The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction

Akçay, Murat; durmaz, tahir; KELEŞ, Telat; YETER, Ekrem; Bozkurt, Engin; AYHAN, Hüseyin; BAYRAM, Akar Nihal

The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction

Telat KELEŞ, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye)

Tahir DURMAZ, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye)

Akar Nihal BAYRAM, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye)

Murat AKÇAY, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye)

Ekrem YETER, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye)

Hüseyin AYHAN, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Ankara, Türkiye)

Engin BOZKURT (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Rize, Türkiye)

Turkish Journal of Medical Sciences

1 0

Yıl: 2009 Cilt: 39 Sayı: 2 Sayfa Aralığı: 167 - 172 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction

Öz:

Amaç: Homosisteinin endotelyal hücre proliferasyonunu inhibe ettiği bilinmektedir. Koroner kollateral dolaşımın gelişimini etkileyen faktörler iyi bilinmemektedir. Bu çalışmada plazma homosistein düzeylerinin akut miyokard infarktüsü sonrası anjiyografik olarak saptanabilen kollaterallerin gelişimi üzerine tekisi araştırılmıştır. Yöntem ve Gereç: Çalışmaya akut ST yükselmeli miyokard infarktüsü geçiren 60 hasta alınmıştır. Tüm hastalara hastaneye yatırıldıktan sonraki 1-4. günler arasında koroner anjiyografi yapılmıştır (ortalama 2,3 ± 1,2 gün). Kollateral damar gelişimi rentrop sınıflamasına göre derecelendirilmiş, 0 ve 1 kötü kollateral gelişimi, 2 ve 3 ise iyi kollateral gelişimi olarak gruplandırılmıştır. Bulgular: 35 hastada (% 58,3) kötü kollateral gelişimi saptanmıştır. Geri kalan 25 hastada ise (% 41,7) kollateral gelişimin iyi olduğu görülmüştür. Ortalama plasma homosistein konsantrasyonu kötü ve iyi kollateral grublarında sırasıyla 18,2 ± 8,6 μmol/l ve 12,7 ± 2,4 μmol/l bulunmuştur (P = 0,008). Rentrop sınıfı ile homosistein düzeyi arasında anlamlı negatif korelasyon olduğu görülmüştür (r = –0,391, P = 0,002). Yaş, cinsiyet, hipertansiyon, diyabet varlığı, sigara alışkanlığı, plazma lipid parametreleri ve homosistein konsantrasyonlarının kollateral gelişimi üzerine etkisine bakıldığında, kollateral gelişini etkileyen tek bağımsız değişkenin homosistein olduğu görülmüştür (OR: 0,71; % 95 güven aralığı 0,57-0,89, P = 0,003). Sonuç: Bu çalışma ile plazma homosistein konsantrasyonları ile akut miyokard infarktüsü sonrası erken dönemdeki kollateral gelişimi arasındaki negatif ilişkinin varlığı ilk kez gösterilmiştir.

Anahtar Kelime: Koroner anjiyografi Akut hastalık Homosistein Kollateral dolaşım Miyokard enfarktüsü

Konular: Cerrahi

Homosistein ve akut miyokard infarktüsü sonrası erken dönemde koroner kollateral gelişimi

Öz:

