Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome

İSMAİLOĞLU, Ziya; İSMAİLOVA, Medine; GÜLEN, Bedia; METIN, HUSEYIN; DUR, Ali; SÖNMEZ, Ertan; AKBAY, Dursun; uysal, ömer

Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome

Ali DUR, (Department of Emergency Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Ziya İSMAİLOĞLU, (Department of Cardiology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Medine İSMAİLOVA, (Department of Internal Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Dursun AKBAY, (Department of Emergency Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Ömer UYSAL, (Department of Emergency Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Hüseyin METİN, (Department of Emergency Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Bedia GÜLEN, (Department of Emergency Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Ertan SÖNMEZ (Department of Emergency Medicine, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey)

Bezmiâlem Science

1 0

Yıl: 2017 Cilt: 5 Sayı: 2 Sayfa Aralığı: 56 - 60 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome

Öz:

Amaç: Bu çalışmada akut koroner sendromlu hastalarda nötrofil lenfosit oranı (NLR) ve High-sensitivity C-reactive protein (HsCRP) gibi inflamatuar belirteçler kullanılarak belirlenen enflamasyon ile syntax severity skoru (SSS) ile belirlenen koroner arter tıkanıklarının şiddeti ile ilişkisi araştırılmıştır.Yöntemler: Bu çalışmada akut koroner sendromu destekleyen belirtilerle başvuran ve ilk altı saat içerisinde koroner anjiografi yapılan hastalar çalışılmıştır. Hastalar NLR değerine göre grup 1 (NLR<=2,7) ve grup 2 (NLR > 2,7) olarak iki bölüme ayrılarak incelenmiştir. SSS değerine göre ise hastalar düşük skoru olanlar grup 1 ve orta ve yüksek grupta olanlar ise grup 2 olarak ikiye ayrılmışlardır. İstatistiksel analizi ise chi-square test ve Mann-Whitney U testi kullanılarak yapılmıştır. Bulgular: Çalışmada 65 erkek ve 22 kadın olmak üzere 87 hasta çalışılmış ve bu hastalardan ise 57 hasta ST elevasyonlu akut miyokard infarktüsü (STEMI) VE 30 hasta ise non ST elevasyonlu akut miyokard infarktüsü (NSTEMI) olarak belirlenmiştir. Düşük NLR değerine sahip 1. gruptaki hasta sayısı 63 ve yüksek NLR değerine sahip 2. gruptaki hasta sayısı ise 24 olarak bulundu. Çalışma sonunda SSS tek değişkenli analizi sonucunda grup 1 hastalarında 23,6±12,7, grup 2 hastalarında ise 13,9±8,7 olarak istatistiksel olarak anlamlı bir sonuç bulundu (p < 0,001). NLR sonuçları ile benzer şekilde SSS ile troponin seviyeleri ve HsCRP değerleri arasındada istatiktiksel olarak anlamlı bir ilişki bulundu.Sonuç: Çalışmada akut koroner sendrom hastalarında NLR değerlerinin SSS ile ölçülen şiddetli koroner arter darlığını öngörmede etkili olabileceği bulunmuştur

Anahtar Kelime:

Konular: Cerrahi

Akut Koroner Sendromun Erken Evresinde Ölçülen İnflamasyon Belirteçleri ve Nötrofil Lenfosit Oranlarının Syntax Severity Skoru ile Ölçülen Koroner Arter Darlığı Üzerinde Prediktif Etkisi

Öz:

Objective: The aim of the present study was to examine a possible association between inflammation, as indicated by High-sensitivity C-reactive protein (HsCRP) and neutrophil/lymphocyte ratio (NLR), and the complexity and severity of coronary artery disease assessed using syntax severity score (SSS) in patients with acute coronary syndrome (ACS).Methods: Patients with symptoms suggestive of ACS who were admitted within 6 h of onset and who underwent coronary angiography were enrolled in the study. According to NLR, we divided patients into two groups: group 1 (NLR<=2.7) and group 2 (NLR > 2.7). According to SSS, patients were divided into two groups: group 1 including low scores and group 2 including intermediate and high scores. Statistical analysis was performed using chi-square test and Mann-Whitney U test.Results: A total of 87 patients (65 males and 22 females) with acute myocardial infarction (AMI; 57 ST-se AMI and 30 nonST-se AMI) were included in this study. Patients were classified into low (NLR<=2.7, n=63) and high (NLR > 2.7, n=24) NLR groups. Univariate analysis demonstrated that SSS was significantly higher in high NLR group than in low NLR group (23.6±12.7 versus 13.9±8.7, p < 0.001). Similar to NLR, significant correlation was revealed among HsCRP, troponin levels, and SSS that indicated their predictive value in the severity of AMI. Conclusion: In present study, we showed NLR to be an independent predictor of hemodynamically significant coronary artery stenosis as measured using SSS

