Kemal KORKMAZ, Hikmet Selçuk GEDİK, Evvah KARAKILIÇ, Özgül Malçok GÜREL, Fatma Nurcan BAŞAR ÖZDOĞAN, Ali ŞAŞMAZ, Özcan ÖZEKE, Kumral ÇAĞLI

Kararlı anjina pektorisli prematür aterosklerotik koroner arter hastalığı olan erkeklerde trombosit sayısı ve ortalama trombosit hacminin tanısal değeri

Amaç: Bu çalışmada prematür koroner arter hastalığı (KAH)'nda, klasik risk faktörleri yanında trombosit sayısı ve ortalama trombosit hacmi (OTH)'nin ek bir biyobelirteç olup olmadığını araştırmayı amaçladık.Yöntemler: Çalışmaya kararlı anjina pektoris (AP) yakınması olan 124 erkek hasta (ortalama yaş: 45,8±13,0 yıl; yaş aralığı: 27-78 yıl) alınmıştır. Hastaların klinik ve laboratuvar verileri (tam kan sayımı, glukoz, kreatinin, lipid profili) kaydedilmiştir. Hematolojik parametreler otomatik kan sayım cihazı ile ölçülmüştür. Tüm hastalar konvansiyonel koroner anjiyografi ile değerlendirilmiştir. Son 6 ay içinde akut koroner sendrom geçiren, kalp kapak hastalığı, yapısal veya konjenital kalp hastalığı, tiroid ve/veya karaciğer fonksiyon bozukluğu, aktif enfeksiyon bulguları olan hastalar çalışma dışı bırakılmıştır. Bulgular: Çalışmaya alınan 124 erkek hasta; kırk yaş ve altı (40) kararlı AP'si olanlar (matür KAH) (n=38) ve yaşlarına bakılmaksızın koroner anjiyografide normal koroner arterler (NKA) tespit edilenler (n=35) olmak üzere 3 gruba ayrılmıştır. Prematür KAH ile matür KAH ve prematür KAH ile NKA'lar OTH düzeyi açısından karşılaştırıldığında anlamlı fark bulunmadı (p>0,05). Prematür KAH olanlarda OTH ile trombosit sayısı arasında istatistiksel olarak anlamlı bir korelasyon izlendi ve bu korelasyon karşıt yönlü idi (r=-0,419, p=0,002). Ciddi KAH olan prematür ve matür KAH olgularında hafif KAH olanlarla karşılaştırıldığında OTH daha yüksek olmakla beraber aradaki fark istatistiksel olarak anlamlı değildi (p>0,05). Sonuç: Kararlı AP'li prematür KAH olan erkek hastalar, matür KAH olan veya NKA tespit edilenlerle karşılaştırıldığında OTH düzeyi açısından anlamlı fark saptanmadı. Ancak KAH'ın ciddiyeti ile OTH arasında istatistiksel olarak anlamlı olmayan doğrusal bir ilişki bulundu

The diagnostic value of mean platelet volume in males with premature atherosclerotic coronary artery disease having stable angina pectoris

Objective: In this study, we aimed to investigate whether platelet count and mean platelet volume (MPV) could be new biomarkers addition to classical risk factors in premature coronary artery disease (CAD). Methods: Totally 124 male patients (mean age: 45.8±13.0 year; range of age: 27-78 year), with stable angina pectoris, were included. Clinical and laboratory findings (whole blood cell count, glucose, creatinine, lipid profile) were recorded. Automatic blood counter was used for hematological parameters. Conventional coronary angiography was performed. Patients having acute coronary syndrome within the last six months, with severe valvular, structural or congenital heart disease, thyroid and hepatic dysfunction or signs of any infection were excluded. Results: The study population were separated into three groups by coronary angiography: 51 with stable CAD aged 0.05). A significant negative correlation was found between MPV and platelet count in premature CAD (r=-0.419, p=0.002). Both in premature CAD and mature CAD groups, higher MPV values was found in critical CAD subgroup than noncritical CAD subgroup, but the difference was not statistically significant (p>0.05).Conclusion: There was no significant difference in MPV between premature and mature male CAD patients compared to NCA group. A positive but non-significant correlation was found between the MPV values and the severity of CAD. J Clin Exp Invest 2014; 5 (3): 381-385

