda periferik arter hastalığının (PAH)
tanımlanması için kullanılır. PAH’nın bir göstergesi olarak AKİ, koroner arter
hastalığını (KAH) tahmin etmek için yaygın bir şekilde kullanılmaktadır.
Eritrosit dağılım genişliği (EDG) dolaşımdaki eritrositlerin boyutlarındaki
değişkenliğin bir ölçüsüdür. EDG’deki artışlar hem kararlı hem de kararsız
haldeki KAH ile ilişkilidir. Bu çalışmada, kararlı anjina pektoris (KAP)
hastalarında EDG ve AKİ belirteçlerinin SYNTAX skoru (SS) kullanılarak koroner
lezyon şiddeti üzerine prediktif bilgi sağlayıp sağlayamayacağını araştırmayı
amaçladık.



Gereç ve Yöntemler: Çalışmaya 109 KAP hastası dahil
edildi. Hastalar önce 40 hasta normal koroner arterler ve 69 hasta KAH grubuna
ayrılarak değerlendirildi. Sonrasında KAH hasta grubu, KAH şiddetini
anjiyografik olarak derecelendiren SS’na göre iki ayrı alt gruba (SS 1-22
(n=32) ve SS >22 (n=37) ayrılarak incelendi. p<0.05 anlamlı kabul edildi.



Bulgular: Çok değişkenli regresyon analizi EDG ve AKİ’nin
KAH varlığının bağımsız birer prediktörü olduğunu gösterdi (sırasıyla; OR:
6,209, p= 0,001 ve OR: -2,342, p<0,001). Fakat aynı analiz AKİ’nin KAH
şiddetini öngörmede EDG’den daha iyi olduğunu gösterdi (sırasıyla; OR: 1,568,
p= 0,215 ve OR: -1,540, p<0,001).



Sonuçlar: Koroner arter hastalığı varlığında EDG’nin
anlamlı derecede arttığı, AKİ’nin anlamlı derecede azaldığı görülmüştür. KAH
varlığını öngörmede EDG ve AKİ’nin kullanışlı birer değişken olduğu tespit
edilmiştir. AKİ, KAH’ın şiddetini tahmin etmede EDG'den daha güçlü bir
öngördürücüdür.

Kaynakça

  • Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation. 2004;110: 738-743.
  • Aboyans V, Criqui MH, Abraham P, et al. Measurement and interpretation of the ankle-brachial index: a scientifc statement from the American Heart Association. Circulation. 2012;126:2890-2909
  • Zheng ZJ, Sharrett AR, Chambless LE, Rosamond WD, Nieto FJ, Sheps DS, et al. Associations of anklebrachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) Study. Atherosclerosis. 1997;131:115-125.
  • Newman AB, Siscovick DS, Manolio TA, Polak J, Fried LP, Borhani NO, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group. Circulation. 1993;88:837-845.
  • Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. Eurointervention. 2005;1:219-227.
  • Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation 2008;117:163-168.
  • Ma FL, Li S, Li XL, Liu J, Qing P, Guo YL, et al. Correlation of red cell distribution width with the severity of coronary artery disease: a large Chinese cohort study from a single center. Chin Med J (Engl) 2013;126:1053-1057.
  • Montalescot G, Sechtem U, Achenbach S, Achenbach S, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34:2949-3003.
  • SYNTAX Working Group. SYNTAX score calculator. http://www.syntaxscore.com. Accessed January 15, 2011.
  • Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-society consensus for the management of peripheral arterial disease (TASC II). J VascSurg 2007; 45: 5-67.
  • Palmerini T, Genereux P, Caixeta A, Cristea E, Lansky A, Mehran R, et al. Prognostic Value of the SYNTAX Score in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention Analysis From the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) Trial. J Am CollCardiol, 2011; 57: 2389-2397.
  • Papa EDE, Helber I, Ehrlichmann MR, et al. Ankle-brachial index as a predictor of coronary disease events in elderly submitted to coronary angiography. Clinics. 2013;68:1481-1487.
  • Chang ST, Chen CL, Chu CM, Chung CM, Hsu JT, Cheng HW, et al. Ankle-arm index as a predictor of lesion morphology and risk classification for coronary artery disease undergoing angioplasty. Int J Cardiol. 2006;113:385-390.
  • Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J 2009;158:659-666.
  • Demirkol S, Balta S, Celik T, Arslan Z, Unlu M, Cakar M, et al. Assessment of the relationship between red cell distribution width and cardiac syndrome X. KardiolPol 2013;71:480-484.
  • Akin F, Köse N, Ayça B, Katkat F, Duran M, Uysal OK, et al. Relation between red cell distribution width and severity of coronary artery disease in patients with acute myocardial infarction. Angiology2013;64:592-596.
  • Isik T, Uyarel H, Tanboga IH, Kurt M, Ekinci M, Kaya A, et al. Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease. Coron Artery Dis2012;23:51-56.
  • Drakopoulou M, Toutouzas K, Stefanadi E, Tsiamis E, Tousoulis D, Stefanadis C. Association of inflammatory markers with angiographic severity and extent of coronary artery disease. Atherosclerosis 2009;206:335-339.
  • Krintus M, Kozinski M, Kubica J, Sypniewska G. Critical appraisal of inflammatory markers in cardiovascular risk stratifcation. Crit Rev Clin Lab Sci 2014;51:263-279.
  • Jelkmann W. Proinflammatory cytokines lowering erythropoietin production. J Interferon Cytokine Res 1998;18:555-559.
  • 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;133:628-632.
  • Bąk E, Marcisz C, Kadlubowska M, Michalik A, Krawczyk B, Dobrzyń-Matusiak D, et al. Independent Factors of Changes of Ankle-Brachial Index in Peripheral Arterial Occlusive Disease in Elderly Patients with or without Diabetes. Int J Environ Res Public Health 2016;13:1-11.
  • Nabais S, Losa N, Gaspar A, Rocha S, Costa J, Azevedo P, et al. Association between red blood cell distribution width and outcomes at six months in patients with acute coronary syndromes. Rev Port Cardiol 2009;28:905-924.