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Weber M, Dill T, Arnold R, Rau M, Ekinci O, Müller KD, et al. Nterminal B-type natriuretic peptide predicts extent of coronary artery disease and ischemia in patients with stable angina pectoris. Am Heart J 2004; 148: 612-20 [CrossRef]
2. Koenig W. High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy. Int J Cardiol 2013; 168: 5126-34. [CrossRef]
3. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008; 102: 653-7. [CrossRef]
4. Prospero BO, David JS, Edward FT, Matthew WW, Bruton ES, Harold LD. Relation of leukocytosis to C-reactive protein and interleukin-6 among patient undergoing percutaneous coronary intervention. Am J Cardiol 2005; 4: 538-42.
5. Libby P, Simon DI. Inflammation and thrombosis: the clot thickens. Circulation 2001; 103: 1718-20. [CrossRef]
6. Avanzas P, Quiles J, Lopez de Sa E, Sánchez A, Rubio R, García E, et al. Neutrophil count and infarct size in patients with acute myocardial infarction. Int J Cardiol 2004; 97: 155-6. [CrossRef]
7. Folsom AR, Chambless LE, Ballantyne CM, Coresh J, Heiss G, Wu KK, et al. An assessment of incremental coronary risk prediction using Creactive protein and other novel risk markers: the atherosclerosis risk in communities study. Arch Intern Med 2006; 166: 1368-73. [CrossRef]
8. Thompson A, Gao P, Orfei L, Watson S, Di Angelantonio E, Kaptoge S, et al. Lipoprotein-associated phospholipase A(2) and risk of coronary disease, stroke, and mortality: collaborative analysis of 32 prospective studies. Lancet 2010; 375: 1536-44. [CrossRef]
9. Zahorec R. Ratio neutrophil to lymphocyte counts-rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
10. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX score: an angiographic tool grading the complexity of coronary artery disease. Eurointervention 2005; 1: 219 -27.
11. Capodanno D, Di Salvo ME, Cincotta G, Miano M, Tamburino C, Tamburino C. Usefulness of the SYNTAX score for predicting clinical outcome after percutaneous coronary intervention of unprotected left main coronary artery disease. Circ Cardiovasc Intervent 2009; 2: 302- 8. [CrossRef]
12. Serruys PW, Onuma Y, Garg S, Garg S, Sarno G, van den Brand M, et al. Assessment of the SYNTAX score in the Syntax study. EuroIntervention 2009; 5: 50-6. [CrossRef]
13. Genereux P, Palmerini T, Caixeta A, Cristea E, Mehran R, Sanchez R, et al. SYNTAX score reproducibility and variability between interventional cardiologists, core laboratory technicians, and quantitative coronary measurements. Circ Cardiovasc Interv 2011; 4: 553-61. [CrossRef]
14. Poludasu S, Cavusoglu E, Khan W, Marmur JD. Neutrophil to lymphocyte ratio as a predictor of long-term mortality in African Americans undergoing percutaneous coronary intervention. Clin Cardiol 2009; 32: E6e10.
15. Bhutta H, Agha R, Wong J, Tang TY, Wilson YG, Walsh SR. Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a crosssectional study. Vasc Endovascular Surg 2011; 45: 227e31.
16. Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, et al. SYNTAX Investigators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009; 360: 961-72. [CrossRef]
17. Carter AM. Inflammation, thrombosis and acute coronary syndromes. Diab Vasc Dis Res 2005; 2: 113-21. [CrossRef]
18. Madjid M, Casscells SW, Willerson JT. Biomarkers of inflammation as surrogate markers in detection of vulnerable plaques and vulnerable patients. Cardiovascular Medicine. 3rd edn. Springer-Verlag London Limited, London, pp. 641-51.
19. Danesh J, Kaptoge S, Mann AG, Sarwar N, Wood A, Sara BA, et al. Long-term interleukin-6 levels and subsequent risk of coronary heart disease: two newprospective studies and a systematic review. PLoS Med 2008; 5: e78 [CrossRef]
20. Jilma B, Blann A, Pernerstorfer T, Stohlawetz P, Eichler HG, Vondrovec B, et al. Regulation of adhesion molecules during human endotoxemia. Am J Respir Crit Care Med 1999; 159: 857-63. [CrossRef]
21. Azab B, Zaher M, Weiserbs KF, Torbey E, Lacossiere K, Gaddam S, et al. Usefulness of neutrophil to lymphocyte ratio in predicting shortand long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol 2010; 106: 470e6.
22. Cho KH, Jeong MH, Ahmed K, Hachinohe D, Choi HS, Chang SY, et al. Value of early risk stratification using hemoglobin level and neutrophil-to-lymphocyte ratio in patients with STelevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol 2011; 107: 849e56.
23. Omland T, de Lemos JA, Sabatine MS, Christophi CA, Rice MM, Jablonski KA, et al. A sensitive cardiac troponin T assay in stable coronary artery disease. N Engl J Med 2009; 361: 2538-47. [CrossRef]
24. Wallace TW, Abdullah SM, Drazner MH, Das SR, Khera A, McGuire DK, et al. Prevalence and determinants of troponin T elevation in the general population. Circulation 2006; 113: 1958-65. [CrossRef]
25. Guasti L, Dentali F, Castiglioni L, Maroni L, Marino F, Squizzato A, et al. Neutrophils and clinical outcomes in patients with acute coronary syndromes and/or cardiac revascularisation. A systematic review on more than 34,000 subjects. Thromb Haemost 2011; 106: 591-9. [CrossRef]
26. Kaya H, Ertas F, İslamoglu Y, Kaya Z, Atılgan ZA, Çil H, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost 2014; 20: 50-4. [CrossRef]
27. Yildiz A, Yuksel M, Oylumlu M, Polat N, Akyüz A, Acet H, et al. The Utility of the Platelet-Lymphocyte Ratio for Predicting No Reflow in Patients With ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb Hemost 2015; 21: 223-8. [CrossRef]
28. Acet H, Ertaş F, Akıl MA, Oylumlu M, Polat N, Yıldız A, et al. New inflammatory predictors for non-valvular atrial fibrillation: echocardiographic epicardial fat thickness and neutrophil to lymphocyte ratio. Int J Cardiovasc Imaging 2014; 30: 81-9. [CrossRef]
29. Polat N, Yıldız A, Yüksel M, Bilik MZ, Aydın M, Acet H, et al. Association of Neutrophil-Lymphocyte Ratio With the Presence and Severity of Rheumatic Mitral Valve Stenosis. Clin Appl Thromb Hemost 2014; 20: 793-8. [CrossRef]

