Serum immunoglobulin E seviyesi ile koroner arter hastalığı ve SYNTAX skoru arasındaki ilişki

Amaç: İnflamasyon aterosklerozun patogenezinde önemli bir role sahiptir. Alerjik inflamasyonun da aterosklerozun ilerlemesinde önemli bir etkisi mevcuttur. Çalışmamızda IgE düzeyi ile koroner arter hastalığı (KAH) arasında ilişki olup olmadığına baktık. Ayrıca KAH ciddiyetini gösteren SYNTAX skoru arasındaki ilişkiyi de değerlendirdik.Metot: Çalışmaya ardışık olarak 171 tane koroner angiografi planlanan hasta alındı. Astım, oto immun hastalık, alerjik dermatit, alerji öyküsü, parazit infestasyonu, kanser, ciddi böbrek yetmezliği (glomeriüler filtrasyon hızı <30 ml/min), kronik karaciğer hastalığı, romatizmal kalp hastalığı, kalp kapak hastalığı olanlar dışlandı. Hastalar KAH varlığına göre olan ve olmayan diye iki gruba ayrıldı. En az bir ana koroner arterde %50 ve üzeri darlık KAH olarak değerlendirildi. Hastaların klinik ve laboratuvar sonuçlarından bağımsız olarak 2 kardiyoloji uzmanı tarafından KAH ciddiyeti SYNTAX skoru algoritmasına göre değerlendirildi. IgE düzeylerine ilk başvuruda, koroner angiografi öncesinde alınan venöz kan tahlillerinde bakıldı.Sonuçlar: Koroner angiografi sonuçlarına göre 88 hasta (%51,5) KAH olan ve 83 hasta (%48,5) ise KAH olmayan olarak değerlendirildi. KAH olan grupta olmayan gruba göre yaş ortalaması daha yüksek (61,9±11,6 yıl vs 56,7±9,7 yıl, p:0,002), erkek cinsiyet daha fazla (67,5% vs.47,7%, p:0,009), hipertansiyon (80,7% vs 63,6%, p:0,013) ve hiperlipidemi (63,9% vs 28,4%, p<0,001) prevelansları daha fazla idi. Serum IgE düzeyleri KAH olan grupta olmayan gruba göre (99,05 IU/ml (51-192) vs. 24,25 IU/ml (13,8-55), p<0.001) daha yüksek idi. Çoklu logistik regresyon analizine göre IgE düzeyleri KAH için bağımsız bir faktör olarak bulundu (OR 1,003; 95% CI 1,000–1,005; p=0,041). Ek olarak, serum IgE düzeyleri ile SYNTAX skoru arasında orta derecede pozitif bir korelasyon tespit edildi (r:0,483, p<0,001). Sonuç: Çalışmamızda geleneksel risk faktörleri düzenlendikten sonra, serum IgE düzeylerinin KAH varlığı açısından bağımsız pozitif bir faktör olduğu gösterildi. KAH ciddiyetini gösteren SYNTAX skoru ile serum IgE düzeyleri arasında orta derecede pozitif bir korelasyon tespit edildi.

Anahtar Kelimeler:

Immunoglobulin E, koroner arter hastalığı, aterosklerozis, SYNTAX skoru, alerjik inflamasyon

Relation of serum Immunoglobulin E level with coronary artery disease and SYNTAX score

Aim: Inflammation has a significant role in the pathogenesis of atherosclerosis and allergic inflammation has also an important impact on atherosclerosis progression. In this study, we investigated whether the serum IgE levels are associated with coronary artery disease (CAD) and SYNTAX score as a parameter for severity of the disease. Methods: A total of 171 patients who were planned coronary angiography were recruited consecutively into this study. The patients who had a diagnosis of asthma, autoimmune diseases, allergic dermatitis, history of allergic diseases, parasitic infections, malignancy, severe renal failure (estimated glomerular filtration rate <30 mL/min), chronic hepatic disease, rheumatic and valvular heart diseases were excluded from the study. The patients were divided into two groups according to the presence of CAD as called CAD and non-CAD groups. CAD was diagnosed according to the presence of more than 50% stenosis at least in one main coronary artery. Two expert cardiologists who were blinded to the patients’ clinical and laboratory data reviewed the coronary angiography and evaluated the coronary atherosclerotic lesion severity independently. The SYNTAX score is calculated using the algorithm on the baseline diagnostic angiogram. Serum samples for determining total serum levels of IgE were collected from the patients were at the admission just prior to coronary angiography. Results: Based on the coronary angiography, 88 patients (51.5%) were in the non-CAD and 83 patients (48.5%) were in the CAD group. CAD patients tend to be older (61.9±11.6 years vs 56.7±9.7years, p=0.002) and male (67.5% vs.47.7%, p=0.009) with a higher prevalence of hypertension (80.7% vs 63.6%, p=0.013), and hyperlipidemia (63.9% vs 28.4%, p<0.001) compared to non-CAD patients. The serum IgE levels were significantly higher in the CAD group than those in the non-CAD group (99.05 IU/ml (51-192) vs. 24.25 IU/ml (13.8-55), p<0.001). By multivariate logistic regression analysis, serum IgE levels were found as an independent predictor for CAD (OR 1.003; 95% CI 1.000–1.005; p=0.041). In addition, there was a positive moderate correlation between SYNTAX score and Ig E levels (r:0,483, p<0.001). Conclusion: In this trial, we showed that the serum IgE levels are positively associated with the presence of CAD even after adjusting for traditional cardiovascular risk factors. Furthermore, serum IgE levels are correlated with the SYNTAX score and the complexity of coronary artery disease.

Keywords:

Immunoglobulin E, coronary artery disease, atherosclerosis, SNYTAX score, allergic inflammation,

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