The Relationship between Red Cell Distribution Width and Ankle-Brachial Pressure Index of the Coronary Artery Lesion Severity in Patients with Stable Angina Pectoris

Yıl 2018, , 311 - 319, 29.06.2018
https://doi.org/10.31832/smj.415819

Öz

Objective:
Ankle-brachial pressure index (ABI) is a noninvasive and inexpensive method
used to identify peripheral arterial disease (PAD) in the elderly population.
As a marker of PAD, ABI is widely used to predict coronary artery disease
(CAD). Red cell distribution width (RDW) is a measure of the variability in the
size of erythrocytes in circulation. Increases in RDW are associated with both
stable and unstable CAD. In this study, we aimed to investigate whether RDW and
ABI markers could provide predictive information on coronary lesion complexity
using SYNTAX score (SS) in patients with stable angina pectoris

(SAP)
.

Materials and Methods:
One hundred SAP patients were included in the study. Patients were divided into
40 patients with normal coronary arteries and 69 patients with CAD.
Subsequently, the CAD patient group was examined by separating two subgroups
(SS 1-22 (n=32) and SS >22 (n=37)) according to the SS that rated CAD severity
as angiography. p <0.05 was considered significant.

Results: Multivariate
regression analysis showed that RDW and ABI were independently predictors of
CAD (OR: 6,209, p=0.001 and OR: -2,342, p<0.001, respectively). However, the
same analysis showed that ABI was better than RDW in predicting the severity of
CAD (OR: 1,568, p=0,215 and OR: -1,540, p<0.001).







Conclusions: In the
presence of CAD has been shown that RDW increases significantly and ABI
decreases significantly. It has also been found that RDW and ABI are useful
variables for predicting the presence of CAD. ABI is a strong predictor of the
severity of CAD than RDW.

