A kan grubu elektif koroner anjiografi yapılan hastalarda yavaş koroner akımı

Year 2020, Volume: 11 Issue: 2, 35 - 42, 21.03.2020

Birsen Doğanay , Mevlüt Serdar Kuyumcu , Mustafa Çetin , Yücel Balbay

https://doi.org/10.18663/tjcl.647111

Abstract

Amaç:Koroner yavaş akım (KYA), koroner arter tıkanıklığı yokluğunda, koroner arterlerde kontrastın yavaş ilerlemesi ile karakterize anjiyografik bir fenomendir. Benign bulgu olarak görülmediğinden ve hala ikna edici patofizyolojik bir açıklama olmadığı için daha fazla araştırmaya ihtiyaç vardır. Bu çalışmada, ABO kan grupları ve koroner akış karakteristikleri arasındaki ilişkiyi değerlendirmeyi amaçladık.
Gereç ve Yöntemler:KYA’lı 230 hastanın klinik, laboratuvar ve anjiyografik verileri retrospektif olarak kurumsal veri tabanlarımızdan toplandı.250 yaş cinsiyet uyumlu normal koroner akımı olan hasta kontrol grubu olarak kullanıldı.Koroner akım TIMI kare sayısı kullanılarak değerlendirildi.Koroner akım özellikleri ABO kan gruplarına göre değerlendirildi.
Bulgular:KYA’ltoplam 230 hasta (125 erkek, ortalama yaş: 54,6 ± 9,1 yıl) ve normal koroner akım(NKA)’lı 250 hasta (134 erkek, ortalama yaş: 53,7 ± 10,1 yıl) çalışmaya dahil edildi.KYA grubunda sigara içiciliği (33.5% vs %23.2; p=0.012), trombosit sayısı (257.2±73.3 x103/mm3 vs. 240.5±63.7 x103/mm3, p=0.011)ve ortalama trombosit hacmi(9.2±1.4 fL vs. 8.8±1.2 fL, p=0.001)NKA’lılardandaha yüksekti.A kan grubuna sahip olmak KYA grubunda,NKA’lı bireylerden daha yaygındı.Regresyon analizinde kan grubu A (OR = 1.94; p = 0.003), sigara içimi (OR = 1.57; p = 0.033), trombosit sayısı (OR = 1.03; p = 0.008) ve ortalama trombosit hacmi (OR = 1.27; p = 0.002) KYA’nınbağımsız belirleyicileri olarak bulundu.
Sonuçlar:A Kan grubu, KYA grubunda daha yaygındır ve bağımsız olarak KYA'yıöngörür. Altta yatan mekanizmaları değerlendirmek için daha ileri çalışmalara ihtiyaç vardır, ancak kan grupları ve SCF arasındaki ilişki çok yönlü görünmektedir.

Keywords

Kan grubu antijenleri, tam kan sayımı, koroner yavaş akım, trombositler, TIMI kare sayısı

Blood group A predicts slow coronary flow in patients undergoing elective coronary angiography

Abstract

Aim:Coronary slow flow (CSF) is an angiographic phenomenon characterized by slow progression of contrast in the coronary arteries in the absence of coronary artery obstruction. As it is not considered as benign finding and there is still no convincible pathophysiologic explanation, further research is needed. In the present study, we aimed to evaluate the relationship between ABO blood groups and coronary flow characteristics.
Material and Methods: The clinical, laboratory and angiographic data of 230 patients with SCF were collected retrospectively from our institutional databases. A total of 250age- and gender-matched subjects with normal coronary flow (NCF) were used as a control group. Coronary flow was assessed by using the thrombolysis in myocardial infarction frame count (TFC). Coronary flow characteristics were evaluated according to ABO blood groups.
Results:A total of230 patients with SCF (125 males, mean age: 54.6±9.1 years) and 250 subjects with NCF (134 males, mean age: 53.7±10.1 years) were included. In SCF group, cigarette smoking (33.5% vs %23.2; p=0.012), platelet count (257.2±73.3 x103/mm3 vs. 240.5±63.7 x103/mm3, p=0.011) and mean MPV (9.2±1.4 fL vs. 8.8±1.2 fL, p=0.001) were higher than subjects with NCF. Having blood group A was more common in SCF group than subjects with NCF (53.5% vs 41.2%; p=0.039).In the regression analysis, blood group A (OR=1.94; p=0.003), cigarette smoking (OR=1.57; p=0.033), platelet count (OR=1.03; p=0.008) and MPV (OR=1.27; p=0.002) were found to be as independent predictors of SCF.
Conclusion:Blood group A is more common in SCF group and independently predicts SCF.Further studies are needed to evaluate the underlying mechanisms, but the relationship between blood groups and SCF seems multifactorial. 

