Çekici Yusuf, Kılıç Salih, Saraçoğlu Erhan, Çetin Mustafa, Veysel Düzen İrfan, Yılmaz Mücahid
Department of Cardiology, Gaziantep Dr Ersin Arslan Training and Research Hospital.
Department of Cardiology, 25 Aralık State Hospital, Gaziantep.
Acta Cardiol Sin. 2019 Jan;35(1):20-26. doi: 10.6515/ACS.201901_35(1).20180701A.
It is unclear whether isolated coronary artery ectasia (iCAE) is associated with whole blood viscosity (WBV). In the present study, we investigated WBV in coronary artery ectasia (CAE) patients.
Seventy-eight patients with iCAE and 83 controls with normal coronary arteries were selected from 12290 patients who underwent coronary angiography between January 2014 and December 2017. WBV was calculated with a validated equation from hematocrit and total plasma protein levels for a low (LSR) and high (HSR) shear rate.
Baseline demographic characteristics and medical history of the groups were similar. The mean level of C-reactive protein (2.1 ± 0.53 vs. 1.93 ± 0.44; p = 0.042) and total protein (7.2 ± 0.3 vs. 7.0 ± 0.6; p = 0.009) were significantly higher in the iCAE group than in the control subjects. Both HSR (4.57 ± 0.6 vs. 3.9 ± 0.7; p < 0.001) and LSR (33.5 ± 9.6 vs. 25.1 ± 9.2; p < 0.001) levels were significantly higher in the iCAE group than in the control group. In ROC analysis, a cut-off value of 4.19 WBV for HSR had an 80.8% sensitivity and 72.3% specificity [area under the curve (AUC): 0.779, 95% CI 70.6-85.1; p < 0.001] and a cut-off value of 27.5 WBV for LSR had an 80.1% sensitivity and 72.3% specificity for predicting iCAE (AUC: 0.788, 95% CI 71.4-86.2; p < 0.001). In multivariate analysis, both LSR (p < 0.001, OR 1.10, 95% CI 1.05-1.15) and HSR (p < 0.001, OR 4.60, 95% CI 2.33-9.09) were independent predictors for the presence of iCAE.
In the present study, we determined that in WBV, both HSR and LSR were significantly higher in the iCAE group than in the control subjects, and that this may be a possible cause of iCAE.
孤立性冠状动脉扩张（iCAE）是否与全血粘度（WBV）相关尚不清楚。在本研究中，我们调查了冠状动脉扩张（CAE）患者的WBV。
从2014年1月至2017年12月接受冠状动脉造影的12290例患者中，选取78例iCAE患者和83例冠状动脉正常的对照者。根据血细胞比容和总血浆蛋白水平，使用经过验证的公式计算低（LSR）和高（HSR）剪切率下的WBV。
两组的基线人口统计学特征和病史相似。iCAE组的C反应蛋白平均水平（2.1±0.53对1.93±0.44；p = 0.042）和总蛋白（7.2±0.3对7.0±0.6；p = 0.009）显著高于对照组。iCAE组的HSR（4.57±0.6对3.9±0.7；p < 0.001）和LSR（33.5±9.6对25.1±9.2；p < 0.001）水平均显著高于对照组。在ROC分析中，HSR的WBV截断值为4.19时，预测iCAE的敏感性为80.8%，特异性为72.3%[曲线下面积（AUC）：0.779，95%CI 70.6 - 85.1；p < 0.001]；LSR的WBV截断值为27.5时，预测iCAE的敏感性为80.1%，特异性为72.3%（AUC：0.788，95%CI 71.4 - 86.2；p < 0.001）。在多变量分析中，LSR（p < 0.001，OR 1.10，95%CI 1.05 - 1.15）和HSR（p < 0.001，OR 4.60，95%CI 2.33 - 9.09）均为iCAE存在的独立预测因素。
在本研究中，我们确定在WBV方面，iCAE组的HSR和LSR均显著高于对照组，这可能是iCAE的一个潜在原因。
