Monosit yüksek/ dansiteli lipoprotein oranı ve yüksek sensiviteli c- reaktif protein değelerinin izole koroner arter ektazisi ile ilişkisi

Öz

Amaç: Izole koroner arter ektazisi (İKAE), koroner arter hastalığının az görülen bir formu olup, aterosklerotik koroner arter hastalığna benzer mortalite ve morbidite oranına sahiptir. Monosit yüksek dansiteli lipoprotein (HDL) oranı ( MHO) klinikte yeni tanımlanan inflamasyon belirteçlerinden biridir. Çalışamızda MHO ve klinikte inflamasyon belirteci olarak sıkça kullanılan yüksek duyarlıklı C-reaktif protein (Yd-Crp) ile İKAE arasıdaki ilişki araştırılmıştır. Gereç ve Yöntemler: Çalışmamızda retrospektif olarak elektif koroner yapılan hastalar incelenmiştir. Hastaneye başvuruşunda koroner anjiografi hemen öncesinde alınan örneklerden Yd-Crp ve MHO oranı hesaplanmıştır. Bulgular: Toplam 98 (61, %62 erkek ) hasta geriye dönük incelenmiş, 28 (%28.6) hastada Diabetes Mellitus saptamıştır. İKAE hasta sayısı 68 (%69.8) olarak bulunmuştur. MHO ve Yd-Crp ; İKAE grubunda normal koroner arterlere sahip gruba göre anlamlı olarak yüksek saptandı (Sırasıyla; MHO: 0.0153 (0.007-0.130)ve 0.0111 (0.005-0.020), p< 0.001, Yd-Crp: 6 (0.2-33)ve 1(0.2-14), p < 0.001). Ek olarak MHO ile Yd- Crp değeri arasında pozitif korelasyon saptandı (r:0,338, p: 0.001). Ayrıca; hipertansiyon , Diabetes Mellitus, sigara kullanımı, Yd-Crp ve MHO değerleri İKAE’ nin bağımsız risk faktörleri olarak bulundu. ROC analizinde MHO için eğri altında kalan alan 0.744 (p<0,001, 95% [CI] 0.64 - 0.84) ve cut- off değeri 0.013 (%69.1 sensivite , % 63.3 spesifite ) saptandı. Sonuç: Sonuç olarak MHO ve Hs-Crp basit ve ucuz şekilde bakılabilen inflamasyon belirteçleri olup, İKAE hastalarında yüksek saptanmıştır. Bu beliteçler, İKAE hastalığının patogenezinin aydınlatılmasında ve tedavinin yönlendirilmesinde faydalı olabilir.

Anahtar Kelimeler

• Koroner arter ektazisi
• Monosit yüksek dansiteli lipoprotein (HDL) oranı
• yüksek duyarlılıklı c- reaktif protein

Monocyte to high-density lipoprotein ratio and high sensitive c-reactive protein levels in patients with isolated coronary artery ectasia

Öz

Aim: Isolated coronary artery ectasia (ICAE) is a rare form of coronary artery disease and has almost same mortality and morbidity rate to atherosclerotic coronary artery disease. Monocyte to HDL-cholesterol ratio (MHR) has been entered the literature as a new inflammatory indicator in various cardiovascular disease. In this study we want to investigate relationship between inflammatory and oxidative markers that high sensitive C reactive protein (Hs-Crp), MHR and ICAE. Material and Methods: We retrospectively observed patients who underwent elective coronary angiography. Patients with ICAE and normal coronary arteries included in the study. MHR and Hs-Crp levels were observed just before the coronary angiography procedure. Results: A total of 98 patients (61, 62 % men) patients were included in this study and 28 (28.6%) of them had DM. 68 (69.3%) of patients had ICAE. MHR was significantly higher in patients with ICAE (0.0153 (0.007-0.130)ve 0.0111 (0.005-0.020), p< 0.001). Hs-Crp was also significantly higher in patients with ICAE (Yd-Crp: 6 (0.2-33)ve 1(0.2-14), p < 0.001). MHR was also significantly correlated with Hs-crp levels (r:0,338, p: 0.001). Additionally; DM, smoking, HT, MHR and Hs-crp were detected as independent risk factors of ICAE in logistic regression analysis. In receiver operating characteristic curve analysis, the area under the curve for predicting CAE was 0.744 (p<0,001, 95% confidence interval [CI] 0.64 to 0.84) and cut- off value was 0.013 (sensitivity 69.1%, specificity 63.3%, ) for the number of MHR. Conclusion: MHO and Hs-Crp are markers of inflammation that can be easily and inexpensively examined and found high in patients with ICAE. These markers may be useful explaining the pathogenesis of ICAE and guiding treatment.

Anahtar Kelimeler

• coronary ectasia
• monocyte to high-density lipoprotein ratio
• high sensitive c reactive protein

Kaynakça

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