Association of Monocyte-to-HDL Cholesterol Ratio with Cardiac Syndrome X is Linked to Systemic Infl ammation

Bu çalışmanın amacı, kardiyak sendrom X (KSX) hastalarında monositin HDL kolesterole oranı (MHO)'nı ve kolay kullanılabilir infl amatuvar göstericileri araştırmaktırHastalar ve Yöntem: Çalışmaya 50'si KSX ve 50'si normal koroner arterlere sahip toplam 100 hasta dahil edilmiştir. Bulgular: Total beyaz küre sayısı, nötrofi l sayısı, monosit sayısı, lenfosit sayısı, nötrofi l/lenfosit oranı, C-reaktif protein, hsCRP ve MHO KSX grubunda artmıştır (p< 0.05), ancak HDL kolesterol CSX hastalarında kontrol grubuna göre azalmıştır (p< 0.05). Korelasyon analizinde MHO'nun hsCRP (r= 0.375, p< 0.001) ve CRP (r= 0.403, p< 0.001) ile pozitif yönde korelasyon olduğu gösterilmiştir. Multivariate logistic regresyon analizinde MHO'nun KSX hastalığını göstermede bağımsız bir gösterge olduğu bulundu [odds ratio: 1.250, 95% confi dence interval (CI): 1.240-1.461, p< 0.001]. Sınır değeri 90.6 alırsak, MHO bu oran ile KSX hastalığının varlığını %78 duyarlılık ve %70 özgüllükle göstermektedir. Sonuç: Çalışmamızda MHO KSX hastalarını göstermede ciddi ve bağımsız bir gösterge olduğu gösterilmiştir.

Monositin HDL Kolesterole Oranının Kardiyak Sendrom X ve Sistemik İnfl amasyon ile İlişkisi

The aim of this study was to investigate an easily available infl ammatory marker and monocyteto-high-density lipoprotein cholesterol ratio (MHR) in patients with cardiac syndrome X (CSX)Patients and Methods: The study population included 100 patients of which 50 had CSX (CSX group) and 50 had normal coronary angiograms (control group). Results: Total white blood cell (WBC) count, monocyte count, neutrophil count, NLR, high-sensitivity C-reactive protein (hs-CRP), C-reactive protein (CRP) and MHR were higher in the CSX group (p< 0.05), whereas high-density lipoprotein cholesterol (HDL-C) level was signifi cantly lower in the CSX group as compared with that in the control group (p< 0.05). In the correlation analysis, MHR revealed a signifi cantly positive correlation with hs-CRP (r= 0.375, p< 0.001) and CRP (r= 0.403, p< 0.001). In the multivariate logistic regression analysis, MHR was independently associated with the presence of CSX (odds ratio: 1.250, 95% confi dence interval [CI]: 1.240-1.461, p< 0.001). Using a cut-off level of 90.6, pre-procedural MHR predicted the presence of slow coronary fl ow (SCF) with a sensitivity of 78% and specifi city of 70%. Conclusion: In conclusion, our fi ndings revealed that higher MHR levels were signifi cantly and independently associated with the presence of CSX.

