Mehmet Koray ADALI, İpek BÜBER, Anıl TÜRKÖZ, Ayşen TİL

Koroner yavaş akım fenomeni olan hastalarda plazma aterojenik indeksinin incelenmesi

Öz Amaç: Koroner yavaş akım fenomeni (KYAF), patofizyolojisi halen net olmasa da koroner arter hastalığı (KAH) öncüsü ve diffüz ateroskleroz ile ilişkili olarak kabul edilmektedir. Plazma aterojenik indeksi (PAİ) yüksek kardiyovasküler risk ile ilişkilidir. Bu çalışmada KYAF ile PAİ arasındaki ilişkinin araştırılması amaçlanmıştır. Gereç ve yöntem: Retrospektif olarak Ocak 2019 ile Kasım 2021 tarihleri arasında koroner anjiyografi (KAG) uygulanan ve KYAF saptanan hastalar ile normal koroner arterleri (NKA) olan toplam 214 hastanın hastane kayıtları ve KAG görüntüleri incelenmiştir. Bulgular: Hastalar KYAF (n=107) ve NKA (n=107) olmak üzere iki gruba ayrıldı. Yaş ortalaması 59.3 olup %50.9’u erkekti. İki grup arasında cinsiyet dağılımı, yaş, HT sıklığı ve sigara öyküsü dışında diğer demografik özellikler benzerdi. Glomerüler filtrasyon hızı (GFH), serum kreatinin düzeyi, LDL-K, HDL-K, non HDL-K ve trigliserid düzeyleri dışında laboratuvar bulguları arasında fark yoktu. PAİ değeri, KYAF olan hastalarda yüksek ve istatiksel olarak anlamlı bulundu (p<0.001). Backward lojistik regresyon analizinde yaş, sigara kullanımı, GFH ve PAİ, KYAF için bağımsız prediktör olarak saptanmıştır. ROC eğrisi analizinde KYAF’yi öngörmede PAİ cut-off değeri 0.068 olarak saptanmıştır [sensitivite %72, spesifite %42, eğri altında kalan alan (AUC)= 0.630; p=0.045]. Sonuç: Aterojenik dislipideminin değerlendirilmesinde hızlı, ucuz, günlük klinik pratikte uygulanabilir bir indeks olan PAİ, KYAF olan hastalarda geleneksel risk faktörleri olan yaş, sigara kullanımı, LDL-K düzeyi ve GFH ile birlikte bağımsız prediktör olarak bulunmuştur.

Anahtar Kelimeler:

Koroner yavaş akım fenomeni, plazma aterojenik indeksi, koroner arter hastalığı

Evaluation of plasma atherogenic index in patients with coronary slow flow phenomenon

Purpose: Coronary slow flow phenomenon (CSFP) is considered a precursor of coronary artery disease (CAD) and associated with diffuse atherosclerosis, although its pathophysiology is still unclear. The atherogenic index of plasma (AIP) is associated with high cardiovascular risk. In this study, it is aimed to investigate the relationship between AIP and CSFP.Material and method: Hospital records and coronary angiography (CAG) images of 214 patients with normal coronary arteries (NCA) and CSFP patients who underwent CAG between January 2019 and November 2021 have been retrospectively reviewed. Results: The patients were divided into two groups, CSFP (n=107) and NCA (n=107). The mean age was 59.3 years and 50.9% were male. Other demographic characteristics were similar between the two groups, except for gender distribution, age, frequency of HT, and smoking history. There was no difference in laboratory findings except glomerular filtration rate (GFR), serum creatinine level, LDL-C, HDL-C, non-HDL-C, and triglyceride levels. The AIP value was found high and statistically significant in patients with CSFP (p<0.001). In the backward logistic regression analysis, age, smoking, GFR, and AIP were determined as independent predictors for CSFP. In ROC curve analysis, the cut-off value of AIP was found 0.068 in predicting CSFP [sensitivity 72%, specificity 42%, area under the curve (AUC)=0.630; p=0.045].Conclusion: AIP, a rapid, inexpensive, and applicable index in daily clinical practice for the evaluation of atherogenic dyslipidemia, was found an independent predictor together with the traditional risk factors of age, smoking, LDL-C level, and GFR in patients with CSFP.

Keywords:

Coronary slow flow, atherogenic index of plasma, coronary artery disease,

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