Akut koroner sendrom ve stabil koroner arter hastalarında gensini skoruna göre hesaplanan koroner arter hastalığı ciddiyeti ile ortalama trombosit hacmi düzeyleri arasındaki ilişki
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Date
2012
Authors
Kuştarcı, Taner
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Koroner kalp hastalığı gelişmiş ülkelerde olduğu gibi ülkemizde de gerek mortalite, gerekse morbidite nedeni olarak ilk sırada yer almaktadır. Akut koroner sendrom (AKS), aterosklerotik plaktaki rüptür ya da ülserasyon sonucu ortamda trombüs oluşmasıyla gelişmektedir. Burada trombositlerin aktivasyonu önemli rol oynar. Büyük trombositler metabolik ve enzimatik olarak daha aktiftir ve artmış trombotik potansiyele sahiptir. Çalışmamızda AKS ve stabil koroner arter hastalığı tanısı alarak koroner anjiyografi yapılmış olguların Gensini skoru kullanılarak hesaplanan koroner arter hastalığı ciddiyeti ile ortalama trombosit hacmi (OTH) düzeyleri arasındaki ilişki değerlendirildi.Çalışmaya, tümüne koroner anjiyografi uygulanmış kararsız angina pektoris (USAP), ST segment elevasyonlu miyokard infarktüsü (STEMI) ve ST segment elevasyonsuz miyokard infarktüsü (NSTEMI) tanılarını alan AKS vakaları ile stabil angina pektoris (SAP) olgularından oluşan toplam 159 hasta ve göğüs ağrısı nedeni ile yapılan koroner anjiyografide koroner arterleri normal olarak değerlendirilmiş kontrol grubunu oluşturan 41 olgu alındı. Tüm olgular tanılarına göre 5 gruba ayrıldı.OTH ve trombosit sayısı, AKS'li hastalarda hastaneye yatışlarında, stabil angina ve kontrol grubu olgularında ise koroner anjiyografi öncesi rutin poliklinik takiplerinde çalışılmış hemogram sonuçları incelenerek değerlendirildi. Koroner anjiyografi sonuçlarına ulaşılarak koroner arter hastalığı ciddiyeti, Gensini skorlama sistemine uygun olacak şekilde belirlendi.OTH düzeyleri, AKS'li olgularda, SAP ve kontrol grubuna göre anlamlı olarak yüksek bulundu (p<0,001), yine AKS hastalarında OTH ve Gensini skoru arasında pozitif korelasyon saptandı (r: 0,230, p: 0,011).Sonuç olarak çalışmamızda, OTH düzeyleri, AKS' de anlamlı olarak yüksek bulunmuştur. Bu durum ilgili çalışmaları destekler niteliktedir ve OTH düzeyinin yükselmesi koroner arter hastalığı ciddiyeti ile paralellik göstermektedir.
Coronary heart disease is the first reason of morbidity and mortality in our country as well as developed countries. Acute coronary syndrome (ACS) is occured by thrombosis in the environment as a result of atherosclerotic plaque rupture or ulceration. Platelet activation plays an important role in this situation. Large platelets are metabolically and enzymatically more active and have increased thrombotic potential. In our study, the association between mean platelet volume (MPV) and severity of coronary heart disease which is calculated by Gensini score were evaluated in patients who are underwent coronary angiography with the diagnosis of ACS and stable coronary artery disease.159 patients were underwent with the diagnosis of unstable angina pectoris (USAP), st segment elevated myocardial infarction (STEMI), non st elevation myocardial infarction (NSTEMI) and stable angina pectoris (SAP). 41 patients with normal coronary arteries, evaluated by coronary angiography are in control group. All subjects were divided in to five groups according to their diagnosis.MPV and platelet count were analyzed from full blood count in ACS patients when hospitalized, in SAP and control cases with routine outpatient follow up results before coronary angiography. The severity of CAD was calculated using Gensini score.In ACS patients, levels of MPV were significantly higher than SAP and control cases. Positive correlation was found between MPV and Gensini score in ACS cases (r: 0,230, p: 0,011).As a result, levels of MPV were significantly higher in ACS patients. This result supports other related studies. Evaluation in levels of MPV shows correlation with severity of CAD.
Coronary heart disease is the first reason of morbidity and mortality in our country as well as developed countries. Acute coronary syndrome (ACS) is occured by thrombosis in the environment as a result of atherosclerotic plaque rupture or ulceration. Platelet activation plays an important role in this situation. Large platelets are metabolically and enzymatically more active and have increased thrombotic potential. In our study, the association between mean platelet volume (MPV) and severity of coronary heart disease which is calculated by Gensini score were evaluated in patients who are underwent coronary angiography with the diagnosis of ACS and stable coronary artery disease.159 patients were underwent with the diagnosis of unstable angina pectoris (USAP), st segment elevated myocardial infarction (STEMI), non st elevation myocardial infarction (NSTEMI) and stable angina pectoris (SAP). 41 patients with normal coronary arteries, evaluated by coronary angiography are in control group. All subjects were divided in to five groups according to their diagnosis.MPV and platelet count were analyzed from full blood count in ACS patients when hospitalized, in SAP and control cases with routine outpatient follow up results before coronary angiography. The severity of CAD was calculated using Gensini score.In ACS patients, levels of MPV were significantly higher than SAP and control cases. Positive correlation was found between MPV and Gensini score in ACS cases (r: 0,230, p: 0,011).As a result, levels of MPV were significantly higher in ACS patients. This result supports other related studies. Evaluation in levels of MPV shows correlation with severity of CAD.
Description
Keywords
Ortalama trombosit hacmi, Gensini skoru, Koroner arter hastalığı, Mean platelet volume, Gensini score, Coronary artery disease
Citation
Kuştarcı, T. (2012). Akut koroner sendrom ve stabil koroner arter hastalarında gensini skoruna göre hesaplanan koroner arter hastalığı ciddiyeti ile ortalama trombosit hacmi düzeyleri arasındaki ilişki. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.