Koroner arter stent restenozlu hastalarda serum prolidaz düzeyinin değerlendirilmesi
Küçük Resim Yok
Tarih
2014
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Koroner arter stent restenozu, koroner revaskülarizasyon sırasında oluşan hasarlanmaya karşı, damar çapında azalma ile ortaya çıkan olumsuz yanıt olarak tanımlanabilir. Prolidaz, kollajen metabolizmasında yeni matriks oluşumunda ve hücre büyümesinde rol alan bir enzimdir. Kollajen oluşumunda etkisi olan serum prolidaz enziminin stent içi restenozda etkili olabileceği düşünülerek bu çalışma planlandı. Bildiğimiz kadarıyla günümüzde stent içi restenoz (SİR)'lu hastalarda serum prolidaz enziminin değerini araştıran bir çalışma yapılmamıştır. Bu nedenle çalışmamızın amacı stent içi restenoz ile serum prolidaz seviyesi arasındaki ilişkiyi ortaya koymaktır. Abant İzzet Baysal Üniversitesi Araştırma ve Uygulama Hastanesi Kardiyoloji ve Acil polikliniklerine 2013-2014 yılları arasında klinik veya non-invaziv testler sonucunda orta ve yüksek riskli olduğu tespit edilen ve anjiyografi uygulanan 70 hasta çalışmaya dahil edildi. 40 hastada stent içi restenoz saptanırken kalan 30 hastada anjiyografik olarak kritik lezyon saptanmadı. 70 hastanın da serum prolidaz düzeyleri ölçüldü. Serum prolidaz düzeyi, SİR olan grupta olmayan gruba kıyasla anlamlı derecede yüksek ölçüldü ve istatistiksel olarak anlamlı bulundu (p=0.02). SİR, sigara içen grupta içmeyen gruba göre anlamlı derece fazla bulundu (p=0.04). Restenotik stent yüzdesi artışı ile serum prolidaz düzeyleri arasında yapılan karşılaştırmada ise restenotik stent yüzde oranı arttıkça serum prolidaz düzeyinin de arttığı saptandı, istatistiksel olarak anlamlı bulundu (p=0.04). Bu çalışmadan elde edilen veriler, serum prolidaz enzim düzeylerinin stent restenozuyla yakından ilişkili ve restenoz ciddiyetinin bağımsız bir öngördürücüsü olduğunu göstermektedir. Bulgularımız, koroner stentle PKG yapılan hastalarda prolidaz enzim düzeylerinin stent restenozunun erken ve doğru değerlendirilmesine imkan sağlayacağına, mevcut tedavinin değiştirilmesi ya da yoğunlaştırılması zamanının belirlenmesine katkı sağlayabileceğini düşündürmektedir.
Coronary artery stent restenosis can be defined as the negative response resulting from the reduction in the veins due to the damage during coronary revascularization. Prolidase is an enzyme involved in new matrix formation in collagen metabolism and cell development. This study has been planned on the basis that the serum prolidase enzyme that has an impact on collagen formation may have an impact on in-stent restenosis. Based on what is known to date, there has been no study done on assesing the serum prolidase enzyme levels in in-stent restenosis patients. For this reason, our study objective is to identify the relationship between the in-stent restenosis and serum prolidase levels. 70 patients identified as medium or high risk on the basis of clinical or non-invasive tests and subject to an angiography in 2013-2014 at Abant Izzet Baysal University research and application hospital cardiology and emergency policlinic were included in the study. In 40 patients, in-stent restenosis was identified. In the other 30 patients, angiographically determined critical lesion was not identified. In all patients the serum prolidase levels were measured. The serum prolidase levels in the group with instent restenosis as compared to the group without was found to be meaningfully higher and to be statistically meaningful (p=0.02). In-stent restenosis was found to be meaningfully higher in smokers compared to non smokers (p=0.04). In the comparison between the increase in the stenotic stent percentage and serum prolidase levels, it was found that as the stenotic stent percentage increased the serum prolidase levels increased in a statistically meaningful way (p=0.04). The data from this study shows that serum prolidase enzyme levels are closely related to stent restenosis and are independent indicators of restenosis seriousness. Our findings lead us to think that in patients subject to coronary stent and PKG, prolidase enzyme levels may enable early and correct assessment of stent restenosis, and may contribute to the change in the treatment or determination of the timing of increasing the intensity.
Coronary artery stent restenosis can be defined as the negative response resulting from the reduction in the veins due to the damage during coronary revascularization. Prolidase is an enzyme involved in new matrix formation in collagen metabolism and cell development. This study has been planned on the basis that the serum prolidase enzyme that has an impact on collagen formation may have an impact on in-stent restenosis. Based on what is known to date, there has been no study done on assesing the serum prolidase enzyme levels in in-stent restenosis patients. For this reason, our study objective is to identify the relationship between the in-stent restenosis and serum prolidase levels. 70 patients identified as medium or high risk on the basis of clinical or non-invasive tests and subject to an angiography in 2013-2014 at Abant Izzet Baysal University research and application hospital cardiology and emergency policlinic were included in the study. In 40 patients, in-stent restenosis was identified. In the other 30 patients, angiographically determined critical lesion was not identified. In all patients the serum prolidase levels were measured. The serum prolidase levels in the group with instent restenosis as compared to the group without was found to be meaningfully higher and to be statistically meaningful (p=0.02). In-stent restenosis was found to be meaningfully higher in smokers compared to non smokers (p=0.04). In the comparison between the increase in the stenotic stent percentage and serum prolidase levels, it was found that as the stenotic stent percentage increased the serum prolidase levels increased in a statistically meaningful way (p=0.04). The data from this study shows that serum prolidase enzyme levels are closely related to stent restenosis and are independent indicators of restenosis seriousness. Our findings lead us to think that in patients subject to coronary stent and PKG, prolidase enzyme levels may enable early and correct assessment of stent restenosis, and may contribute to the change in the treatment or determination of the timing of increasing the intensity.
Açıklama
Tıp Fakültesi, Kardiyoloji Ana Bilim Dalı
Anahtar Kelimeler
Kardiyoloji, Cardiology