PDF

___

Kaski JC, Rosano GM, Collins P, Nihoyannopoulos P, Maseri A, Poole- Wilson PA. Cardiac syndrome X: clinical characteristics and left ventricular function. Long-term follow-up study. J Am Coll Cardiol 1995;25:807-14.
Scholz M, Wegener K, Unverdorben M, Kleipzig H. Long-term outcome in patients with angina-like chest pain and normal coronary angiograms [in German]. Herz 2003; 28:413-20.
Bugiardini R, Manfrini O, Pizzi C, Fontana F, Morgagni G. Endothelial function predicts future development of coronary artery disease: a study of women with chest pain and normal coronary angiograms. Circulation 2004; 109:2518-23.
Al Suwaıd J, Hıgano ST, Holmes Dr JR, Lerman A. Pathophysiology, diagnosis, and current management strategies for chest pain in patients with normal fi ndings on angiography. Mayo Clin Proc 2001;76:813-22.
Hurst T, Olson TH, Olson LE, Appleton CP. Cardiac syndrome X and endothelial dysfunction: new concepts in prognosis and treatment. Am J Med 2006;119:560-6.
Luo C, Li Y, Liu D, Hu C, Du Z. The association of brachial fl ow-mediated dilatation and high-sensitivity C-reactive protein levels with Duke treadmill score in patients with suspected microvascular angina. Exp Clin Cardiol 2012;17:197-201.
Recio-Mayoral A, Rimoldi OE, Camci PG, Kaski JC. Infl ammation and microvascular dysfunction in cardiac syndrome X patients without conventional risk factors for coronary artery disease. JACC Cardiovasc Imaging 2013;6:660-7.
Ancuta P, Wang J, Gabuzda D. CD16+ monocytes produce IL-6, CCL2, and matrix metalloproteinase-9 upon interaction with CX3CL1- expressing endothelial cells. J Leukoc Biol 2006;80:1156e1164.
Hessler JR, Robertson AL, Chisolm GM. LDL-induced cytotoxicity and its inhibition by HDL in human vascular smooth muscle and endothelial cells in culture. Atherosclerosis 1979;32:213e229.
Li XP, Zhao SP, Zhang XY, Liu L, Gao M, Zhou QC. Protective effect of high density lipoprotein on endothelium-dependent vasodilatation. Int J Cardiol 2000;73:231e236.
Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol 2014;46:1619e1625.
Canpolat U, Aytemir K, Yorgun H, Şahiner L, Kaya EB, Çay S, et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fi brillation recurrence after cryoballoon-based catheter ablation. Europace 2015;pii:euu291.
Canpolat U, Çetin EH, Cetin S, Aydin S, Akboga MK, Yayla C, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary fl ow is linked to systemic infl ammation. Clin Appl Thromb Hemost 2015; pii: 1076029615594002.
Karataş MB, Çanga Y, Özcan KS, İpek G, Güngör B, Onuk T, et al. Monocyte to high-density lipoprotein ratio as a newprognosticmarker in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Emerg Med 2015 Oct 27. pii: S0735-6757(15)00939-0. doi: 10.1016/j.ajem.2015.10.049
Demirkol S, Balta S, Unlu M, Arslan Z, Cakar M, Kucuk U, et al. Neutrophils/lymphocytes ratio in patients with cardiac syndrome X and its association with carotid intima-media thickness. Clin Appl Thromb Hemost 2014; 20:250-5.
Tenekecıoğlu E, Yılmaz M, Demır S, Bekler A, Ozluk OA, Aydın U, et al. Lower hdl-cholesterol is associated with systemic infl ammation in cardiac syndrome X. Minerva Med 2014 Jul 16.
Ghattas A, Griffi ths HR, Devitt A, Lip GY, Shantsila E. Monocytes in coronary artery disease and atherosclerosis: where are we now? J Am Coll Cardiol 2013;62:1541-51.
Gratchev A, Sobenin I, Orekhov A, Kzhyshkowska J. Monocytes as a diagnostic marker of cardiovascular diseases. Immunobiology 2012;217:476- 82.
Murphy AJ, Chin-Dusting JP, Sviridov D, Woollard KJ. The anti infl ammatory effects of high density lipoproteins. Curr Med Chem 2009;16:667-75.
Murphy AJ, Woollard KJ. High-density lipoprotein: a potent inhibitor of infl ammation. Clin Exp Pharmacol Physiol 2010;37:710-8.
Cockerill GW, Rye KA, Gamble JR, Vadas MA, Barter PJ. High-density lipoproteins inhibit cytokine-induced expression of endothelial, cell adhesion molecules. Arterioscler Thromb Vasc Biol 1995;15:1987-94.
Murphy AJ, Woollard KJ, Hoang A, Mukhamedova N, Stirzaker RA, McCormick SP, et al. High density lipoprotein reduces the human monocyte infl ammatory response. Arterioscler Thromb Vasc Biol 2008;28:2071-7.
Burke AP, Farb A, Malcom GT, Liang YH, Smialek J, Virmani R. Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. N Engl J Med 1997;336:1276-82.
Kundi H, Gok M, Kiziltunc E, Cetin M, Cicekcioglu H, Cetin ZG, et al. Relation between monocyte to high-density lipoprotein cholesterol ratio with presence and severity of isolated coronary artery ectasia. Am J Cardiol 2015;116:1685-9. doi: 10.1016/j.amjcard.2015.08.036