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

Year 2020, , 282 - 287, 30.09.2020

Alparslan Kılıç Onur Baydar

https://doi.org/10.18663/tjcl.699728

Abstract

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.

Keywords

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

Abstract

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.

Keywords

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

References

• 1. Falsetti HL, Carrol RJ. Coronary artery aneurysm. A review of the literature with a report of 11 new cases. Chest 1976; 69: 630-636.
• 2.Ancuta P, Wang J, Gabuzda D. CD16þmonocytes produce IL-6, CCL2,and matrix metalloproteinase-9 upon interaction with CX3CL1-expressing endothelial cells. J Leukoc Biol 2006; 80: 1156-64.
• 3.Hessler JR, Robertson AL, Chisolm GM. LDL-induced cytotoxicityand its inhibition by HDL in human vascular smooth muscle andendothelial cells in culture. Atherosclerosis 1979; 32: 213-29.
• 4.Li XP, Zhao SP, Zhang XY, Liu L, Gao M, Zhou QC. Protective effectof high density lipoprotein on endothelium-dependent vasodilatation. Int J Cardiol 2000; 73: 231-6.
• 5.Parthasarathy S, Barnett J, Fong LG. High-density lipoprotein inhibitsthe oxidative modification of low-density lipoprotein. Biochim Biophys Acta 1990; 1044: 275-83.
• 6.Turhan H, Erbay AR, Yasar AS, Balci M, Bicer A, Yetkin E. Com-parison of C-reactive protein levels in patients with coronary arteryectasia versus patients with obstructive coronary artery disease. Am J Cardiol 2004; 94: 1303-6.
• 7. Tokgozoglu L, Ergene O, Kinay O, Nazli C, Hascelik G, Hoscan Y.Plasma interleukin-6 levels are increased in coronary artery ectasia. Acta Cardiol 2004; 59: 515-9.
• 8.Kocaman SA, Taçoy G, Sahinarslan A, Cengel A. Relationship be-tween total and differential leukocyte counts and isolated coronaryartery ectasia. Coron Artery Dis 2008; 19: 307-10.
• 9. Kundi H, Gok M, Kiziltunc E et al. Relation Between Monocyte to High-Density Lipoprotein Cholesterol Ratio With Presence and Severity of Isolated Coronary Artery Ectasia. Am J Cardiol 2015; 116: 1685-9
• 10. Frithz G, Cullhed I, Bjork L. Congenital localized coronary artery aneurysm without fistula. Report of a preoperatively diagnosed case. Am Heart J 1968; 76: 674-9.
• 11. Türkmen M, Bitigen A, Esen AM. Coronary Artery Ectasia. J Med Sci 2006; 26: 68-72.
• 12. Krüger D, Stierle U, Herrmann G, Simon R, Sheikhzadeh A. Exercise-induced myocardial ischemia in isolated coronary artery ectasias andaneurysms (“dilated coronaropathy”).J Am Coll Cardiol 1999; 34: 1461-70.
• 13. Antoniadis AP, Chatzizisis YS, Giannoglou GD. Pathogenetic mech-anisms of coronary ectasia. Int J Cardiol 2008; 130: 335-43.
• 14. 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.
• 15. Dogan A, Tuzun N, Turker Y, Akcay S, Kaya S, Ozaydin M. Matrixmetalloproteinases and inflammatory markers in coronary artery ectasia: their relationship to severity of coronary artery ectasia.CoronArtery Dis 2008; 19: 559-63.
• 16. Canpolat U, Aytemir K, Yorgun H et al. The role of preprocedural monocyte-to-high-densitylipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace 2015; 17: 1807-15
• 17. Hafiane A, Genest J. High density lipoproteins: measurement tech-niques and potential biomarkers of cardiovascular risk. BBA Clin 2015; 3: 175-88.
• 18. Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDLcholesterol ratio and cardiovascular events in patients with chronickidney disease. Int Urol Nephrol 2014; 46: 1619-25
• 19. Canpolat U, Çetin EH, Cetin S et al. Association of monocyte-to-HDL cholesterol ratio with slow coronaryflow is linked to systemic inflammation. Clin Appl Thromb Hemost 2016; 22: 476-82
• 20. Murphy AJ, Westerterp M, Yvan-Charvet L, Tall AR. Anti-atherogenicmechanisms of high density lipoprotein: effects on myeloid cells.Biochim Biophys Acta 2012; 1821: 513-21.
• 21.Ansell BJ, Navab M, Hama S et al. Inflammatory/antiin-flammatory properties of high-density lipoprotein distinguish patientsfrom control subjects better than high-density lipoprotein cholesterollevels and are favorably affected by simvastatin treatment. Circulation 2003; 108: 2751-6.
• 22.Navab M, Reddy ST, Van Lenten BJ, Buga GM, Hough G, WagnerAC, et al. High-density lipoprotein and 4F peptide reducesystemic inflammation by modulating intestinal oxidized lipid meta-bolism novel hypotheses and review of literature. Arterioscler Thromb Vasc Biol 2012; 32: 2553-60