Ornek Ender, Kurtul Alparslan
Department of Cardiology, aAnkara Numune Education and Research Hospital bAnkara Education and Research Hospital, Ankara, Turkey.
Coron Artery Dis. 2017 Sep;28(6):492-497. doi: 10.1097/MCA.0000000000000530.
In patients with coronary artery disease, coronary collateral circulation (CCC) develops as an adaptation to ischemia and contributes toward reduction of cardiovascular events. Recently, the mean platelet volume-to-lymphocyte ratio (MPVLR) has emerged as a novel and readily available marker of inflammation and thrombosis. This study aimed to investigate the relationship between MPVLR and development of CCC.
A total of 332 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCC into two groups: group with adequate CCC (n=243) and group with impaired CCC (n=89). Routine complete blood count parameters and high-sensitivity C-reactive protein (hsCRP) were measured before coronary arteriography.
Both MPVLR and hsCRP levels were higher in the impaired CCC group (P<0.001 and P=0.007, respectively). Multivariate logistic regression analysis indicated that MPVLR was associated independently with impaired CCC [odds ratio (OR): 1.706, 95% confidence interval (CI): 1.328-2.192, P<0.001]. In addition to MPVLR, hsCRP (OR: 1.144, P=0.030) and fasting blood glucose (OR: 1.007, P=0.049) were also associated independently with impaired CCC. In receiver operating characteristics curve analysis, an optimal cut-off point for MPVLR (4.47) was found to predict the presence of good CCC with a sensitivity of 75.3% and a specificity of 71.2% (P<0001).
Our findings suggest that measurement of MPVLR may predict the development of CCC in patients with stable coronary artery disease. An increased MPVLR is associated independently with impaired CCC in these patients.
在冠状动脉疾病患者中，冠状动脉侧支循环（CCC）作为对缺血的一种适应性反应而形成，并有助于减少心血管事件。最近，平均血小板体积与淋巴细胞比率（MPVLR）已成为一种新的、易于获得的炎症和血栓形成标志物。本研究旨在探讨MPVLR与CCC形成之间的关系。
总共纳入332例接受冠状动脉造影的稳定型心绞痛患者，并根据CCC的形成情况将其分为两组：CCC良好组（n = 243）和CCC受损组（n = 89）。在冠状动脉造影前测量常规全血细胞计数参数和高敏C反应蛋白（hsCRP）。
CCC受损组的MPVLR和hsCRP水平均较高（分别为P < 0.001和P = 0.007）。多因素逻辑回归分析表明，MPVLR与CCC受损独立相关[比值比（OR）：1.706，95%置信区间（CI）：1.328 - 2.192，P < 0.001]。除了MPVLR外，hsCRP（OR：1.144，P = 0.030）和空腹血糖（OR：1.007，P = 0.049）也与CCC受损独立相关。在受试者工作特征曲线分析中，发现MPVLR的最佳截断点为4.47，用于预测良好CCC的存在，敏感性为75.3%，特异性为7
1.2%（P < 0.001）。
我们的研究结果表明，测量MPVLR可能预测稳定型冠状动脉疾病患者的CCC形成。在这些患者中，MPVLR升高与CCC受损独立相关。
