Abstract
Amaç:Kardiyak sendrom X; koroner anjiyografide akım sınırlayıcı
darlık olmaksızın, pozitif
kardiyovasküler stres testin ya da miyokardiyal perfüzyon sintigrafisinde
iskeminin eşlik ettiği anjina benzeri tipik göğüs ağrısından oluşur. Kardiyak
sendrom X’li hastalardaki anjina benzeri göğüs ağrısını açıklayabilecek en
muhtemel patofizyolojik mekanizmalar, takip eden mikrovasküler iskemi,
endotelyal disfonksiyon ve inflamasyondur. Biz bu çalışmada kardiyak sendrom
X’li hastalardaki platelet/lenfosit oranını kontrollerle kıyaslayarak,
platelet/lenfosit oranının bu hastalıktaki rolünü ortaya koymayı hedefledik.
Yöntem: Çalışma grubu anjiyografik olarak normal koroner arterleri olan
ancak egzersizle tetiklenen tipik anjina pektorise ya da miyokardiyal perfüzyon
sintigrafisinde iskemiye sahip olduğu için kardiyak sendrom X tanısı almış,
koroner anjiyografi uygulanmış 100 hastadan oluşmaktadır. Kontrol grubu içinse
sağlık kontrolleri için başvurmuş hasta grubuna benzer yaş ve cinsiyete sahip
sağlıklı 100 gönüllü alındı.
Bulgular: Hematolojik belirteçler karşılaştırıldığında, çalışma grubundaki
ortalama platelet/lenfosit oranları kontrol grubuna kıyasla daha yüksekken(sırayla 260±16, 217±14; p=0.04), diğer hematolojik parametreler
açısından gruplar arasında anlamlı fark yoktu.
Sonuç: Çalışmamızın sonuçlarına dayanarak, rutin olarak çalışılan tam kan
sayımından kolayca hesaplanabilen ve bu nedenle ek masraf gerektirmeyen
platelet/lenfosit oranının kardiyak sendrom X’in değerlendirilmesinde
kullanışlı olabileceği söylenebilir.
References
- 1. Outcome of patients with a final diagnosis of chest pain of undetermined origin admitted under the suspicion of acute coronary syndrome. Laurence Prina,Wyat Decker,Amy Weaver. Ann Emerg Med.2004;43:59-67
- 2. Cardiac syndrome X. Kaski J.C. and Russo G. Hosp Pract (Off Ed) 2000;35:75-6
- 3. Cardiac syndrome X and endothelial dysfunction. Hurst T, Olson TH, Olson LE. American Journal of Medicine. July 2006-Volume 119,Issue 7,560-6
- 4. Role of endothelial dysfunction in atherosclerosis. Davignon J, Ganz P. Circulation. 2004;109:27-32.
- 5. Biochemical parameters of endothelial dysfunction in CSX. Kolasinska-Kloch W, Lesniak W, Kiec-Wilk B. Scand J Clin Lab.2002;62(1):7-13
- 6. Long term follow-up of patients with endothelial dysfunction. Suwaidi JA, Hamasaki S, Higano S, Nishimura RA, Holmes DR, Lerman A. Circulation.2000 Mar 7;101(9):948-54
- 7. Evaluation of mean platelet volume in patients with cardiac syndrome X. Demirkol S, Balta S, Unlu M. Clinics.2012;67(9):1019-22
- 8. Association of PLR with severity of coronary artery disease. Akboga MK, Canpolat U, Yayla C. Angiology.2006 Jan;67(1):89-95
- 9. NLR and PLR ratio in patients with dipper versus non-dipper hypertension. Sunbul M, Gerin F, Durmus E, Kıvrak T. Clin Exp Hypertens.2014;36(4):217-21
- 10. Endothelial dysfunction in patients with PTE. Kurtipek E, Büyükterzi Z, Büyükterzi M. Clin Respir J 2015 Apr 27. doi: 10.1111
- 11. Association of epicardial adipose tissue, NLR and PLR with diabetic nephropaty. Akbas EM, Demirtas L, Ozcicek A. Int J Clin Exp Med. 2014 Jul 15;7(7):1794-801
- 12. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336: 973-9
- 13. Cosin-Sales J, Pizzi C, Brown S, Kaski JC. C-reactive protein, clinical presentation, and ischemic activity in patients with chest pain and normal coronary angiograms. J Am Coll Cardiol 2003; 41: 146-7
- 14. Rosalki SB. C-reactive protein. Int J Clin Pract 2001; 55: 26-7
- 15. Arroyo-Espliguero R, Mollichelli N, Avanzas P et al. Chronic inflammation and increased arterial stiffness in patients with cardiac syndrome X. Eur Heart J 2003; 24: 200-1
- 16. Recio-Mayoral A, Rımoldı OE, Camıcı PG, Kaskı JC. Inflammation and microvascular dysfunction in cardiac syndrome X patients without conventional risk factors for coronary artery disease. JACC Cardiovasc Imaging 2013;6:660-7
- 17. Rınkevich D, Belcık T, Gupta NC, Cannard E, Alkayed NJ, Kaul S. Coronary autoregulation is abnormal in syndrome X: Insights using myocardial contrast echocardiography. J Am Soc Echocardiogr 2013;26:290-6
Abstract
Objective:Cardiac
syndrome X consist of anginal-like typical chest pain with positive
cardiovascular stres test or presence of ischemia on myocardial perfusion
scintigraphy but no flow-limiting stenosis on coronary angiography.
