Research Article
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Assesment of blood parameters relevant to aterosclerosis and coronary artery disease after paratiroidectomy

Year 2018, Volume: 40 Issue: 4, 438 - 445, 29.12.2018
https://doi.org/10.7197/223.vi.504097

Abstract

Objective: The
preoperative and postoperative calcium, parathormone levels, platelet counts,
mean platelet volume values of the patients were compared in order to
investigate the changes in the risk of atherosclerosis and coronary artery
disease in parathyroidectomy.



Method: Twelve male
and 43 female patients who underwent parathyroidectomy between 01.01.2008 and
01.01.2018 at the Cumhuriyet University Surgical Oncology Clinic were included
in the study. On the tenth preoperative and postoperative day, blood was drawn
for the platelet, mean platelet volume, calcium and parathyroid hormone levels
after a fasting period of twelve hours. The preoperative and postoperative
calcium, parathormone levels, platelet counts, mean platelet volume values of
the patients were compared in order to investigate the changes in the risk of
atherosclerosis and coronary artery disease in parathyroidectomy.



Results: The mean
pre-operative blood calcium levels of the patients included in the study were
10.75 ± 1.49 mg / dl, . Mean postoperative blood calcium level was 8.59 ± 1.14
mg / dl. The mean preoperative mean platelet volume of the patients was 26.1 ±
121.55 fL, Postoperative mean platelet volume was 9.36 ± 1.26 fL. The mean
preoperative parathormone level was 535,08 ± 711,08, The mean postoperative
parathyroid hormone level was 74.47 ± 128.02 pg / ml. The mean preoperative
blood platelet count of the patients included in the study was 418000 ± 8000 /
mm³, The mean postoperative blood platelet count was 252000 ± 7000 / mm³.



Conclusions: In our study,
we found that the decrease in serum parathormone level, serum platelet level,
mean platelet volume, after parathyroidectomy was statistically significant.
Mean platelet volume and platelet count were decreased after parathyroidectomy,
which are indicators of atherosclerosis and coronary artery disease;
Parathyroidectomy reduces the risk of atherosclerosis and coronary artery
disease. Additional clinical and laboratory studies are needed to support the
risk of atherosclerosis and coronary artery disease after parathyroidectomy.

