Osman BEKTAŞ, Diyar KÖPRÜLÜ, Sezgin ALBAYRAK, Adil BAYRAMOĞLU, Zeki Yüksel GÜNAYDIN, Mehmet YAMAN, Ahmet KAYA

İzole Koroner Ektazide Kopeptin Düzeyi

Giriş: Bu çalışmada koroner arter hastalığı şüphesiyle koroner anjiyografi yapılan ve izole koroner ektazi saptanan hastalarda kopeptin düzeyi araştırıldı. Hastalar ve Yöntem: Merkezimizde Mayıs 2015-Temmuz 2016 tarihleri arasında koroner anjiyografi uygulanan 3412 hastada, en az iki bağımsız operatörün değerlendirilmesi sonucunda 308 koroner arter ektazi (KAE) olgusu saptandı. Bu hastalardan ciddi koroner arter hastalığı (KAH) olmayan izole KAE’si olan 41 hasta çalışmaya alındı. Kontrol grubu, KAH şüphesiyle koroner anjiyografisi yapılıp normal koroner arter saptanan yaş ve cinsiyet olarak uyumlu 33 bireyden oluşturuldu. Daha önce ciddi KAH nedeniyle koroner revaskülarizasyon yapılan hastalar, bilinen konjestif kalp yetersizliği ve ciddi kalp kapak hastalığı olanlar ve sol ventrikül ejeksiyon fraksiyonu %50’nin altında olanlar çalışma dışı bırakıldı. Her iki grupta kan örneği alınarak kopeptin düzeyleri karşılaştırıldı. Bulgular: KAE’li hastalar içinde izole KAE sıklığı %14.9 idi. Total koroner anjiyografi serisi arasında ise izole KAE sıklığı %1.34 idi. İzole KAE’li hastaların %70’i erkek %30’u kadın idi. Ortalama yaş 58 ± 9.2 idi. Kontrol ve hasta grubu arasında KAH risk faktörleri olan sigara, diyabet ve hipertansiyon sıklığı açısından belirgin farklılık yoktu ancak hiperlipidemi izole KAE’li hastalarda daha fazlaydı. Markis sınıflamasına göre KAE’li hastaların, %4.3’ü tip I, %17.4’ü tip II, %32.6’sı tip III ve %45.6’sı tip IV olarak saptandı. Koroner arterleri normal saptanan hastalarda kopeptin düzeyi 7.8 ± 0.9 pmol/L iken izole KAE’li hastalarda bu değer 9.7 ± 1.6 pmol/L olarak saptandı (p< 0.028). Sonuç: İzole KAE’sinde kopeptin düzeyi artmıştır. Çalışmamızın sonuçlarının kopeptin düzeylerinin artmış olduğu izole KAE’li hastaların uzun dönem takip edildiği randomize çalışmalar ile desteklenmesi gerekmektedir.

Anahtar Kelimeler:

İzole koroner ektazi, kopeptin

Copeptin Level in Isolated Coronary Artery Ectasia

Introduction: The level of copeptin was investigated in patients who underwent coronary angiography for suspected coronary artery disease and diagnosed with isolated coronary artery ectasia (CAE). Patients and Methods: A total of 308 patients were diagnosed as having coronary ectasia out of 3412 patients who underwent coronary angiography between May 2015 and July 2016. The evaluations were performed by two experienced physicians who were aware of the study design. Among these patients, 41 patients who did not have severe coronary artery disease (CAD) and who were diagnosed as having isolated CAE were included in the study. The control group comprised 33 age- and gender-matched individuals diagnosed as having normal coronary arteries following coronary angiography for suspected CAD. Patients with a previous coronary revascularization for severe CAD, known congestive heart disease and severe cardiac valve disease, and a left ventricular ejection fraction below 50% were excluded from the study. Blood samples were obtained from both groups and the serum copeptin levels were compared with each other. Results: Among patients with CAE, the frequency of isolated CAE was 14.9%. Among the total coronary angiography series, the frequency of isolated CAE was 1.34%. Most patients with isolated CAE were men (70%; women: 30%), and the mean age of the patients was 58 ± 9.2 years. In patients with isolated CAE, the frequencies of type I, type II, type III, and type IV CAE were found to be 4.3%, 17.4%, 32.6%, and 45.6%, respectively, according to Markis classification. The level of copeptin was found to be 7.8 ± 0.9 pmol/L in patients with normal coronary arteries and 9.7 ± 1.6 pmol/L in patients with isolated CAE (p< 0.028). Conclusion: The level of copeptin is increased in patients with isolated CAE. However, our results have to be supported by long-term randomized studies on isolated CAE patients with and high copeptin levels.

Keywords:

Isolated coronary ectasia, copeptin,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi