ÖZET

Amaç:

Sistemik immün enflamasyon indeksi (SII) ve aterojenik plazma indeksi (AIP) son yıllarda tanımlanmış, ateroskleroz ve enflamasyon sürecinde önemli rol alan indekslerdir. Bu çalışmamızda koroner anjiyografide fraksiyonel akış rezervi (FFR) uygulanan hastalarda, tespit edilen aterosklerotik lezyon ciddiyeti ile AIP ve SII arasındaki ilişkiyi araştırmayı amaçladık.

Yöntem:

Bu çalışma kapsamında, koroner anjiyografide elektif FFR işlemi uygulanan 119 hasta retrospektif olarak incelendi. FFR lezyon ciddiyetine göre; FFR <0,8 grup (77 hasta), FFR >0,8 grup (42 hasta) şeklinde iki grup oluşturuldu. İki grup arasında SII, AIP, demografik veriler ve diğer parametreler karşılaştırıldı.

Bulgular:

FFR uygulanan gruplarda yüksek yoğunluklu lipoprotein (p=0,001), platelet (p=0,007), ortalama trombosit hacmi (MPV) (p=0,016), monosit (p<0,001), lenfosit (p<0,001), SII (p<0,001), AIP (p=0,009) ve HbA1c (p<0,001) açısından iki grup arasında istatistiksel olarak anlamlı derecede farklılık saptandı. Yapılan tek değişkenli regresyon analizinde HbA1c [olasılık oranı (OO): 10; %95 güven aralığı (GA): 3,2-3,5, p<0,001], monosit (OO: 273,8; %95 GA: 24,8-3015,3, p<0,001), MPV (OO: 0,6; %95 GA: 0,39-0,91, p=0,02), SII (OO: 1,06; %95 GA: 1,03-1,09, p<0,001) ve AIP’nin (OO: 3,7; %95 GA: 1,6-10, p=0,01) birer prediktör olduğu saptandı. Yapılan çok değişkenli regresyon analizinde ise HbA1c (OO: 9,41; %95 GA: 1,89-46,73, p=0,006), monosit (OO: 108,2; %95 GA: 6,8-1726,2, p=0,001) ve SII (OO: 1,005; %95 GA: 1,002-1,008, p=0,004) parametrelerinin bağımsız birer prediktör olduğu saptandı. Uygulanan ROC analizi ile SII %75 sensitivite %72 spesifite ile [eğrinin altındaki alan (AUC): 0,79; %95 GA: 0,72-0,87, p<0,001], AIP %62 sensitivite %60 spesifite ile (AUC: 0,64; %95 GA: 0,54-0,75, p=0,008) FFR lezyon ciddiyetini öngörmekteydi.

Sonuç:

Bu çalışmamızda özellikle AIP ve SII gibi basit, hızlı ve düşük maliyetli yöntemlerin, FFR’de saptanan lezyon ciddiyeti ile ilişkili parametreler olabileceğine vurgu yapmak istiyoruz. Bu parametreler kolay ulaşılabilir, tekrarlanabilir ve yaygın olarak kullanılabilmektedirler.

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Fraksiyonel Akım Rezervi Kullanılarak Saptanan Koroner Lezyon Ciddiyeti ile Sistemik İmmün Enflamasyon İndeksi ve Aterojenik Plazma İndeksi Arasındaki Korelasyon

ÖZET

References