Monosit/yüksek yoğunluklu lipoprotein oranının koroner arter ektaziyi öngörmedeki yararı

Öz

Amaç: Monosit sayısının yüksek yoğunluklu lipoprotein kolesterole oranı (MYYLKO) koroner arter hastalığı olan hastalarda yararlı bir enflamasyon belirteci olduğu gösterilmiştir. Bu nedenle, çalışmamızdaki amacımız MYYLKO’nın koroner arter ektazi (KAE) arasında ilişki olup olmadığını araştırmaktı.

Gereç ve yöntemler: Geriye dönük vaka-kontrol çalışmasında, Temmuz 2013 ve Temmuz 2016 tarihleri arasında elektif koroner anjiyografi olan toplam 5500 hasta tarandı. Bu hastalardan, 150 (2,7%) hastada KAE bulundu. Kontrol grubu yaş, cinsiyet ve vücut kitle indeksi açısından eşleşen 150 normal koroner arter hastalarından oluştu.

Bulgular: MYYLKO’nın ortanca değeri istatistiksel olarak KAE hastalarında daha yüksek bulundu (p<0.05).Çoklu değişken analizde, MYYLKO (Odds oranı:1.71, 95%Güven Aralığı:1.219-2.484, p=0.002) KAE’nin bağımsız öngörücüsü olarak saptandı.

Sonuç: MYYLKO’nın KAE’li hastalarda sağlıklı kişilere göre daha yüksek olduğunu gözlemledik. Bu bulgularımız KAE ile koroner arter hastalığının ortak bir patofizyolojik mekanizmayı işaret edebilir.

Anahtar Kelimeler

• MYYLKO,enflamasyon,koroner arter ektazisi

The usefulness of monocyte to high density lipoprotein cholesterol ratio in prediction for coronary artery ectasia

Öz

Aim: Monocyte count to high density lipoprotein cholesterol ratio (MHR) has been shown to be a useful inflammatory marker in patients with coronary artery disease. Hence, the aim of the study was to evaluate whether there is an association between coronary artery ectasia (CAE) and MHR.

Material and methods: In this retrospective case-control study, a total of 5500 patients who underwent an elective coronary angiography between July 2013 and July 2016 were retrospectively screened. Of these patients, 150 (2.7%) patients were found to have an isolated CAE. The control group was consisted of 150 normal coronary artery patients who matched with this group in terms of age, gender, and body mass index.

Results: The median value of MHR was found to be a statistically higher in patients with CAE (p<0.05). In multivariable analyses, MHR (OR: 1.71, 95% CI: 1.219-2.484, p=0.002) was found to be an independent predictor of CAE.

Conclusion: We observed that MHR levels were higher in CAE patients when compared to healthy subjects. Our findings may indicate a common pathophysiological mechanism between CAE and coronary artery disease.

Anahtar Kelimeler

• MHR,inflammation,coronary artery ectasy

Kaynakça

1. 1. Swaye PS, Fisher LD, Litwin P et al. Aneurysmal coronary artery disease. Circulation 1983; 67: 134-38.
2. 2. Befeler B, Aranda MJ, Embi A, Mullin FL, El-Sherif N, Lazzara R. Coronary artery aneurysms: study of the etiology, clinical course and effect on left ventricular function and prognosis. Am J Med 1977; 62: 597-607.
3. 3. Oliveros RA, Falsetti HL, Carroll RJ, Heinle RA, Ryan GF. Atherosclerotic coronary artery aneurysm. Report of five cases and review of literature. Arch Intern Med 1974; 134: 1072-76.
4. 4. Kruger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias and aneurysms ("dilated coronopathy"). J Am Coll Cardiol 1999; 34: 1461-70.
5. 5.Alford WC Jr, Stoney WS, Burrus GR, Frist RA, Thomas CS Jr. Recognition and operative management of patients with arteriosclerotic coronary artery aneurysms. Ann Thorac Surg 1976; 22: 317-21.
6. 6. Ancuta P, Wang J, Gabuzda D. CD16+ monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol 2006; 80: 1156-64.
7. 7. Cetin MS, Ozcan Cetin EH, Kalender E et al. Monocyte to HDL Cholesterol Ratio Predicts Coronary Artery Disease Severity and Future Major Cardiovascular Adverse Events in Acute Coronary Syndrome. Hear Lung Circ. 2016; 25: 1077-86.
8. 8. Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R. Clinical significance of coronary arterial ectasia. Am J Cardiol. 1976; 37: 217-22.

9. 9. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34: 2159-19.
10. 10. Mancia G, De Backer G, Dominiczak A et al. 2007 guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007; 25: 1105-87.
11. 11. Sadr-Ameli M, Sharifi M. The natural history of ectatic coronary artery disease. Iranian Heart J 2001; 2: 12-16.
12. 12. Li JJ, Nie SP, Qian XW, Zeng HS, Zhang CY. Chronic inflammatory status in patients with coronary artery ectasia. Cytokine 2009; 46: 61-64.
13. 13. Turhan H, Erbay AR, Yasar AS et al. Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selectin levels in patients with isolated coronary artery ectasia. Coron Artery Dis 2005; 16: 45-50.
14. 14. Işık T, Ayhan E, Uyarel H, Tanboğa IH, Kurt M, Uluganyan M, Ergelen M, Eksik A. Association of neutrophil to lymphocyte ratio with presence of isolated coronary artery ectasia. Turk Kardiyol Dern Ars 2013; 41: 123-30.
15. 15. Takahashi K, Takeya M, Sakashita N. Multifunctional roles of macrophages in the development and progression of atherosclerosis in humans and experimental animals. Med Electron Microsc 2002; 35: 179-203.
16. 16. Hessler JR, Robertson AL, Chisolm GM. LDL-induced cytotoxicity and its inhibition by HDL in human vascular smooth muscle and endothelial cells in culture. Atherosclerosis 1979; 32: 213-29.
17. 17. Gratchev A, Sobenin I, Orekhov A, Kzhyshkowska J. Monocytes as a diagnostic marker of cardiovascular diseases. Immunobiology 2012; 217: 476-82.
18. 18. Murphy AJ, Woollard KJ, Hoang A et al. High-density lipoprotein reduces the human monocyte inflammatory response. Arterioscler Thromb Vasc Biol 2008; 28: 2071-77.
19. 19. Canpolat U, Aytemir K, Yorgun H et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace 2015; 17: 1807-15.
20. 20. Kundi H, Gok M, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, Karayigit O, Ornek E. Relation Between Monocyte to High-Density Lipoprotein Cholesterol Ratio With Presence and Severity of Isolated Coronary Artery Ectasia. Am J Cardiol. 2015; 116: 1685-89.