APA	DUR A, İSMAİLOĞLU Z, İSMAİLOVA M, AKBAY D, uysal ö, METIN H, GÜLEN B, SÖNMEZ E (2017). Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. , 56 - 60.
Chicago	DUR Ali,İSMAİLOĞLU Ziya,İSMAİLOVA Medine,AKBAY Dursun,uysal ömer,METIN HUSEYIN,GÜLEN Bedia,SÖNMEZ Ertan Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. (2017): 56 - 60.
MLA	DUR Ali,İSMAİLOĞLU Ziya,İSMAİLOVA Medine,AKBAY Dursun,uysal ömer,METIN HUSEYIN,GÜLEN Bedia,SÖNMEZ Ertan Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. , 2017, ss.56 - 60.
AMA	DUR A,İSMAİLOĞLU Z,İSMAİLOVA M,AKBAY D,uysal ö,METIN H,GÜLEN B,SÖNMEZ E Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. . 2017; 56 - 60.
Vancouver	DUR A,İSMAİLOĞLU Z,İSMAİLOVA M,AKBAY D,uysal ö,METIN H,GÜLEN B,SÖNMEZ E Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. . 2017; 56 - 60.
IEEE	DUR A,İSMAİLOĞLU Z,İSMAİLOVA M,AKBAY D,uysal ö,METIN H,GÜLEN B,SÖNMEZ E "Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome." , ss.56 - 60, 2017.
ISNAD	DUR, Ali vd. "Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome". (2017), 56-60.

APA	DUR A, İSMAİLOĞLU Z, İSMAİLOVA M, AKBAY D, uysal ö, METIN H, GÜLEN B, SÖNMEZ E (2017). Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. Bezmiâlem Science, 5(2), 56 - 60.
Chicago	DUR Ali,İSMAİLOĞLU Ziya,İSMAİLOVA Medine,AKBAY Dursun,uysal ömer,METIN HUSEYIN,GÜLEN Bedia,SÖNMEZ Ertan Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. Bezmiâlem Science 5, no.2 (2017): 56 - 60.
MLA	DUR Ali,İSMAİLOĞLU Ziya,İSMAİLOVA Medine,AKBAY Dursun,uysal ömer,METIN HUSEYIN,GÜLEN Bedia,SÖNMEZ Ertan Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. Bezmiâlem Science, vol.5, no.2, 2017, ss.56 - 60.
AMA	DUR A,İSMAİLOĞLU Z,İSMAİLOVA M,AKBAY D,uysal ö,METIN H,GÜLEN B,SÖNMEZ E Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. Bezmiâlem Science. 2017; 5(2): 56 - 60.
Vancouver	DUR A,İSMAİLOĞLU Z,İSMAİLOVA M,AKBAY D,uysal ö,METIN H,GÜLEN B,SÖNMEZ E Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. Bezmiâlem Science. 2017; 5(2): 56 - 60.
IEEE	DUR A,İSMAİLOĞLU Z,İSMAİLOVA M,AKBAY D,uysal ö,METIN H,GÜLEN B,SÖNMEZ E "Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome." Bezmiâlem Science, 5, ss.56 - 60, 2017.
ISNAD	DUR, Ali vd. "Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome". Bezmiâlem Science 5/2 (2017), 56-60.