Cem DOĞAN, Onur TAŞAR, Zübeyde BAYRAM, Rezzan DENİZ ACAR, Murat ÇAP, Emrah ERDOĞAN, Cihangir KAYMAZ, Nihal ÖZDEMİR

Artmış Kalıntı Kolesterol Kan Düzeyleri İlk Defa Geçirilen Akut Koroner Sendrom ile İlişkilidir

Giriş: Açlık dışı kalıntı kolesterolün artması, artmış düşük dansiteli lipoprotein kolesterol (LDL-C) gibi iskemik kardiyovasküler hastalıklar için artmış risk ile ilişkilidir. Çalışmamızın amacı, ilk kez akut koroner sendrom (AKS) ile gelen hastalarda kalıntı kolesterol ve akut koroner sendromun arasındaki ilişkiyi araştırmaktır. Hastalar ve Yöntem: İlk kez akut koroner sendrom ile başvuran 226 hasta ve normal koroner arter olarak sonuçlanmış 192 elektif koroner anjiyografi hastasında, diğer lipit profili parametrelerinin yanı sıra, açlık dışı kalıntı kolesterolün artan konsantrasyonlarını karşılaştırdık. Bulgular: AKS hastaları kontrol grubu ile karşılaştırıldığında erkek cinsiyet fazla, daha genç ve daha fazla oranda diabetes mellitus mevcuttu (tümü için p< 0.001). AKS hastalarında glukoz ve beyaz kan hücresi düzeyleri de daha yüksekti. Kalıntı kolesterol, LDL-C değerine benzer şekilde, AKS grubunda istatistiksel olarak kontrol grubu ile karşılaştırıldığında daha yüksekti (p< 0.001). Tek değişkenli ve çok değişkenli ikili lojistik regresyon analizinde yüksek kan kalıntı kolesterolü, yüksek kan LDL-C değerleri ve düşük kan HDL-C değerleri ile akut koroner sendromlar arasında anlamlı bir ilişki mevcuttu. Sonuç: Çalışmamız, yüksek kan LDL-C seviyelerinde olduğu gibi artmış kalıntı kolesterol düzeylerinin artmış ilk kez yaşanılan AKS riski ile ilişkili olduğunu göstermiştir. AKS hastalarında LDL-C düzeylerinin düşürülmesinin yanı sıra kalıntı kolesterol düzeylerinin düşürülmesi üzerine daha fazla çalışma yapılmalı ve odaklanılmalıdır.

Anahtar Kelimeler:

Akut koroner sendrom, kalıntı kolesterol, trigliseritten zengin lipoproteinler

Increased Remnant Cholesterol Blood Concentration Associated with First Acute Coronary Syndrome

Introduction: This study aimed to investigate the association between remnant cholesterol and acute coronary syndrome (ACS) and its predictive value for acute coronary syndrome occurring for the first time. Patients and Methods: We compared increasing concentrations of non-fasting remnant cholesterol aside from other lipid profile parameters to investigate this association in 226 patients with ACS for the first time and 192 elective coronary angiography patients with normal coronary arteries. Results: Patients with ACS were mostly males and were younger than those in the control group; moreover, they had higher percentage of diabetes mellitus (for all p< 0.001). Glucose and white blood cell levels at admission were also higher in patients with ACS. Remnant cholesterol level (such as LDL-C) was statistically higher in the ACS group compared with those of the control group (p< 0.001). In the univariate and bivariate binary logistic regression analysis, high blood remnant cholesterol, high blood LDL-C, and low blood HDL-C levels had a predictive value for ACSs. Conclusion: This study demonstrated that remnant cholesterol levels (such as high blood LDL-C levels) are associated with increased risk of ACS for the first time. Further studies should be performed focusing on lowering remnant cholesterol levels apart from lowering LDL-C levels in patients with ACS.

Keywords:

Acute coronary syndrome, remnant cholesterol, triglyceride-rich lipoproteins,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi