Ortalama Trombosit Hacmi/Trombosit Sayısı (MPV/PLT Oranı ile Periferik Arter Hastalığı Arasındaki İlişki
Amaç: Çalışmamızda ortalama trombosit hacmi/trombosit sayısı oranının periferik arter hastalığı (PAH) gelişimine etkisini kontrol grubu ile karşılaştırarak değerlendirmeyi amaçladık. Yöntem: Hastanemizde alt ekstremite renkli Doppler ultrasonografi incelemesi sonucu periferik arter hastalığı saptanan toplam 115 hasta ile periferik arter hastalığı olmayan 100 kişi kontrol olarak çalışmaya alınmıştır. Bulgular: Periferik arter hastalığı (PAD) olan grupta ortalama yaş kontrol grubuna göre anlamlı olarak yüksek bulunmuştur (69.12±10.58 vs. 52.83±13.05, p<0.001). Grupların cinsiyet oranlarında istatistiksel olarak anlamlı fark yoktur (p=0.218). Koroner arter hastalığı öyküsü (p<0.001), diabetes mellitus (p=0.009), hipertansiyon (p<0.001) ve sigara öyküsü (p<0.001) PAH grubunda kontrol grubuna göre anlamlı olarak yüksek bulunmuştur. Serum glukozu (121,27±25,66 - 104,81±34,77; p<0,001), MPV seviyeleri (9,99±0,79 - 9,04±0,7; p<0,001) ve MPV/PLT oranı (0,041±0,07 - 0,037±0,006, p< 0.001) PAD grubunda kontrol grubuna göre anlamlı olarak yüksek bulunmuştur. Serum HDL düzeyleri (45,03±11,5'e karşı 48,67±12,52 p=0,026) PAD grubunda kontrol grubuna göre anlamlı olarak düşüktür. Çok değişkenli analizde yaş, MPV ve MPV/PLT oranı periferik arter hastalığı için bağımsız belirteçler olarak belirlenmiştir. Sonuç: Çalışmamızda MPV ve MPV/PLT yapıları periferik arter yapısından bağımsız aygıtları bulunmuştur.
The Relationship Between Mean Platelet Volume/Platelet Count (MPV/ PLT) Ratio and Peripheral Artery Disease
Background/Aim: In our study, we aimed to evaluate the effect of mean platelet volume/platelet count ratio on the development of peripheral artery disease (PAD) by comparing it with the control group. Material and Methods: A total of 115 patients with peripheral artery disease as a result of lower extremity color Doppler ultrasonography examination in our hospital were included in the study as the patient group and 100 individuals without peripheral artery disease as the control group. Results: History of coronary artery disease (p<0.001), diabetes mellitus (p=0.009), hypertension (p<0.001) and smoking history (p<0.001) were significantly higher in the PAD group than in the control group. Serum glucose (121.27±25.66 vs. 104.81±34.77; p<0.001), MPV levels (9.99±0.79 vs. 9.04±0.7; p<0.001) and MPV/PLT ratio (0.041±0.07 vs. 0.037±0.006, p< 0.001) were found to be significantly higher in the PAD group than in the control group. Serum HDL levels (45.03±11.5 vs. 48.67±12.52 p=0.026) were significantly lower in the PAD group than in the control group. In multivariate analysis, age, MPV and MPV/PLT ratio were determined as independent predictors for peripheral arterial disease. Conclusion: In our study, we found that MPV and MPV/PLT ratio were independent predictors of peripheral artery disease.
___
- Jimbo M. Diagnosis and treatment of peripheral arterial disease. JAMA 2002;287(3):314-5.
- Fowkes FG, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. The Lancet 2013;382:1329–40.
- Hirsch AT, Hartman L, Town RJ, Virnig BA. National health care costs of peripheral arterial disease in the Medicare population. Vascular Medicine 2008;13(3):209-15.
- Shammas NW. Epidemiology, classification, and modifiable risk factors of peripheral arterial disease. Vasc Health Risk Manag 2007;3:229-34.
- Murphy TP, Cutlip DE, Regensteiner JG, Clever Study Investigators. Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: Six-month outcomes from the claudication: Exercise versus endoluminal revascularization (CLEVER) study. Journal of Vascular Surgery 2012;55(3):886–7.
- Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation 2019;139(10):e56-e528.
- Association AD. 8. Cardiovascular disease and risk management. Diabetes care 2016;39(Supplement 1):S60-S71.
- Ross R. Atherosclerosis--an inflammatory disease. N Engl J Med 1999; 340(2):115-26.
- Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Bychowski J. Beta-thromboglobulin and platelets in unstable angina. Kardiol Pol 2003;58:449-55.
- Fei Y, Zong G-q, Chen J, Liu R-m. Evaluation of the value of d-dimer, P-selectin, and platelet count for prediction of portal vein thrombosis after devascularization. Clinical and Applied Thrombosis/Hemostasis 2016;22(5):471-5.
- Senaran H, İleri M, Altınbaş A, Kosar A, Yetkin E, Ozturk M, et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001;24(5):405-8.
- O'Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995;26(6):995-9.
- Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, McGinn JT, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011;22(8):557-66.
- Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal 2018;39(33):3021-104.
- Kendall D. American Diabetes Association Complete Guide to Diabetes: The Ultimate Home Diabetes Reference 5th ed., Virginia: American Diabetes Association; 2000.
- Ranke C, Creutzig A, Alexander K. Duplex scanning of the peripheral arteries: correlation of the peak velocity ratio with angiographic diameter reduction. Ultrasound in medicine & biology 1992;18(5):433-40.
