Koroner yavaş akımın ortalama trombosit nacmi/lenfosit oranı ile İlişkisi

Öz

Amaç: Bu çalışmanın amacı, kolayca hesaplanabilen yeni bir inflamatuar belirteç olan ortalama trombosit hacmi/ lenfosit oranının koroner yavaş akım şiddeti ile ilişkisini araştırmaktır.

Gereç ve Yöntemler: Kesitsel tipte yapılan bu çalışmada, Nisan 2016 ile Nisan 2017 tarihleri arasında hastanemize başvuran toplam 166 hasta dahil edilmiştir. Koroner yavaş akım grubuna 83 hasta, normal koroner akım grubuna 83 hasta dahil edildi. Tüm hastaların koroner akım hızları Timi Kare Sayımı (TIMI) yöntemi ile hesaplanmıştır. Tüm verilerin analizi için SPSS 22.0 istatistiksel paket programı kullanılmıştır.

Bulgular: Ortalama trombosit hacmi/ lenfosit oranı, koroner yavaş akım grubunda normal koroner akım grubuna göre istatistiksel olarak daha anlamlı bulundu. (p <0.001) Çok değişkenli lojistik regresyon analizinde, ortalama trombosit hacmi/ lenfosit oranı koroner yavaş akımın bağımsız öngördürücüsü olduğu bulundu. (p <0.001) Buna ek olarak, HsCRP, total kolesterol, HDL ile koroner yavaş akım arasında pozitif bir korelasyon saptandı. (p <0.05)

Sonuç: Yeni ve basit bir inflamasyon göstergesi olan ortalama trombosit hacmi / lenfosit oranı, koroner yavaş akım saptanan hastalarda daha yüksek bulundu. Bu yüksek oran, koroner yavaş akım saptanan hastaları takipte klinisyenler için önemli bir gösterge niteliği taşıyor olabilir.

Anahtar Kelimeler

• inflamasyon,lenfosit,ortalama trombosit hacmi,yavaş akım

Relationship between coronary slow flow and mean platelet volume / lymphocyte ratio

Öz

Aim: The aim of this study was to investigate the association of the mean platelet volume to lymphocyte ratio, a novel inflammatory marker that is easily calculated, with coronary slow flow severity.

Material and Method: In this cross-sectional study, a total of 166 patients referred to our hospital between April 2016 and April 2017 were included. 83 patients were included in the coronary slow flow group, and 83 patients were included in the normal coronary flow group. Coronary flow velocities of all patients were measured by the Timi Frame Count (TIMI) method. SPSS 22.0 statistical package program was used for analysis of all data.

Results: MPVLR was statistically more significant in coronary slow flow group compared to normal coronary flow group.(p<0.001) In multivariate regression analysis, MVPLR was found to be an independent predictor of coronary slow flow.(p<0.001) In addition, there was a positive correlation between HsCRP, total cholesterol, HDL and coronary slow flow. (p<0.05)

Conclusion: Mean platelet volume to lymphocyte ratio, a new and simple indicator of inflammation, was found to be higher in patients with coronary slow flow. This high ratio may be indicative for clinicians following patients with severe coronary slow flow.

Anahtar Kelimeler

• inflammation,lymphocyte,mean platelet volume,coronary slow fl

Kaynakça

1. 1. Tambe AA, Demany MA, Zimmerman HA, Mascarenhas E. Angina pectoris and slow flow velocity of dye in coronary arteries. A new angiographic finding. Am Heart J 1972; 84: 66-67
2. 2. Goel PK, Gupta SK, Agarwal A, Kapoor A. Slow coronary flow: a distinct angiographic subgroup in syndrome X. Angiology 2001; 52: 507–14
3. 3. Tatli E, Yildirim T, Aktoz M. Does coronary slow flow phenomenon lead to myocardial ischemia? Int J Cardiol 2009; 131: 101-2
4. 4. Cesar L, Ramires J, Serrano JC at al. Slow coronary run-off in patients with angina pectoris: clinical significance and thallium-201 scintigraphic study. Braz J Med Biol Res 1996; 29: 605-13
5. 5. Nurkalem Z, Alper AT, Orhan AL at al. Mean platelet volume in patients with slow coronary flow and its relationship with clinical presentation. Turk Kardiyol Dern Ars 2008; 36: 363-67
6. 6. Mosseri M, Yarom R, Gotsman MS, Hasin Y. Histologic evidence for small-vessel coronary artery disease in patients with angina pectoris and patent large coronary arteries. Circulation 1986; 74: 964–72
7. 7. Li JJ, Qin XW, Li ZC at al. Increased plasma C-reactive protein and interleukin-6 concentrations in patients with slow coronary flow. Clin Chim Acta 2007; 385: 43–47
8. 8. Turhan H, Saydam GS, Erbay AR at al. Increased plasma soluble adhesion molecules; ICAM-1, VCAM-1, and E-selectin levels in patients with slow coronary flow. Int J Cardiol 2006; 108: 224–30

