Koroner anjiyografi sırasında saptanan koroner yavaş akım olan sigara içen hastalarda trombosit parametrelerinin araştırılması

Amaç: Artmış morbidite ve mortalite ile ilişkili olan koroner yavaş akış (KYA), ateroskleroz ile ilişkilidir ve koroner arter hastalığının (KAH) bir varyantı olarak kabul edilir. KYA sigara içen hastalarda daha yaygındır. KYA'lı sigara içen hastalarda laboratuvar parametrelerini (özellikle trombosit indeksleri) değerlendirmeyi amaçladık.Yöntemler: Hastalar Ocak 2017 ile Ekim 2019 arasında koroner anjiyografi (KAG) uygulanan hastalardan seçildi. 7287 hastanın KAG kayıtları retrospektif olarak tarandı. Çalışmamız bir vaka kontrol çalışması olarak tasarlandı. Bu prosedürler, klinik endikasyonlara dayanarak iskemik kalp hastalığını tanımlamak için gerçekleştirildi. KAG pozitif invaziv olmayan stres testleri ve/veya aterosklerotik KAH için yüksek klinik şüphesi olan hastalara uygulandı. KYA'lı sigara içen hastalar (n=226) çalışma grubunu oluşturdu ve NKA'lı eşleşen sayıda sigara içen hastalar (n=226) kontrol grubuna dahil edildi. Tüm hastaların demografik özellikleri kaydedildi. Tüm deneklerin hematolojik ve biyokimyasal parametreleri kaydedildi ve değerlendirildi. Bulgular: KYA'lı sigara içen hastalarda (çalışma grubu) LDL kolesterol, trigliserit, total kolesterol, ALT, CRP, MCV, RDW, Trombosit sayısı, PDW, MPV, PCT ve PLR düzeyleri normal koroner arter hastalarına (kontrol grubu) göre daha yüksek bulundu (sırasıyla P=0,034, P=0,015, P=0,033, P=0,006, P<0,001, P=0,033, P=0,021, P=0,039, P=0,006, P=0,010, P=0,021 ve P=0,008). HDL kolesterol KYA'lı sigara içen hastalarda kontrol grubuna göre daha düşük bulundu. (P=0,007).Sonuç: Sonuçlarımıza göre, yüksek trombosit parametreleri koroner akım patogenezinde rol oynayabilir. Trombosit parametrelerinin yüksekliği KYA varlığını gösterebilir. Bulgularımız sigara içen KYA hastalarında inflamasyon ve trombosit fonksiyon bozukluğu kanıtlarını desteklemektedir. Bu ilişkiyi göstermek için randomize moleküler düzeyde kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Koroner yavaş akım, Ortalama trombosit hacmi, Plateletkrit, Trombosit dağılım genişliği, Sigara kullanımı

An investigation of platelet parameters in smoking patients with coronary slow flow detected during coronary angiography

Aim: Coronary slow flow (CSF), which is linked to increased morbidity and mortality, is associated with atherosclerosis, and considered a variant of coronary artery disease (CAD). CSF is more common in smoking patients. We aimed to evaluate laboratory parameters, especially platelet indices, in smoking patients with CSF. Methods: Patients were selected from those who underwent coronary angiography (CAG) between January 2017 and October 2019. CAG records of 7287 patients were screened retrospectively for our case-control study. Procedures were carried out to identify ischemic heart disease based on clinical indications. CAG was performed in patients with positive non-invasive stress tests and/or high clinical suspicion for atherosclerotic CAD. Smoking patients with CSF (n=226) constituted the study group and matched number (n=226) of smoking patients with NCA were included in the control group. The demographic characteristics of all patients were recorded. Hematologic and biochemical parameters of all subjects were recorded and evaluated. Results: LDL cholesterol, triglyceride, total cholesterol, ALT, CRP, MCV, RDW, platelet count, PDW, MPV, PCT, and PLR levels were higher in smoking patients with CSF (study group) than normal coronary artery patients (control group) (P=0.034, P=0.015, P=0.033, P=0.006, P<0.001, P=0.033, P=0.021, P=0.039, P=0.006, P=0.010, P=0.021 and P=0.008, respectively). HDL cholesterol was found lower in smoking patients with CSF compared to controls (P=0.007).Conclusion: According to our results, high platelet parameters may play a role in coronary flow pathogenesis. The height of platelet parameters may indicate the presence of CSF. Our findings support the evidence for inflammation and platelet dysfunction in smoking patients with CSF. Extensive studies at a randomized molecular level are needed to demonstrate this relationship.

Keywords:

Coronary slow flow, Mean platelet volume, Plateletcrit, Platelet distribution width, Smoking,

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