Akut Koroner Sendrom ile Gelen Hastalarda Çok Damar Hastalığı ile Monosit/HDL-C Oranı Arasındaki İlişki

Amaç: Akut koroner sendromlar tüm dünyada ölümün en sık nedenleri arasındadır. İnflamasyon akut koroner sendrom (AKS) etyoloji ve patogenezinde önemli bir yere sahiptir. Bugüne kadar inflamasyonu değerlendirmek için bir çok farklı parametre kullanılmıştır. Monosit /HDL-C oranı (MHO) son yıllarda kullanıma giren yeni bir inflamasyon belirtecidir. Çalışmamızın amacı, AKS ile başvuran hastalarda MHO’nun klinik önemini saptamaktır. Materyal ve metod: Bu retrospektif çalışmaya, akut koroner sendrom tanısıyla kliniğimize başvurmuş ve koroner anjiyografi yapılmış 195 hasta dahil edildi. Tüm hastaların rutin hematolojik ve biyokimyasal parametreleri geriye dönük olarak incelendi. Monosit sayısının HDL kolesterole bölünmesi ile MHO elde edildi. Hastalar MHO tertillerine göre 3 gruba ayrıldı. Her 3 grup, anjiyografik özellikler ve MHO açısından karşılaştırıldı. Bulgular: Her 3 grup arasında bazal demografik karakteristikler açısından anlamlı bir farklılık saptanmadı. Ancak, MHO arttıkça 3 damar hastalığı sıklığının da giderek arttığı tespit edildi. (sırasıyla % 12, %33 , %52, P<0.001). Korelasyon analizinde yaş (r= 0.326 , p<0.001) ve MHO’nın (r=0.347 , p<0.001) kritik darlık bulunan damar sayısı ile pozitif şekilde korele olduğu tespit edildi. Yapılan çok değişkenli lojistik regresyon analizinde yaş (risk oranı: 1.052; %95 güven aralığı: 1.020 - 1.085; P =0.001), MHO (risk oranı:1.075, %95 güven aralığı: 1.192 – 5.087; P <0.001) ve Diyabetes mellitus (risk oranı:2.462 ; %95 güven aralığı : 1.192 – 5.087; P =0.015 ) 3 damar hastalığının bağımsız prediktörleri olarak tespit edildi. MHO sınır değerinin ≥ 19.1 alınması, % 71.9 duyarlılık ve % 61.8 özgüllük ile akut koroner sendromlu hastalarda çok damar hastalığını öngördü. Sonuç: MHO yeni bir inflamasyon belirtecidir. Çalışmamızda MHO’nun AKS ile başvuran hastalarda çok damar hastalığını bağımsız bir şekilde öngördüğünü tespit ettik. Anahtar kelimeler: Monosit/HDL oranı ; Akut koroner sendrom; İnflamasyon ; Çok damar hastalığı

Anahtar Kelimeler:

monosit/HDL-C oranı, Akut koroner sendrom, İnflamasyon, Çok damar hastalığı

The relationship Between Multivessel Disease and Monocyte/HDL-C Ratio In Patients Presenting with Acute Coronary Syndrome

Background: Acute coronary syndromes are among the most common causes of death worldwide. Inflammation has an important place in the etiology and pathogenesis of ACS (acute coronary syndrome). To date, many diffe-rent parameters have been used to assess inflammation. Monocyte HDL ratio (MHR) is a new marker of inflamma-tion that has come into use in recent years. The aim of our study is to determine the clinical significance of MHR in patients presenting with ACS.Materials and Methods: In this retrospective study, 195 patients who applied to our clinic with the diagnosis of acute coronary syndrome and underwent coronary angiography were included. Routine hematological and biochemical parameters of all patients were analyzed retrospectively. MHR was obtained by dividing the number of monocytes by HDL cholesterol. The patients were divided into 3 groups according to their MHR tertiles. All 3 groups were compared for angiographic features and MHR.Results: There was no significant difference between the 3 groups in terms of baseline demographic characteris-tics. However, it was determined that the frequency of 3-vessel disease increased gradually as MHR increased. (12%, 33%, 52%, respectively, p<0.001). In the correlation analysis, age (r= 0.326 , p<0.001) and MHR (r=0.347 , p<0.001) were positively correlated with the number of vessels with critical stenosis. In the multivariate logistic regression analysis, age (hazard ratio: 1.052; 95% confidence interval: 1.020 - 1.085; p = 0.001), MHR (hazard ratio: 1.075, 95% confidence interval: 1.192 - 5.087; p <0.001) and diabetes mellitus (hazard ratio: 2.462 ; 95% confidence interval: 1.192 – 5.087; p = 0.015 ) were identified as independent predictors of multivessel disease. Taking the MHR cut-off value ≥ 19.1 predicted multivessel disease in patients with acute coronary syndrome, with a sensitivity of 71.9% and a specificity of 61.8%.Conclusions: MHR is a new marker of inflammation. In our study, we found that MHR independently predicted multivessel disease in patients presenting with ACS.Keywords: Monocyte/HDL ratio; Acute coronary syndrome; Inflammation; Multivessel disease

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