Preoperatif MPV, KABGO sonrası Serebrovasküler Olay için prediktör olabilir mi?

Amaç. Çalışmamızda; izole Koroner Arter Bypas Greft Operasyonu (KABGO) uygulanmışhastalarda, preoperatif MPV değerleri ile postoperatif serebrovasküler olay (SVO) arasındaki ilişkiaraştırıldı. Yöntem. Ocak 2010 ve Haziran 2014 arasında Kalp ve Damar Cerrahisi KliniğindeKABGO yapılmış 265 hasta çalışmaya alınmıştır. Homojen bir çalışma grubu oluşturmak için;diyaliz giren, kreatinin seviyeleri 2 mg/dLnin üstünde olan, operasyon içerisinde aortadamakroskopik patoloji tespit edilen ve bu sebeple operasyon prosedüründe değişiklik yapılanhastalar ile acil statüsünde ve re-do operasyona alınan hastalar çalışmaya dahil edilmemiştir.Çalışmadaki bütün hastalara izole KABGO (kros klemp kullanılarak on-pump veya pompadestekli beating heart veya beating heart) yapılmıştır. Hastaların hepsinde kros klemp süreleri 70dakikayı, kardiyopulmoner bypass süreleri 120 dakikayı geçmemiştir. Preoperatif dönemdeçalışmaya katılan hastaların kan örnekleri, antikoagülan olarak etilen diamin tetra asetik asit(EDTA) bulunan standart tüplere alınmıştır. Toplanan bu örneklere, Sysmex KX-21N cihazıkullanılarak analiz yapılmış ve MPV değerleri elde edilmiştir. Bulgular. Çalışmaya katılanhastaların preoperatif MVP değerleri; Grup 1de 7,04 ± 0,5 Femtolitre (fL) (mean ±standartsapma) iken, Grup 2de 9,05 ± 1,3 fL olduğu tespit edildi. Sonuç. Yapılan istatiksel analizde,preoperatif yüksek MPV değerleri ile postoperatif SVO arasında anlamlı ilişki olduğu tespitedilmiştir (p

May Preoperative MPV predictor f or Cerebrovascular Event Af ter CABG?

Aim. In our study; we researched relation between preoperative MPV values and postoperativeSVO in patients who underwent isolated CABG surgery. Metohds. 265 patients who underwentisolated CABG surgery in depertmant of Cardiovascular Surgery between January 2010 and June2014, were taken in this study. Because of homogeneous study group was constituted, this studydo not include patients who patients with dialysis, patients have creatinin level>2 mgr/dL, patientswho plaque were showed on aortic wall in this causes changes operation style, patiens underwentemergency surgery. All patients in our study were performed CABG (on-pump with cross clampor pump support beating heart or beating heart) surgery. All patients cross clamp andcardiopulmonary bypass times less than 70 min. and 120 min. In preoperative period, bloodsamples of all participants were taken with standart tubes including EDTA. Collected thesesamples were analysed with Sysmex KX-21N system and MPV values were determined. Results.Preoperative MPV values of patients who to be added in our study, in the group 1 was found mean± standart deviation 7.04 ±0.5 Femtoliter (fL) while, in the group 2 was found mean ± standartdeviation 9.05 ± 1.3 fL. Conclusion. According to was made statistically analysis, it was foundsignificant relation between preoperative high MPV values and postoperative SVO (p

