İzole Koroner Ektazide Kopeptin Düzeyi

Giriş: Bu çalışmada koroner arter hastalığı şüphesiylekoroner anjiyografi yapılan ve izole koroner ektazi saptanan hastalardakopeptin düzeyi araştırıldı.Hastalar ve Yöntem: Merkezimizde Mayıs 2015-Temmuz 2016tarihleri arasında koroner anjiyografi uygulanan 3412 hastada, en az ikibağımsız operatörün değerlendirilmesi sonucunda 308 koroner arter ektazi (KAE)olgusu saptandı. Bu hastalardan ciddi koroner arter hastalığı (KAH)olmayan  izole KAE’si olan 41 hastaçalışmaya alındı. Kontrol grubu, KAH şüphesiyle koroner anjiyografisi yapılıpnormal koroner arter saptanan yaş ve cinsiyet olarak uyumlu 33 bireydenoluşturuldu. Daha önce ciddi KAH nedeniyle koroner revaskülarizasyon yapılanhastalar, bilinen konjestif kalp yetersizliği ve ciddi kalp kapak hastalığıolanlar ve sol ventrikül ejeksiyon fraksiyonu %50’nin altında olanlar çalışmadışı bırakıldı. Her iki grupta kan örneği alınarak kopeptin düzeylerikarşılaştırıldı.Bulgular: KAE’li hastalar içinde izole KAE sıklığı %14.9 idi. Totalkoroner anjiyografi serisi arasında ise izole KAE sıklığı %1.34 idi. İzoleKAE’li hastaların %70’i erkek %30’u kadın idi. Ortalama yaş 58 ± 9.2 idi.Kontrol ve hasta grubu arasında KAH risk faktörleri olan sigara, diyabet vehipertansiyon sıklığı açısından belirgin farklılık yoktu ancak hiperlipidemiizole KAE’li hastalarda daha fazlaydı. Markis sınıflamasına göre KAE’lihastaların, %4.3’ü tip I, %17.4’ü tip II, %32.6’sı tip III ve %45.6’sı tip IVolarak saptandı. Koroner arterleri normal saptanan hastalarda kopeptin düzeyi7.8 ± 0.9 pmol/L iken izole KAE’li hastalarda bu değer 9.7 ± 1.6 pmol/L olaraksaptandı (p< 0.028).Sonuç: İzole KAE’sinde kopeptindüzeyi artmıştır. Çalışmamızın sonuçlarının kopeptin düzeylerinin artmış olduğuizole KAE’li hastaların uzun dönem takip edildiği randomize çalışmalar iledesteklenmesi gerekmektedir.
Anahtar Kelimeler:

İzole koroner ektazi, kopeptin

Copeptin Level in Isolated Coronary Artery Ectasia

Introduction:Thelevel of copeptin was investigated in patients who underwent coronaryangiography for suspected coronary artery disease and diagnosed with isolatedcoronary artery ectasia (CAE).Patientsand Methods: A total of 308 patients were diagnosed as having coronaryectasia out of 3412 patients who underwent coronary angiography between May2015 and July 2016. The evaluations were performed by two experiencedphysicians who were aware of the study design. Among these patients, 41patients who did not have severe coronary artery disease (CAD) and who werediagnosed as having isolated CAE were included in the study. The control groupcomprised 33 age- and gender-matched individuals diagnosed as having normalcoronary arteries following coronary angiography for suspected CAD. Patientswith a previous coronary revascularization for severe CAD, known congestiveheart disease and severe cardiac valve disease, and a left ventricular ejectionfraction below 50% were excluded from the study. Blood samples were obtainedfrom both groups and the serum copeptin levels were compared with each other.Results: Amongpatients with CAE, the frequency of isolated CAE was 14.9%. Among the totalcoronary angiography series, the frequency of isolated CAE was 1.34%. Most patientswith isolated CAE were men (70%; women: 30%), and the mean age of the patientswas 58 ± 9.2 years. In patients with isolated CAE, the frequencies of type I,type II, type III, and type IV CAE were found to be 4.3%, 17.4%, 32.6%, and45.6%, respectively, according to Markis classification. The level of copeptinwas found to be 7.8 ± 0.9 pmol/L in patients with normal coronary arteries and9.7 ± 1.6 pmol/L in patients with isolated CAE (p< 0.028).Conclusion: The level of copeptin isincreased in patients with isolated CAE. However, our results have to besupported by long-term randomized studies on isolated CAE patients with andhigh copeptin levels.

Kaynakça

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Kaynak Göster

Vancouver Bektaş O , Köprülü D , Albayrak S , Bayramoğlu A , Günaydın Z , Yaman M , Kaya A . Copeptin Level in Isolated Coronary Artery Ectasia. Koşuyolu Heart Journal. 2018; 117-121.

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