Keywords

Blood group antigens, complete blood count, coronary slow flow, platelets, TIMI frame count

References

• 1. Wang X, Nie SP. The coronary slow flow phenomenon: characteristics, mechanisms and implications. Cardiovasc Diagn Ther 2011; 1: 37-43.
• 2. Fineschi M, Gori T. Coronary slow-flow phenomenon or syndrome Y: a microvascular angina awaiting recognition. J Am Coll Cardiol 2010; 56: 239-40; author reply 240.
• 3. Mangieri E, Macchiarelli G, Ciavolella M et al. Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries. Cathet Cardiovasc Diagn 1996; 37: 375-81.
• 4. Cutri N, Zeitz C, Kucia AM, Beltrame JF. ST/T wave changes during acute coronary syndrome presentation in patients with the coronary slow flow phenomenon. Int J Cardiol 2011; 146: 457-58.
• 5. Okutucu S, Oto A. ECG in Coronary Artery Disease. Interpreting ECGs in Clinical Practice. Cham: Springer International Publishing, 2018: 65-75.
• 6. Horjeti B, Goda A. Acute ischemia manifestation in a patient with coronary slow flow phenomenon. J Electrocardiol 2012; 45: 277-79.
• 7. Ghaffari S, Tajlil A, Aslanabadi N et al. Clinical and laboratory predictors of coronary slow flow in coronary angiography. Perfusion 2017; 32: 13-19.
• 8. von Beckerath N, Koch W, Mehilli J et al. ABO locus O1 allele and risk of myocardial infarction. Blood Coagul Fibrinolysis 2004; 15: 61-67.
• 9. Lee HF, Lin YC, Lin CP, Wang CL, Chang CJ, Hsu LA. Association of blood group A with coronary artery disease in young adults in Taiwan. Intern Med 2012; 51: 1815-20.
• 10. Mitchell JR. An association between abo blood-group distribution and geographical differences in death-rates. Lancet 1977; 1: 295-97.
• 11. Karabuva S, Carevic V, Radic M, Fabijanic D. The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease. Biochem Med (Zagreb) 2013; 23: 351-59.
• 12. Ray KK, Francis S, Crossman DC. Measurement of plasma von Willebrand factor in acute coronary syndromes and the influence of ABO blood group status. J Thromb Haemost 2004; 2: 2053-54.
• 13. O'Donnell J, Laffan MA. The relationship between ABO histo-blood group, factor VIII and von Willebrand factor. Transfus Med 2001; 11: 343-51.
• 14. Sun X, Feng J, Wu W, Peng M, Shi J. ABO blood types associated with the risk of venous thromboembolism in Han Chinese people: A hospital-based study of 200,000 patients. Sci Rep 2017; 7: 42925.
• 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. Arjmand N, Dehghani MR. Complete blood cell count components and coronary slow-flow phenomenon. Ther Clin Risk Manag 2016; 12: 1827-29.
• 17. Dogan M, Akyel A, Cimen T et al. Relationship between neutrophil to lymphocyte ratio and slow coronary flow. Clin Appl Thromb Hemost 2015; 21: 251-54.
• 18. Slipko Z, Latuchowska B, Wojtkowska E. [Body structure and ABO and Rh blood groups in patients with advanced coronary heart disease after aorto-coronary by-pass surgery]. Pol Arch Med Wewn 1994; 91: 55-60.
• 19. Biancari F, Satta J, Pokela R, Juvonen T. ABO blood group distribution and severity of coronary artery disease among patients undergoing coronary artery bypass surgery in Northern Finland. Thromb Res 2002; 108: 195-96.
• 20. Huang X, Zou Y, Li L, Chen S, Hou J, Yu B. Relation of ABO Blood Groups to the Plaque Characteristic of Coronary Atherosclerosis. Biomed Res Int 2017; 2017: 2674726.
• 21. Chen Z, Yang SH, Xu H, Li JJ. ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis. Sci Rep 2016; 6: 23250.
• 22. Whincup PH, Cook DG, Phillips AN, Shaper AG. ABO blood group and ischaemic heart disease in British men. BMJ 1990; 300: 1679-82.
• 23. Wazirali H, Asfaque, R.A., Herzig, J.W. Association of blood group a with increased risk of coronary heart disease in the Pakistani population. Pak J Physiol 2005; 1: 1-3.
• 24. Ruggeri ZM. The role of von Willebrand factor in thrombus formation. Thromb Res 2007;120 Suppl 1: 5-9.
• 25. He M, Wolpin B, Rexrode K et al. ABO blood group and risk of coronary heart disease in two prospective cohort studies. Arterioscler Thromb Vasc Biol 2012; 32: 2314-20.
• 26. Blann AD. Plasma von Willebrand factor, thrombosis, and the endothelium: the first 30 years. Thromb Haemost 2006; 95: 49-55.
• 27. Larson NB, Bell EJ, Decker PA et al. ABO blood group associations with markers of endothelial dysfunction in the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2016; 251: 422-29.
• 28. Seyyed-Mohammadzad MH, Khademvatani K, Kerachian A, Eskandari R, Rezaei Y. Slow coronary flow phenomenon and increased platelet volume indices. Korean Circ J 2014; 44: 400-5.