- Aboyans V, Björck M, Brodmann M, Collet J-P, Czerny M, De Carlo M, et al. Questions and answers on diagnosis and management of patients with Peripheral Arterial Diseases: a companion document of the 2017 ESC Guidelines for the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) Endorsed by: the European Stroke Organisation (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). European heart journal 2018;39(9):e35-e41.
- Regensteiner JG, Hiatt WR, Coll JR, Criqui MH, Treat-Jacobson D, McDermott MM, et al. The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program. Vascular medicine 2008;13(1):15-24.
- Murabito JM, D’Agostino RB, Silbershatz H, Wilson PW. Intermittent claudication: a risk profile from the Framingham Heart Study. Circulation 1997;96(1):44-9.
- Beks P, Mackaay A, De Neeling J, De Vries H, Bouter L, Heine R. Peripheral arterial disease in relation to glycaemic level in an elderly Caucasian population: the Hoorn study. Diabetologia 1995;38(1):86-96.
- Creager MA, Lüscher TF, of pwta, Cosentino F, Beckman JA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part I. Circulation 2003;108(12):1527-32.
- Control CfD, Prevention. Annual smoking-attributable mortality, years of potential life lost, and economic costs--United States, 1995-1999. MMWR Morbidity and mortality weekly report. 2002;51(14):300-3.
- Armstrong EJ, Wu J, Singh GD, Dawson DL, Pevec WC, Amsterdam EA, et al. Smoking cessation is associated with decreased mortality and improved amputation-free survival among patients with symptomatic peripheral artery disease. Journal of Vascular Surgery 2014;60(6):1565-71. Siegel-Axel D, Langer H, Lindemann S, Gawaz M. Role of platelets in atherosclerosis and inflammation. Med Klin 2006;101(6):467-75.
- Siegel-Axel D, Langer H, Lindemann S, Gawaz M. Die Rolle von Thrombozyten bei Entzündungs-und Atheroskleroseprozessen. Medizinische Klinik 2006;101(6):467-75.
- Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arteriosclerosis, thrombosis, and vascular biology 2003;23(12):2131-7.
- Furman MI, Benoit SE, Barnard MR, Valeri CR, Borbone ML, Becker RC, et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery disease. Am Coll Cardiol 1998;31(2):352-8.
- Furman MI, Barnard MR, Krueger LA, Fox ML, Shilale EA, Lessard DM, et al. Circulating monocyte-platelet aggregates are an early marker of acute myocardial infarction. J Am Coll Cardiol 2001;38(4):1002-6.
- Da Costa Martins P, Van Den Berk N, Ulfman LH, Koenderman L, Hordijk P, Zwaginga J. Platelet-monocyte complexes support monocyte adhesion to endothelium by enhancing secondary tethering and cluster formation. Arteriosclerosis, thrombosis, and vascular biology 2004;24(1):193-9.
- Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002;13(5-6):301-6.
- Yasar A, Bilen E, Yuksel I, Arslantas U, Karakas F, Kirbas O, et al. Association between admission mean platelet volume and coronary patency after thrombolytic therapy for acute myocardial infarction. Turk Kardiyol Dern Ars 2010;38(2):85-9.
- Martin J, Bath P, Burr ML. Influence of platelet size on outcome after myocardial infarction. The Lancet. 1991;338(8780):1409-11.
- Ulusoy RE, Yokuşoğlu M, Kırılmaz A, Nevruz O, Baysan O, Kılıçaslan F, et al. Mean platelet volume in ST elevation and non-ST elevation myocardial infarction. Gulhane Med J 2011;53(2):114-8.
- Braekkan S, Mathiesen E, Njølstad I, Wilsgaard T, Størmer J, Hansen J. Mean platelet volume is a risk factor for venous thromboembolism: the Tromsø study. Journal of Thrombosis and Haemostasis 2009;8(1):157-62.
- Kostrubiec M, Łabyk A, Pedowska-Włoszek J, Hrynkiewicz-Szymańska A, Pacho S, Jankowski K, et al. Mean platelet volume predicts early death in acute pulmonary embolism. Heart 2010;96(6):460-5.
- Taşoğlu I, Yalçınkaya A, Ulaş MM, Lafçı G, Çiçek O, Ulus AT, et al. Could mean platelet volume be a predictive marker for mechanical valve thrombosis. Turkish J Thorac Cardiovasc Surg 2011;19(3):301-4.
- Li S, Wang C, Zhong X, Li H, Fu X, Ran X. Variance of mean platelet volume in subjects with normal glucose tolerance, impaired glucose regulation and type 2 diabetic mellitus and its relationship with diabetic peripheral artery disease. Zhonghua Yi Xue Za Zhi 2012;92(4):232-5.
- Yener AU, Cicek OF, Cicek MC, Ozkan T, Korkmaz K, Yener O, et al. Does a basic blood test tell the location of peripheral arterial lesions? Acta Medica Mediterranea 2015;31:377-81.
- Berger JS, Eraso LH, Xie D, Sha D, Mohler III ER. Mean platelet volume and prevalence of peripheral artery disease, the National Health and Nutrition Examination Survey, 1999–2004. Atherosclerosis 2010;213(2):586-91.
- Asoğlu R, Asoğlu E, Çelik H, Türkmen S, Aktürk E. Ortalama trombosit hacmi/trombosit sayisi (MPV/PLT) orani ile koroner yavaş akim arasindaki ilişki. Journal of Human Rhythm 2018;4(4):175-82.
- Çakır I, Günay NE, Baktır AO. ST-segment yüksekliği olan miyokard enfarktüsünde platelet biyobelirteçleri. Türk Klinik Biyokimya Dergisi 2019;17(3):120-5.