References

  • 1-Sucak GT, Yağcı M, Ersöz G, Haznedar R. Sağlıklı kişilerde platelet fonksiyonlarının yaş ile ilişkisinin tam kan agregometresi ile araştırılması. Türkiye Tıp Dergisi Dahili Tıp Bilimleri 2000;7:118-23.
  • 2- Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002;117:399-404.
  • 3- Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Bychowski J. Beta-thromboglobulin and platelets in unstable angina. Kardiol Pol 2003;58:449-455. Braunwald E. Unstable angina. A classification. Circulation 1989;80:410-414.
  • 4- Braunwald E. Unstable angina. A classification. Circulation 1989;80:410-414.
  • 5- Threatte GA. Usefulness of the mean platelet volume. Clin Lab Med 1993;13:937-950.
  • 6- Van der Loo B, Martin JF. Megakaryocytes and platelets in vascular disease. Baillieres Clin Haematol 1997; 10: 109-23.
  • 7- Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177-90
  • 8- Demirin H, Ozhan H, Ucgun T, et al. Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study. Thromb Res 2011;128:358-60.
  • 9- Broadley AJ, Gapper P, Schmitt M, Frenneaux MP. Supine rest reduces platelet activation and aggregation. Platelets 2003;14:3-7
  • 10- Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 2007;120:245-50.
  • 11- Jüppner H, Brown EM, Kroneberg H. Parathyroid hormone. In: Favus M, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999. p. 80-7.
  • 12- Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease-a review. Eur Heart J 2004;25:1776-87.
  • 13- Hedbäck G, Odén A. Increased risk of death from primary hyperparathyroidism-an update. Eur J Clin Invest 1998;28:2716.
  • 14- Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone levels predict coronary heart disease: the Tromsø Study. Eur J Cardiovasc Prev Rehabil 2004;11:69-74.
  • 15-Smith JC, Page MD, John R, Wheeler MH, Cockcroft JR, Scanlon MF, et al. Augmentation of central arterial pressure in mild primary hyperparathyroidism. J Clin Endocrinol Metab 2000;85:3515-9.
  • 16-Stefenelli T, Mayr H, Bergler-Klein J, Globits S, Woloszczuk W, Niederle B. Primary hyperparathyroidism: incidence of cardiac abnormalities and partial reversibility after successful parathyroidectomy. Am J Med 1993;95:197-202.
  • 17-Bro S, Olgaard K. Effects of excess PTH on nonclassical target organs. Am J Kidney Dis 1997;30:606-20.
  • 18- Schlüter KD, Millar BC, McDermott BJ, Piper HM. Regulation of protein synthesis and degradation in adult ventricular cardiomyocytes. Am J Physiol 1995;269:C1347-55.
  • 19- Drouet L. Atherothrombosis as a systemic disease. Cerebrovasc Dis 2002;13(Suppl.1):16.
  • 20- Stary HC. Natural history and histological classification of atherosclerotic lesions: an update. Arterioscler Thromb Vasc Biol 2000;20(5):1177-8.
  • 21- Onat A, Kahraman G, Ökçün B, Dönmez K, Keleş İ, Sansoy V. Türk Erişkinlerinde Ölüm ve Koroner Olaylar: TEKHARF Çalışması Kohortunun 5-Yıllık Takibi. Türk Kardiyol Dern Arş 1996;24(1):8-15.
  • 22- Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone levels predict coronary heart disease: the Tromsø Study. Eur J Cardiovasc Prev Rehabil 2004;11:69-74.
  • 23-Grandi NC, Breitling LP, Hahmann H, Wüsten B, März W, Rothenbacher D, et al. Serum parathyroid hormone and risk of adverse outcomes in patients with stable coronary heart disease. Heart 2011;97:1215-21.
  • 24- Anderson JL, Vanwoerkom RC, Horne BD, Bair TL, May HT, Lappé DL, et al. Parathyroid hormone, vitamin D, renal dysfunction, and cardiovascular disease: dependent or independent risk factors? Am Heart J 2011;162:331-339.e2.
  • 25- Yuvanç U, Çiçek D, Yeşilbursa D ve ark. Akut miyokard infarktüsünde ortalama trombosit hacminin bir yıllık mortalite ve revaskülarizasyon ihtiyacı üzerine etkisi. MN-Kardiyoloji Derg 2004;11:416-20.
  • 26- Keskin A, Taşkale MG, Sermez Y. Diabetes mellituslu hastalarda trombosit volüm değişiklikleri ve diyabetik komplikasyonlarla ilişkisi. Pamukkale Üniv Tıp Fak Dergisi 2000;6:5-8.
  • 27- Açıkel M, Erol K, Bozkurt E, Alp N, Şenocak H. Akut miyokard infarktüsünde ortalama trombosit hacmi ile erken dönem komplikasyonlar arasındaki ilişki. Türk Kardiyol Dern Arş 2001;29:229-32.
  • 28- Şahin M, Elçik M, Köşüş A, Balcı B, Yeşildağ O, Sağkan O. Koroner arter hastalığının klinik ve anjiyografik görünümü ile trombosit sayısı ve volümünün ilişkisi. Ondokuz Mayıs Üniv Tıp Dergisi 2000;17:98-102.-
  • 29- Funiak S, Kvetensky J, Hudecek J, et al. Large blood platelets risk factors in myocardial infarction. Vnitr Lek 1994;40:167-9.
  • 30- Halbmayer WM, Haushofer A, Radek J, Schon R, Deutsch M, Fischer M. Platelet size, fibrinogen and lipoprotein(a) in coronary heart disease. Coron Artery Dis 1995;6:397-402.
Year 2018, Volume: 40 Issue: 4, 438 - 445, 29.12.2018
https://doi.org/10.7197/223.vi.504097