Aim: Homocysteine is known to inhibit endothelial cell proliferation, which is a key event in angiogenesis. Factors responsible for the presence or absence of coronary collateral circulation are poorly understood. Therefore, in this study we investigated the effect of plasma homocysteine level on the early formation of angiographically visible collaterals after acute myocardial infarction. Materials and Methods: The study included 60 patients that had ST-segment elevation myocardial infarction (STEMI). All the patients underwent coronary angiography 1-4 days after admission (mean: 2.3 ± 1.2 days). Patients were graded according to Rentrop classification. Patients with grade 0 or 1 collateral vessels were classified as poor collaterals; patients with grade 2 or 3 collateral vessels were classified as good collaterals. Results: In all, 35 (58.3%) patients had poor collateral vessel filling and the remaining 25 (41.7%) patients had good collateral filling. Plasma homocysteine concentration in patients with poor and good collateral formation was 18.2 ± 8.6 μmol/l and 12.7 ± 2.4 μmol/l, respectively (P = 0.008). There was a negative linear correlation between Rentrop subclasses and plasma homocysteine concentration (r = –0.391, P = 0.002). We assessed the effect of demographic variables, such as age, gender, hypertension, diabetes mellitus, smoking, lipid parameters, and plasma homocysteine concentration, on the development of collaterals. The only independent variable that affected the development of collaterals was homocysteine level (OR: 0.71; 95% CI = 0.57-0.89, P = 0.003). Conclusions: This study demonstrates for the first time that there is an inverse relationship between the early development of collateral circulation after acute myocardial infarction and plasma homocysteine concentration.

Anahtar Kelime: Collateral Circulation Myocardial Infarction Coronary Angiography Acute Disease Homocysteine

Konular: Cerrahi

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

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APA	KELEŞ T, durmaz t, BAYRAM A, Akçay M, YETER E, AYHAN H, Bozkurt E (2009). The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. , 167 - 172.
Chicago	KELEŞ Telat,durmaz tahir,BAYRAM Akar Nihal,Akçay Murat,YETER Ekrem,AYHAN Hüseyin,Bozkurt Engin The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. (2009): 167 - 172.
MLA	KELEŞ Telat,durmaz tahir,BAYRAM Akar Nihal,Akçay Murat,YETER Ekrem,AYHAN Hüseyin,Bozkurt Engin The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. , 2009, ss.167 - 172.
AMA	KELEŞ T,durmaz t,BAYRAM A,Akçay M,YETER E,AYHAN H,Bozkurt E The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. . 2009; 167 - 172.
Vancouver	KELEŞ T,durmaz t,BAYRAM A,Akçay M,YETER E,AYHAN H,Bozkurt E The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. . 2009; 167 - 172.
IEEE	KELEŞ T,durmaz t,BAYRAM A,Akçay M,YETER E,AYHAN H,Bozkurt E "The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction." , ss.167 - 172, 2009.
ISNAD	KELEŞ, Telat vd. "The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction". (2009), 167-172.

APA	KELEŞ T, durmaz t, BAYRAM A, Akçay M, YETER E, AYHAN H, Bozkurt E (2009). The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. Turkish Journal of Medical Sciences, 39(2), 167 - 172.
Chicago	KELEŞ Telat,durmaz tahir,BAYRAM Akar Nihal,Akçay Murat,YETER Ekrem,AYHAN Hüseyin,Bozkurt Engin The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. Turkish Journal of Medical Sciences 39, no.2 (2009): 167 - 172.
MLA	KELEŞ Telat,durmaz tahir,BAYRAM Akar Nihal,Akçay Murat,YETER Ekrem,AYHAN Hüseyin,Bozkurt Engin The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. Turkish Journal of Medical Sciences, vol.39, no.2, 2009, ss.167 - 172.
AMA	KELEŞ T,durmaz t,BAYRAM A,Akçay M,YETER E,AYHAN H,Bozkurt E The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. Turkish Journal of Medical Sciences. 2009; 39(2): 167 - 172.
Vancouver	KELEŞ T,durmaz t,BAYRAM A,Akçay M,YETER E,AYHAN H,Bozkurt E The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction. Turkish Journal of Medical Sciences. 2009; 39(2): 167 - 172.
IEEE	KELEŞ T,durmaz t,BAYRAM A,Akçay M,YETER E,AYHAN H,Bozkurt E "The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction." Turkish Journal of Medical Sciences, 39, ss.167 - 172, 2009.
ISNAD	KELEŞ, Telat vd. "The relationship between plasma homocysteine and early coronary collateral vessel development after acute myocardial infarction". Turkish Journal of Medical Sciences 39/2 (2009), 167-172.