9. 9. Cakmak M, Tanriverdi H, Cakmak N, Evrengul H, Cetemen S, Kuru O. Simvastatin may improve myocardial perfusion abnormality in slow coronary flow. Cardiology 2008; 110: 39–44
10. 10. Gökçe M, Kaplan S, Tekelioğlu Y, Erdoğan T, Küçükosmanoğlu M. Platelet function disorder in patients with coronary slow flow. Clin Cardiol 2005; 28: 145–48
11. 11. Massberg S, Schulz C, Gawaz M. Role of platelets in the pathophysiology of acute coronary syndrome. Semin Vasc Med 2003; 3: 147–62
12. 12. Thompson, CB, Eaton, KA, Princiotta, Rushin CA, Valeri CR. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity, and function. Br J Haematol 1982; 50: 509-19
13. 13. Horne BD, Anderson JL, John JM et al. Which white blood cell subtypes predict increased cardiovascular risk? J. Am Coll Cardiol 2005; 45: 1638-43
14. 14. Núñez J, Miñana G, Bodí V at al. Low lymphocyte count and cardiovascular diseases. Curr Med Chem 2011; 18: 3226-33
15. 15. Gibson CM, Cannon CP, Daley WL et al. TIMI frame count a quantitative method of assessing coronary artery flow. Circulation 1996; 93: 879-88
16. 16. Davì G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med 2007; 357: 2482–94
17. 17. Arevalo-Lorido JC, Carretero-Gomez J, Alvarez-Oliva A et al. Mean platelet volume in acute phase of ischemic stroke, as predictor of mortality and functional outcome after 1 year. J Stroke Cerebrovasc Dis 2013; 22: 297–303
18. 18. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010; 14: 28–32
19. 19. O'Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995; 26: 995–99
20. 20. Papanas N, Mikhailidis DP. Mean platelet volume: a predictor of mortality in diabetic and non-diabetic patients with STEMI? J Diabetes Complications 2014; 28: 581-82
21. 21. Akgul O, Uyarel H, Pusuroglu H et al. Prognostic value of elevated mean platelet volume in patients undergoing primary angioplasty for ST-elevation myocardial infarction. Acta Cardiol 2013; 68: 307-14
22. 22. Sarli B, Baktir AO, Saglam H et al. Mean platelet volume is associated with poor postinterventional myocardial blush grade in patients with ST-segment elevation myocardial infarction. Coron Artery Dis 2013; 24: 285-89
23. 23. Yang A, Pizzulli L, Lüderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris. Thromb Res 2006; 117: 371-77
24. 24. Dragu R, Khoury S, Zuckerman R et al. Predictive value of white blood cell subtypes for long-term outcome following myocardial infarction. Atherosclerosis 2008; 196: 405-12
25. 25. Thomson S.P, Gibbons R.J, Smars P.A et al. Incremental value of the leukocyte differential and the rapid creatine kinase-MB isoenzyme for the early diagnosis of myocardial infarction. Ann Intern Med 1995; 122: 335–41
26. 26. Blum A, Sclarovsky S, Rehavia E, Shohat B. Levels of T-lymphocyte subpopulations, interleukin-1 beta, and soluble interleukin-2 receptor in acute myocardial infarction. Am Heart J 1994; 127: 1226-30
27. 27. Ommen S.R, Gibbons R.J, Hodge D.O, Thomson S.P. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol 1997; 79: 812-14
28. 28. Huehnergarth K.V, Mozaffarian D, Sullivan M.D et al. Usefulness of relative lymphocyte count as an independent predictor of death/urgent transplant in heart failure. Am J Cardiol 2005; 95: 1492-95
29. 29. Acanfora D, Gheorghiade M, Trojano L et al. Relative lymphocyte count: A prognostic indicator of mortality in elderly patients with congestive heart failure. Am Heart J 2001; 142: 167-73
30. 30. Sezgin AT, Barutcu I, Sezgin N at al. Contribution of plasma lipid disturbances to vascular endothelial function in patients with slow coronary flow. Angiology 2007; 57: 694-701
31. 31. Yazici M, Demircan S, Aksakal E at al. Plasma insulin, glucose and lipid levels, and their relations with corrected TIMI frame count in patients with slow coronary flow. Anadolu Kardiyol Derg 2003; 3: 222-26
32. 32. Barutcu I, Sezgin AT, Sezgin N et al. Increased high sensitive CRP level and its significance in pathogenesis of slow coronary flow. Angiology 2007; 58: 401-7
33. 33. Yayla Ç, Akboğa MK, Gayretli Yayla K et al. A novel marker of inflammation in patients with slow coronary flow: lymphocyte-to-monocyte ratio. Biomark Med 2016; 10: 485-93
34. 34. Akboga MK, Canpolat U, Balci KG et al. Increased Platelet to Lymphocyte Ratio is Related to Slow Coronary Flow. Angiology 2016; 67: 21-6
35. 35. Hudzik B, Szkodziński J, Lekston A, Gierlotka M, Poloński L, Gąsior M. Mean platelet volume-to-lymphocyte ratio:novel marker of poor short-and long term prognosis in patients with diabetes mellitus and acute myocardial infarction J Diabetes Complications 2016; 30: 1097-102