Kalaycıoğlu Ezgi, Gökdeniz Tayyar, Aykan Ahmet Cağrı, Gül Ilker, Boyacı Faruk, Gürsoy Ozan Mustafa, Belen Erdal, Celik Sükrü
Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Department of Cardiology, Trabzon, Turkey.
Kardiol Pol. 2014;72(4):372-80. doi: 10.5603/KP.a2013.0349. Epub 2014 Jan 10.
Previous studies have demonstrated that inflammation, neurohormonal process and cardiovascular risk factors are associated with the development of coronary artery ectasia (CAE). However, the underlying mechanisms responsible for ectasia formation are not fully understood. The neutrophil to lymphocyte (N/L) ratio has recently emerged as a new inflammation marker for cardiovascular disease.
In this study, we hypothesised that CAE could be associated with more severe inflammation compared to obstructive coronary artery disease (O-CAD) with regard to N/L ratio values.
A total of 405 patients with isolated CAE, O-CAD and insignificant CAD (controls) were enrolled. Severity of isolated CAE was determined according to the Markis classification. N/L ratio values were compared between the three groups.
We determined that the patients with isolated CAE had significantly elevated N/L ratio values compared to O-CAD and control groups (2.5 vs. 1.9, p < 0.001 and vs. 1.6, p < 0.001, respectively). In multivariate analysis adjusted for age, sex, diabetes mellitus (DM) and hypertension, N/L ratio was independently associated with the presence (N/L ratio, OR = 2.48, 95% CI 2.03-3.02, p < 0. 001) and severity (DM, OR = 2.90, 95% CI 1.02-8.18, p = 0.044, N/L ratio, OR = 1.88, 95% CI 1.47-2.41, p = 0.004) of isolated CAE. ROC curve analysis revealed that a N/L ratio value of > 2.06 identified the patients with isolated CAE.
We showed that patients with isolated CAE had a significantly higher N/L ratio than patients with O-CAD and control groups. This finding suggests that a more severe inflammatory process could be involved in the development of CAE.
既往研究表明，炎症、神经激素过程和心血管危险因素与冠状动脉扩张（CAE）的发生有关。然而，导致血管扩张形成的潜在机制尚未完全明确。中性粒细胞与淋巴细胞（N/L）比值最近已成为心血管疾病的一种新的炎症标志物。
在本研究中，我们假设就N/L比值而言，与阻塞性冠状动脉疾病（O-CAD）相比，CAE可能与更严重的炎症相关。
共纳入405例孤立性CAE、O-CAD和轻度CAD（对照组）患者。根据Markis分类确定孤立性CAE的严重程度。比较三组之间的N/L比值。
我们发现，与O-CAD组和对照组相比，孤立性CAE患者的N/L比值显著升高（分别为2.5 vs. 1.9，p < 0.001；vs. 1.6，p < 0.001）。在对年龄、性别、糖尿病（DM）和高血压进行校正的多变量分析中，N/L比值与孤立性CAE的存在（N/L比值，OR = 2.48，95%CI 2.03 - 3.02，p < 0.001）和严重程度（DM，OR = 2.90，95%CI 1.02 - 8.18，p = 0.044；N/L比值，OR = 1.88，95%CI 1.47 - 2.41，p = 0.004）独立相关。ROC曲线分析显示，N/L比值>2.06可识别孤立性CAE患者。
我们表明，孤立性CAE患者的N/L比值显著高于O-CAD患者和对照组。这一发现表明，更严重的炎症过程可能参与了CAE的发生。
