Öz
Amaç:
Karotis plakları morfolojik alt yapıya göre kalsifik, mikst ve yağlı tiplere ayrılır. Mikst ve yağlı karotis plaklarının bileşimi ve kararsızlığı nedeniyle artmış rüptür, tromboembolizm ve inme riski daha belirgindir. Bu çalışma, orta düzey karotis arter darlığı olan hastalarda monosit/yüksek yoğunluklu lipoprotein kolesterol (HDL-C) oranının (MHR) mikst ve yağlı plakları öngörmedeki rolünü değerlendirmeyi amaçlamıştır.
Yöntem:
Bu retrospektif kohort çalışmaya karotis arterde %50-70 stenozu olan toplam 223 asemptomatik hasta alındı. Hastalar plak morfolojisine göre üç gruba ayrıldı: 94 kalsifik, 71 mikst ve 58 yağlı plak olanlar. Gruplar MHR açısından karşılaştırıldı. MHR’nin mikst ve yağlı plak için öngörücü rolü araştırıldı.
Bulgular:
Mikst ve yağlı plak grubunda MHR anlamlı olarak daha yüksekti (16,951±5,935’e karşı 20,181±9,405’e karşı 11,200±4,126, p<0,001). Mikst plak tahmini için 13,61 cut-off değerinin üzerinde, %71,8 duyarlılığa ve %56,6 özgüllüğe sahipti [Eğrinin altındaki alan (EAA): 0,645, %95 güven aralığı (GA): 0,571-0,718, p=0,001]. Ayrıca MHR, yağlı plak tahmini için 14,40 cut-off değerinin üzerinde, %77,6 duyarlılığa ve %62,4 özgüllüğe sahipti (EAA: 0,746, %95 GA: 0,675-0,818, p<0,001). Çok değişkenli regresyon analizinde; diğer risk faktörleri ayarlandıktan sonra, orta düzey karotis arter darlığında, MHR’nin hem mikst [olasılık oranı (OO): 1,230, p<0,001) hem de yağlı (OO: 1,364, p<0,001) plakların anlamlı bağımsız prediktörü olduğu bulunmuştur.
Sonuç:
MHR, asemptomatik orta düzey karotis arter stenozunda mikst ve yağlı plakların öngörülmesinde olumlu bir rol oynamaktadır.
Anahtar Kelimeler: Karotis arter, monosit/yüksek yoğunluklu lipoprotein oranı, plak morfolojisi
Kaynakça
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