PDF

___

Kannel WB, Abbott RD. Incidence and prognosis of unrecognized myocardial infarction. An update on the Framingham study. N Engl J Med 1984;311:1144- 1147.
Weinberger I, Rotenberg Z, Fuchs J, et al. Myocardial infarction in young adults under 30 years: risk factors and clinical course. Clin Cardiol 1987;10:9-15.
Perski A, Olsson G, Landou C, et al. Minimum heart rate and coronary atherosclerosis: independent rela- tions to global severity and rate of progression of an- giographic lesions in men with myocardial infarction at a young age. Am Heart J 1992;123:609-616.
Yildirim N, Arat N, Dogan MS, et al. Comparison of tra- ditional risk factors, natural history and angiographic findings between coronary heart disease patients with age _____40 and >or=40 years old. Anadolu Kardiyol Derg 2007;7:124-127.
Wang MH, Lee WL, Wang KY, et al. Short-term follow- up results of drug-eluting stenting in premature coro- nary artery disease patients with multiple atheroscle- rotic risk factors. J Chin Med Assoc 2008;71:342-346.
Chouhan L, Hajar HA, Pomposiello JC. Comparison of thrombolytic therapy for acute myocardial infarction in patients aged _____ 35 and > 55 years. Am J Cardiol 1993;71:157-159.
Slack J, Evans KA. The increased risk of death from ischaemic heart disease in first degree relatives of 121 men and 96 women with ischaemic heart dis- ease. J Med Genet 1966;3:239-257.
Uhl GS, Farrell PW. Myocardial infarction in young adults: risk factors and natural history. Am Heart J 1983;105:548-553.
Neufeld HN, Goldbourt U. Coronary heart disease: ge- netic aspects. Circulation 1983;67:943-954.
Sharma M, Ganguly NK. Premature coronary artery disease in Indians and its associated risk factors. Vasc Health Risk Manag 2005;1:217-225.
Yılmaz N, Ozkan OV, Buyukbas S, et al. Mean platelet volume in patients with acute pancreatitis. J Clin Exp Invest 2011;2:362-365.
Selimoğlu Sen H, Abakay O, Taylan M, et al. The im- portance of mean platelet volume in early mortality of pulmonary embolism. J Clin Exp Invest 2013; 4:298- 301.
Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery dis- ease. Br J Haematol 2002;117:399-404.
Senaran H, Ileri M, Altinbas A, et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001;24:405-408.
Dalby KS, Milner PC, Martin JF. Bleeding time and platelet volume in acute myocardial infarction--a 2 year follow-up study. Thromb Haemost 1988;59:353- 356.
Corash L, Chen HY, Levin J, et al. Regulation of thrombopoiesis: effects of the degree of thrombocy- topenia on megakaryocyte ploidy and platelet volume. Blood 1987;70:177-185.
Butkiewicz AM, Kemona H, Dymicka-Piekarska V, By- chowski J. Beta-thromboglobulin and platelets in un- stable angina. Kardiol Pol 2003;58:449-455.
Braunwald E. Unstable angina. A classification. Circu- lation 1989;80:410-414.
Threatte GA. Usefulness of the mean platelet volume. Clin Lab Med 1993;13:937-950.
McGill DA, Ardlie NG. Abnormal platelet reactivity in men with premature coronary heart disease. Coron Artery Dis 1994;5:889-900.
Furman MI, Benoit SE, Barnard MR, et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery dis- ease. J Am Coll Cardiol 1998;31:352-358.
Pizzulli L, Yang A, Martin JF, Luderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J 1998;19:80-84.
Mathur A, Robinson MS, Cotton J, et al. Platelet re- activity in acute coronary syndromes: evidence for differences in platelet behaviour between unstable angina and myocardial infarction. Thromb Haemost 2001;85:989-994.
Tohgi H, Suzuki H, Tamura K, Kimura B. Platelet vol- ume, aggregation, and adenosine triphosphate re- lease in cerebral thrombosis. Stroke 1991;22:17-21.
Khode V, Sindhur J, Kanbur D, et al. Mean platelet volume and other platelet volume indices in patients with stable coronary artery disease and acute myo- cardial infarction: A case control study. J Cardiovasc Dis Res 2012;3:272-275.
Kilicli-Camur N, Demirtunc R, Konuralp C, et al. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit 2005;11:CR387- CR392.
Bessman JD, Williams LJ, Gilmer PR, Jr. Mean plate- let volume. The inverse relation of platelet size and count in normal subjects, and an artifact of other par- ticles. Am J Clin Pathol 1981;76:289-293.
Thompson CB. From precursor to product: how do megakaryocytes produce platelets? Prog Clin Biol Res 1986;215:361-371.
Karan A, Guray Y, Guray U, et al. [Mean platelet vol- ume and the extent of coronary atherosclerosis in pa- tients with stable coronary artery disease]. Turk Kardi- yol Dern Ars 2013;41:45-50.
Ayhan S, Ozturk S, Erdem A, et al. Hematological parameters and coronary collateral circulation in pa- tients with stable coronary artery disease. Exp Clin Cardiol 2013;18:e12-e15.