The more likely pathophysiologic mechanisms for patients with cardiac syndrome
X are subsequent microvascular ischemia, endothelial dysfunction and
inflammation which may be the explanation of their anginal-like chest pain.
Platelet to lymphocyte ratio is a potential biomarker for inflammation, and associated
with endothelial dysfunction. We aimed to compare the role
of platelet to lymphocyte ratio in patients with cardiac syndrome X
and control subjects in this study.
Method:The
study group consist of 100 patients who underwent coronary angiography and
were diagnosed as cardiac syndrome X according to the presence of
exercise-induced typical angina pectoris and ischemia on myocardial perfusion
scintigraphy with angiographically normal coronary arteries. For control subjects, we recruited 100 healthy gender-
and age-matched individuals who were seen for health check-ups.
Results:According
to comparison of the hematological indices, mean value of the platelet to
lymphocyte ratio in study population was higher than control group (260±16 vs 217±14, respectively; p=0.04)whereas the other hematological
parameters did not differ between groups significantly.
Conclusions:The
platelet to lymphocyte ratio, which is easily
calculated from routinely studied compete blood count and therefore requires no
additional cost might be usefull for the evaluation of
cardiac syndrome X based on the results of our study.
References
- 1. Outcome of patients with a final diagnosis of chest pain of undetermined origin admitted under the suspicion of acute coronary syndrome. Laurence Prina,Wyat Decker,Amy Weaver. Ann Emerg Med.2004;43:59-67
- 2. Cardiac syndrome X. Kaski J.C. and Russo G. Hosp Pract (Off Ed) 2000;35:75-6
- 3. Cardiac syndrome X and endothelial dysfunction. Hurst T, Olson TH, Olson LE. American Journal of Medicine. July 2006-Volume 119,Issue 7,560-6
- 4. Role of endothelial dysfunction in atherosclerosis. Davignon J, Ganz P. Circulation. 2004;109:27-32.
- 5. Biochemical parameters of endothelial dysfunction in CSX. Kolasinska-Kloch W, Lesniak W, Kiec-Wilk B. Scand J Clin Lab.2002;62(1):7-13
- 6. Long term follow-up of patients with endothelial dysfunction. Suwaidi JA, Hamasaki S, Higano S, Nishimura RA, Holmes DR, Lerman A. Circulation.2000 Mar 7;101(9):948-54
- 7. Evaluation of mean platelet volume in patients with cardiac syndrome X. Demirkol S, Balta S, Unlu M. Clinics.2012;67(9):1019-22
- 8. Association of PLR with severity of coronary artery disease. Akboga MK, Canpolat U, Yayla C. Angiology.2006 Jan;67(1):89-95
- 9. NLR and PLR ratio in patients with dipper versus non-dipper hypertension. Sunbul M, Gerin F, Durmus E, Kıvrak T. Clin Exp Hypertens.2014;36(4):217-21
- 10. Endothelial dysfunction in patients with PTE. Kurtipek E, Büyükterzi Z, Büyükterzi M. Clin Respir J 2015 Apr 27. doi: 10.1111
- 11. Association of epicardial adipose tissue, NLR and PLR with diabetic nephropaty. Akbas EM, Demirtas L, Ozcicek A. Int J Clin Exp Med. 2014 Jul 15;7(7):1794-801
- 12. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336: 973-9
- 13. Cosin-Sales J, Pizzi C, Brown S, Kaski JC. C-reactive protein, clinical presentation, and ischemic activity in patients with chest pain and normal coronary angiograms. J Am Coll Cardiol 2003; 41: 146-7
- 14. Rosalki SB. C-reactive protein. Int J Clin Pract 2001; 55: 26-7
- 15. Arroyo-Espliguero R, Mollichelli N, Avanzas P et al. Chronic inflammation and increased arterial stiffness in patients with cardiac syndrome X. Eur Heart J 2003; 24: 200-1
- 16. Recio-Mayoral A, Rımoldı OE, Camıcı PG, Kaskı JC. Inflammation and microvascular dysfunction in cardiac syndrome X patients without conventional risk factors for coronary artery disease. JACC Cardiovasc Imaging 2013;6:660-7
- 17. Rınkevich D, Belcık T, Gupta NC, Cannard E, Alkayed NJ, Kaul S. Coronary autoregulation is abnormal in syndrome X: Insights using myocardial contrast echocardiography. J Am Soc Echocardiogr 2013;26:290-6
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | September 19, 2017 |
| Acceptance Date | August 21, 2017 |
| Published in Issue | Year 2017Volume: 39 Issue: 3 |