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急性冠状动脉综合征和稳定型心绞痛患者中骨保护素水平与冠状动脉疾病程度的关系。

The relation between the levels of osteoprotegerin and the degree of coronary artery disease in patients with acute coronary syndrome and stable angina pectoris.

作者信息

Aksu Feyza, Ozçelik Fatih, Kunduracilar Hakan, Barutçu Ahmet, Yel Mesih, Umit Elif Gülsüm, Altun Armağan

机构信息

Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Turkey.

出版信息

Kardiol Pol. 2014;72(1):34-41. doi: 10.5603/KP.2014.0004.

Abstract

BACKGROUND

Osteoprotegerin (OPG), an inhibitor of osteoclastogenesis, has recently been under the spotlight in studies regarding the pathophysiology of atherosclerosis.

AIM

To evaluate the value of serum OPG in the diagnosis and severity in patients with stable angina pectoris (SA) and unstable angina pectoris/non ST elevation myocardial infarction.

METHODS

This study involved 160 patients, SA (n = 65), acute coronary syndrome (NSTE-ACS; n = 65), and a control group (n = 30). Blood samples were collected in the first hour, after 24 hours and on the fifth day. The prevalence of coronary artery atherosclerotic lesions was determined using the Gensini scoring system.

RESULTS

A statistically significant difference was observed in the first hour OPG levels between the control group and both the SA and NSTE-ACS group (p < 0.001). When the cut-off value was determined as 247.71 pg/mL, the sensitivity and specificity of the first hour OPG levels indicating coronary artery disease were 91.54% and 46.67%, respectively, while the positive predictive value was 88.1% and the negative predictive value was 56%. No correlations were observed between the first, 24th hour and the fifth day OPG levels and the Gensini scores. No relation was denoted between the OPG levels and number of diseased coronary arteries.

CONCLUSIONS

In our study, serum OPG level seemed to be unrelated to the severity or the degree of coronary artery disease in patients with SA and unstable angina pectoris/non ST elevation myocardial infarction. OPG may only be accepted as an indicator of coronary atherosclerosis.

摘要

背景

骨保护素(OPG)是一种破骨细胞生成抑制剂,最近在动脉粥样硬化病理生理学研究中备受关注。

目的

评估血清OPG在稳定型心绞痛(SA)和不稳定型心绞痛/非ST段抬高型心肌梗死患者诊断及病情严重程度评估中的价值。

方法

本研究纳入160例患者,包括SA组(n = 65)、急性冠状动脉综合征(NSTE - ACS组;n = 65)和对照组(n = 30)。在第1小时、24小时及第5天采集血样。采用Gensini评分系统确定冠状动脉粥样硬化病变的患病率。

结果

对照组与SA组和NSTE - ACS组在第1小时的OPG水平存在统计学显著差异(p < 0.001)。当将临界值确定为247.71 pg/mL时,第1小时OPG水平指示冠状动脉疾病的敏感性和特异性分别为91.54%和46.67%,阳性预测值为88.1%,阴性预测值为56%。第1小时、第24小时和第5天的OPG水平与Gensini评分之间未观察到相关性。OPG水平与病变冠状动脉数量之间无关联。

结论

在我们的研究中,血清OPG水平似乎与SA和不稳定型心绞痛/非ST段抬高型心肌梗死患者的冠状动脉疾病严重程度或程度无关。OPG可能仅被视为冠状动脉粥样硬化的一个指标。

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