Kaynakça

  • Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation. 2004;110: 738-743.
  • Aboyans V, Criqui MH, Abraham P, et al. Measurement and interpretation of the ankle-brachial index: a scientifc statement from the American Heart Association. Circulation. 2012;126:2890-2909
  • Zheng ZJ, Sharrett AR, Chambless LE, Rosamond WD, Nieto FJ, Sheps DS, et al. Associations of anklebrachial index with clinical coronary heart disease, stroke and preclinical carotid and popliteal atherosclerosis: the Atherosclerosis Risk in Communities (ARIC) Study. Atherosclerosis. 1997;131:115-125.
  • Newman AB, Siscovick DS, Manolio TA, Polak J, Fried LP, Borhani NO, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group. Circulation. 1993;88:837-845.
  • Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. Eurointervention. 2005;1:219-227.
  • Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation Between Red Blood Cell Distribution Width and Cardiovascular Event Rate in People With Coronary Disease. Circulation 2008;117:163-168.
  • Ma FL, Li S, Li XL, Liu J, Qing P, Guo YL, et al. Correlation of red cell distribution width with the severity of coronary artery disease: a large Chinese cohort study from a single center. Chin Med J (Engl) 2013;126:1053-1057.
  • Montalescot G, Sechtem U, Achenbach S, Achenbach S, Andreotti F, Arden C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34:2949-3003.
  • SYNTAX Working Group. SYNTAX score calculator. http://www.syntaxscore.com. Accessed January 15, 2011.
  • Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-society consensus for the management of peripheral arterial disease (TASC II). J VascSurg 2007; 45: 5-67.
  • Palmerini T, Genereux P, Caixeta A, Cristea E, Lansky A, Mehran R, et al. Prognostic Value of the SYNTAX Score in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention Analysis From the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) Trial. J Am CollCardiol, 2011; 57: 2389-2397.
  • Papa EDE, Helber I, Ehrlichmann MR, et al. Ankle-brachial index as a predictor of coronary disease events in elderly submitted to coronary angiography. Clinics. 2013;68:1481-1487.
  • Chang ST, Chen CL, Chu CM, Chung CM, Hsu JT, Cheng HW, et al. Ankle-arm index as a predictor of lesion morphology and risk classification for coronary artery disease undergoing angioplasty. Int J Cardiol. 2006;113:385-390.
  • Förhécz Z, Gombos T, Borgulya G, Pozsonyi Z, Prohászka Z, Jánoskuti L. Red cell distribution width in heart failure: prediction of clinical events and relationship with markers of ineffective erythropoiesis, inflammation, renal function, and nutritional state. Am Heart J 2009;158:659-666.
  • Demirkol S, Balta S, Celik T, Arslan Z, Unlu M, Cakar M, et al. Assessment of the relationship between red cell distribution width and cardiac syndrome X. KardiolPol 2013;71:480-484.
  • Akin F, Köse N, Ayça B, Katkat F, Duran M, Uysal OK, et al. Relation between red cell distribution width and severity of coronary artery disease in patients with acute myocardial infarction. Angiology2013;64:592-596.
  • Isik T, Uyarel H, Tanboga IH, Kurt M, Ekinci M, Kaya A, et al. Relation of red cell distribution width with the presence, severity, and complexity of coronary artery disease. Coron Artery Dis2012;23:51-56.
  • Drakopoulou M, Toutouzas K, Stefanadi E, Tsiamis E, Tousoulis D, Stefanadis C. Association of inflammatory markers with angiographic severity and extent of coronary artery disease. Atherosclerosis 2009;206:335-339.
  • Krintus M, Kozinski M, Kubica J, Sypniewska G. Critical appraisal of inflammatory markers in cardiovascular risk stratifcation. Crit Rev Clin Lab Sci 2014;51:263-279.
  • Jelkmann W. Proinflammatory cytokines lowering erythropoietin production. J Interferon Cytokine Res 1998;18:555-559.
  • 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;133:628-632.
  • Bąk E, Marcisz C, Kadlubowska M, Michalik A, Krawczyk B, Dobrzyń-Matusiak D, et al. Independent Factors of Changes of Ankle-Brachial Index in Peripheral Arterial Occlusive Disease in Elderly Patients with or without Diabetes. Int J Environ Res Public Health 2016;13:1-11.
  • Nabais S, Losa N, Gaspar A, Rocha S, Costa J, Azevedo P, et al. Association between red blood cell distribution width and outcomes at six months in patients with acute coronary syndromes. Rev Port Cardiol 2009;28:905-924.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Kayıhan Karaman

Barış Aygüç Bu kişi benim

Arif Arısoy

Metin Karayakalı

Samet Yılmaz Bu kişi benim

Serhat Karaman

Cemal Aslan Bu kişi benim

Ataç Çelik

Yayımlanma Tarihi 29 Haziran 2018
Gönderilme Tarihi 16 Nisan 2018
Yayımlandığı Sayı Yıl 2018

Kaynak Göster

AMA Karaman K, Aygüç B, Arısoy A, Karayakalı M, Yılmaz S, Karaman S, Aslan C, Çelik A. Kararlı Anjina Pektorisli Hastalarda Koroner Arter Lezyon Şiddetinin Eritrosit Dağılım Genişliği ve Ayak Bileği-Kol Basınç İndeksi ile İlişkisi. Sakarya Tıp Dergisi. Haziran 2018;8(2):311-319. doi:10.31832/smj.415819

30703

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