Abstract

References

  • 1-Sucak GT, Yağcı M, Ersöz G, Haznedar R. Sağlıklı kişilerde platelet fonksiyonlarının yaş ile ilişkisinin tam kan agregometresi ile araştırılması. Türkiye Tıp Dergisi Dahili Tıp Bilimleri 2000;7:118-23.
  • 2- Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002;117:399-404.
  • 3- Butkiewicz AM, Kemona H, Dymicka-Piekarska V, Bychowski J. Beta-thromboglobulin and platelets in unstable angina. Kardiol Pol 2003;58:449-455. Braunwald E. Unstable angina. A classification. Circulation 1989;80:410-414.
  • 4- Braunwald E. Unstable angina. A classification. Circulation 1989;80:410-414.
  • 5- Threatte GA. Usefulness of the mean platelet volume. Clin Lab Med 1993;13:937-950.
  • 6- Van der Loo B, Martin JF. Megakaryocytes and platelets in vascular disease. Baillieres Clin Haematol 1997; 10: 109-23.
  • 7- Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177-90
  • 8- Demirin H, Ozhan H, Ucgun T, et al. Normal range of mean platelet volume in healthy subjects: Insight from a large epidemiologic study. Thromb Res 2011;128:358-60.
  • 9- Broadley AJ, Gapper P, Schmitt M, Frenneaux MP. Supine rest reduces platelet activation and aggregation. Platelets 2003;14:3-7
  • 10- Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 2007;120:245-50.
  • 11- Jüppner H, Brown EM, Kroneberg H. Parathyroid hormone. In: Favus M, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 1999. p. 80-7.
  • 12- Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease-a review. Eur Heart J 2004;25:1776-87.
  • 13- Hedbäck G, Odén A. Increased risk of death from primary hyperparathyroidism-an update. Eur J Clin Invest 1998;28:2716.
  • 14- Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone levels predict coronary heart disease: the Tromsø Study. Eur J Cardiovasc Prev Rehabil 2004;11:69-74.
  • 15-Smith JC, Page MD, John R, Wheeler MH, Cockcroft JR, Scanlon MF, et al. Augmentation of central arterial pressure in mild primary hyperparathyroidism. J Clin Endocrinol Metab 2000;85:3515-9.
  • 16-Stefenelli T, Mayr H, Bergler-Klein J, Globits S, Woloszczuk W, Niederle B. Primary hyperparathyroidism: incidence of cardiac abnormalities and partial reversibility after successful parathyroidectomy. Am J Med 1993;95:197-202.
  • 17-Bro S, Olgaard K. Effects of excess PTH on nonclassical target organs. Am J Kidney Dis 1997;30:606-20.
  • 18- Schlüter KD, Millar BC, McDermott BJ, Piper HM. Regulation of protein synthesis and degradation in adult ventricular cardiomyocytes. Am J Physiol 1995;269:C1347-55.
  • 19- Drouet L. Atherothrombosis as a systemic disease. Cerebrovasc Dis 2002;13(Suppl.1):16.
  • 20- Stary HC. Natural history and histological classification of atherosclerotic lesions: an update. Arterioscler Thromb Vasc Biol 2000;20(5):1177-8.
  • 21- Onat A, Kahraman G, Ökçün B, Dönmez K, Keleş İ, Sansoy V. Türk Erişkinlerinde Ölüm ve Koroner Olaylar: TEKHARF Çalışması Kohortunun 5-Yıllık Takibi. Türk Kardiyol Dern Arş 1996;24(1):8-15.
  • 22- Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone levels predict coronary heart disease: the Tromsø Study. Eur J Cardiovasc Prev Rehabil 2004;11:69-74.
  • 23-Grandi NC, Breitling LP, Hahmann H, Wüsten B, März W, Rothenbacher D, et al. Serum parathyroid hormone and risk of adverse outcomes in patients with stable coronary heart disease. Heart 2011;97:1215-21.
  • 24- Anderson JL, Vanwoerkom RC, Horne BD, Bair TL, May HT, Lappé DL, et al. Parathyroid hormone, vitamin D, renal dysfunction, and cardiovascular disease: dependent or independent risk factors? Am Heart J 2011;162:331-339.e2.
  • 25- Yuvanç U, Çiçek D, Yeşilbursa D ve ark. Akut miyokard infarktüsünde ortalama trombosit hacminin bir yıllık mortalite ve revaskülarizasyon ihtiyacı üzerine etkisi. MN-Kardiyoloji Derg 2004;11:416-20.
  • 26- Keskin A, Taşkale MG, Sermez Y. Diabetes mellituslu hastalarda trombosit volüm değişiklikleri ve diyabetik komplikasyonlarla ilişkisi. Pamukkale Üniv Tıp Fak Dergisi 2000;6:5-8.
  • 27- Açıkel M, Erol K, Bozkurt E, Alp N, Şenocak H. Akut miyokard infarktüsünde ortalama trombosit hacmi ile erken dönem komplikasyonlar arasındaki ilişki. Türk Kardiyol Dern Arş 2001;29:229-32.
  • 28- Şahin M, Elçik M, Köşüş A, Balcı B, Yeşildağ O, Sağkan O. Koroner arter hastalığının klinik ve anjiyografik görünümü ile trombosit sayısı ve volümünün ilişkisi. Ondokuz Mayıs Üniv Tıp Dergisi 2000;17:98-102.-
  • 29- Funiak S, Kvetensky J, Hudecek J, et al. Large blood platelets risk factors in myocardial infarction. Vnitr Lek 1994;40:167-9.
  • 30- Halbmayer WM, Haushofer A, Radek J, Schon R, Deutsch M, Fischer M. Platelet size, fibrinogen and lipoprotein(a) in coronary heart disease. Coron Artery Dis 1995;6:397-402.
There are 30 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Meriç Emre Bostancı

Murat Can Mollaoğlu

Kürşat Karadayı

Publication Date December 29, 2018
Acceptance Date December 23, 2018
Published in Issue Year 2018Volume: 40 Issue: 4

Cite

AMA Bostancı ME, Mollaoğlu MC, Karadayı K. Assesment of blood parameters relevant to aterosclerosis and coronary artery disease after paratiroidectomy. CMJ. December 2018;40(4):438-445. doi:10.7197/223.vi.504097