Evaluation of Platelet Indices in Diabetic Patients with Myocardial Bridges

Objectives: Myocardial bridges (MB) are a congenital anomaly in which part of the epicardial coronary artery isintramuscular, known as the presence of myocardium, which causes narrowing of the artery during heart contraction.We aimed to evaluate hemogram parameters (especially platelet indices) in diabetic patients with myocardial bridges.Methods: We reviewed angiograms performed between May 2017 and August 2019 at Bolu Abant Izzet Baysal UniversityMedical Faculty Hospital. After appropriate exclusions, diabetic patients were divided into groups with myocardialbridges and normal coronary artery groups. A total of 124 patients were included in the study and hemogram parametersof these two groups were compared. Kolmogorov Smirnov test was used to examine the normality of variables. Data werecompared using univariate tests including independent samples t-test, Mann–Whitney U-test and chi-square test.Results: Compared to control group PDW (17.7 (15.9-19.5) vs.17.4 (16.2-18.9) % p=0.047), MPV (8.3 (6.6-11.4) vs. 7.5(6.6-8.7) Fl p

Miyokardiyal Kas Bandı Olan Diyabetik Hastalarda Trombosit İndekslerinin Değerlendirilmesi

Amaç: Miyokardiyal kas bandı, epikardiyal koroner arterin bir kısmının kalp kasılması sırasında arterin daralmasına neden olan miyokard varlığı olarak bilinen kas içi olduğu konjenital bir anomalidir. Miyokardiyal kas bandı olan diyabetli hastalarda hemogram parametrelerini (özellikle trombosit indeksleri) değerlendirmeyi amaçladık. Yöntemler: Mayıs 2017-Ağustos 2019 tarihleri arasında Bolu Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi'nde yapılan anjiyogramları gözden geçirdik. Uygun dışlamalardan sonra, diyabetik hastalar miyokardiyal kas bandı olan grup ve normal koroner arter gruplarına ayrıldı. Çalışmaya toplam124 hasta dahil edildi ve bu iki grubun hemogram parametreleri karşılaştırıldı. Değişkenlerin normalliğini incelemek için Kolmogorov Smirnov testi kullanıldı. Veriler bağımsız örneklem t-testi, Mann-Whitney U-testi ve ki-kare testi gibi tek değişkenli testler kullanılarak karşılaştırıldı. Bulgular: Kontrol grubu ile kıyaslandığında PDW (17.7 (15.9-19.5) vs.17.4 (16.2-18.9) % p=0.047), MPV (8.3 (6.6-11.4) vs. 7.5 (6.6- 8.7) Fl p

PDF

___

1. Rogers IS, Tremmel JA, Schnittger I. Myocardial bridges: Overview of diagnosis and management. Congenit Heart Dis. 2017; 12: 619-23.

2. De Giorgio F, Grassi VM, Polacco M, et al. Myocardial bridging and sudden cardiac death: is the actual classification exhaustive? Int J Cardiol.. 2014;172:e383-e4.

3. Tsujita K, Maehara A, Mintz GS, et al. Comparison of angiographic and intravascular ultrasonic detection of myocardial bridging of the left anterior descending coronary artery. Am J Cardiol. 2008; 102: 1608-13.

4. Reyman HC. Dissertatio de vasis cordis propriis. Bibl Anat. 1737; 2: 359-78.

5. Podolec J, Siudak Z, Malinowski K et al. Prevalence and clinical presentation of myocardial bridge on the basis of the National Polish Percutaneous Interventions Registry and the Classification of Rare Cardiovascular Diseases. Kardiol Pol. 2018; 77: 465- 70.

6. Möhlenkamp S, Hort W, Ge J, et al. Update on myocardial bridging. Circulation. 2002; 106: 2616- 22.

7. Corban MT, Hung OY, Eshtehardi P et al. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol. 2014; 63: 2346-55.

8. Herrmann J, Higano ST, Lenon RJ, et al. Myocardial bridging is associated with alteration in coronary vasoreactivity. Eur Heart J. 2004; 25: 2134-42.

9. Ge J, Jeremias A, Rupp A et al. New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler. Eur Heart J. 1999; 20: 1707-16.

10. Ogurtsova K, da Rocha Fernandes J, Huang Y et al. IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017; 128: 40-50.

11. Villano A, Mencarelli E, Melita V et al. Endothelial dysfunction and cardiovascular outcome in asymptomatic patients with type 2 diabetes: A pilot study. Diabetes Metab Res Rev. 2020; 36: e3215.

12. Di Angelantonio E, Kaptoge S, Wormser D et al. Association of cardiometabolic multimorbidity with mortality. JAMA. 2015; 314: 52-60.

13. Nakaura T, Nagayoshi Y, Awai K et al. Myocardial bridging is associated with coronary atherosclerosis in the segment proximal to the site of bridging. J Cardiol. 2014; 63: 134-9.

14. Haybar H, Khodadi E, Zibara K, et al. Platelet activation polymorphisms in ischemia. Cardiovasc Hematol Disord Drug Targets. 2018; 18: 153-61.

15. Gary T, Pichler M, Belaj K, et al. Platelet-tolymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One. 2013; 8 :e67688.

16. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost. 2004; 10: 175-8.

17. Erhart S, Beer JH, Reinhart WH. Influence of aspirin on platelet count and volume in humans. Acta Haematol. 1999; 101: 140-4.

18. Bourassa MG, Butnaru A, Lespérance J, et al. Symptomatic myocardial bridges: overview of ischemic mechanisms and current diagnostic and treatment strategies. J Am Coll Cardiol. 2003; 41: 351-9.

19. Sitia S, Tomasoni L, Atzeni F et al. From endothelial dysfunction to atherosclerosis. Autoimmun Rev. 2010; 9: 830-4.

20. Münzel T, Daiber A, Ullrich V, et al. Vascular consequences of endothelial nitric oxide synthase uncoupling for the activity and expression of the soluble guanylyl cyclase and the cGMP-dependent protein kinase. Arterioscler Thromb Vasc Biol. 2005; 25: 1551-7.

21. Ho HCH, Maddaloni E, Buzzetti R. Risk factors and predictive biomarkers of early cardiovascular disease in obese youth. Diabetes Metab Res Rev. 2019; 35: e3134.

22. Bell DS, O’Keefe JH. White cell count, mortality, and metabolic syndrome in the Baltimore longitudinal study of aging. J Am Coll Cardiol. 2007; 50: 1810.

23. Guasti L, Dentali F, Castiglioni L, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost. 2011; 106: 591– 9.

24. Agrawal J, Singh VB, Meena B, et al. Mean paltelet volume (MPV) the neglected marker of cardiovascular risk and glycosylated hemoglobin in diabetic patient. Diabetes Metab Syndr. 2017; 11: 109-12.

25. Sansanayudh N, Anothaisintawee T, Muntham D, et al. Mean platelet volume and coronary artery disease: a systematic review and meta-analysis. Int J Cardiol. 2014; 175: 433-40.

26. Jindal S, Gupta S, Gupta R et al. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications. Hematology. 2011; 16: 86-9.

27. Tulgar Y, Cakar S, Tulgar S, et al. The effect of smoking on neutrophil/lymphocyte and platelet/lymphocyte ratio and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016; 20: 3112-8.

28. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002; 13: 301-6.

29. Jakubowski JA, Thompson CB, Vaillancourt R, et al. Arachidonic acid metabolism by platelets of differing size. Br J Haematol. 1983; 53: 503-11.