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1. Jakubowski JA, Thompson CB, Vaillancourt R, Valeri CR, Deykin D. Arachidonic acid metabolism by platelets of differing size. Br J Haematol 1983; 53: 503-11.
2. Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 2007; 120: 245-50.
3. Khandekar MM, Khurana AS, Deshmukh SD, Kakrani AL, Katdare AD, Inamdar AK. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: An Indian scenario. J Clin Pathol 2006; 59: 146-9.
4. Kiliçli-Camur N, Demirtunç R, Konuralp C, Eskiser A, Başaran Y. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit 2005; 11: 387-92.
5. Nadar SK, Lip GY, Blann AD. Platelet morphology, soluble P selectin and platelet P-selectin in acute ischaemic stroke. The West Birmingham Stroke Project. Thromb Haemost 2004; 92: 1342-8.
6. McCabe DJ, Harrison P, Sidhu PS, Brown MM, Machin SJ. Circulating reticulated platelets in the early and late phases after ischaemic stroke and transient ischaemic attack. Br J Haematol 2004; 126: 861-9.
7. OMalley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995; 26: 995-9.
8. Altunbaş, A. Odabaşoğlu, M. Kemal Balcı, G. Günay, İ. Karadoğan, L. Ündar, Ü. Karayalçın. The Effect of Simvastatin on in vitro Platelet Aggregation in Hypercholesterolemic Patients. H. Turkiye Klinikleri J Med Sci 1999; 19: 25-9.
9. Breuer AC, Furlan AJ, Hanson MR, Lederman RJ, Loop FD, Cosgrove DM, Greenstreet RL, Estafanous FG. Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke 1983; 14: 682-7.
10. Coffey CE, Massey EW, Roberts KB, Curtis S, Jones RH, Pryor DB. Natural history of cerebral complications of coronary artery bypass graft surgery. Neurology 1983; 33: 1416-21.
11. Roach GW, Kanchuger M, Mangano CM, Newman M, Nussmeier N, Wolman R, Aggarwal A, Marschall K, Graham SH, Ley C, Ozanne G, Mangano DT. Adverse cerebral outcomes after coronary bypass surgery. N Engl J Med 1996; 335: 1857-63.
12. Gardner TJ, Horneffer PJ, Manolio TA, Pearson TA, Gott VL, Baaumgartner WA, Borkon AM, Watkins L Jr, Reitz BA. Stroke following coronary artery bypass grafting: a ten year study. Ann Thorac Surg 1985; 40: 574-81.
13. Herlitz J, Wognsen GB, Haglid M, Hartford M, Hjalmarson A, Karlson BW. Risk indicators for cerebrovascular complications after coronary artery bypass grafting. Thorac Cardiovasc Surg 1998; 46: 20-4.
14. Tuman KJ, McCarthy RJ, Najafi H, Ivankovich AD. Differential effects of advanced age on neurologic and cardiac risks of coronary artery operations. J Thorac Cardiovasc Surg 1992; 104: 1510-7.
15. Lynn GM, Stefanko K, Reed JF, Gee W, Nicholas G. Risk factors for stroke after coronary artery bypass. J Thorac Cardiovasc Surg 1992; 104: 1518-23.
16. Harrison MJ. Neurologic complications of coronary artery bypass grafting: diffuse or focal ischemia? Ann Thorac Surg 1995; 59: 1356-8.
17. Hornick P, Smith PL, Taylor KM. Cerebral complications after coronary bypass grafting. Curr Opin Cardiol 1994; 9: 670-9.
18. Breuer AC, Furlan AJ, Hanson MR, Lederman RJ, Loop FD, Cosgrove DM, Greenstreet RL, Estafanous FG. Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke 1983; 14: 682-7.
19. Furlan AJ, Breuer AC. Central nervous system complications of open heart surgery. Stroke 1984; 15: 912-5.
20. Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med 1999; 340:115- 26.
21. Smith NM, Pathansali R, Bath PM. Platelets and stroke. Vasc Med 1999; 4: 165- 72.
22. Tschoepe D, Esser J, Schwippert B, Rosen P, Kehrel B, Niewuenhuis HK, Gries FA. Large platelets circulate in an activated state in diabetes mellitus. Semin Thromb Hemost 1991; 17: 433-9.
23. Kario K, Matsuo T, Nakao K. Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haematol 1992; 14: 281-7.
24. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996; 7: 157-61.
25. Bath PM, Missouris CG, Buckenham T, MacGregor GA. Increased platelet volume and platelet mass in patients with atherosclerotic renal artery stenosis. Clin Sci 1994; 87: 253-7.
26. Taşkın D, Ferhan K, Şeref K, Sabahat G. Mean platelet volume and platelecrit in the acute ischemic stroke. Turkiye Klinikleri J Med Res 1994; 12: 249-52.
27. Jagroop IA, Mikhailidis DP. Angiotensin II can induce and potentiate shape change in human platelets: effect of losartan. J Hum Hypertens 2000; 14: 581-5.
28. Jagroop IA, Mikhailidis DP. Doxazosin, an alpha1-adrenoceptor antagonist, inhibits serotonin-induced shape change in human platelets. J Hum Hypertens 2001; 15: 203-7.
29. Milionis HJ, Elisaf MS, Mikhailidis DP. Platelets and lipid lowering interventions. Platelets 1999; 10: 357-67.
30. Smyth DW, Martin JF, Michalis L, Bucknall CA, Jewitt DE. Influence of platelet size before coronary angioplasty on subsequent restenosis. Eur J Clin Invest 1993; 23: 361-7.
31. Bath PM. The routine measurement of platelet size using sodium citrate alone as the anticoagulant. Thromb Haemost 1993; 70: 687-90.