Plazma P-selektin düzeylerinin koroner balon anjiyoplasti sonrası gelişen restenozla ilişkisi
Küçük Resim Yok
Tarih
2001
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Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnvazif girişimlerin, koroner lezyonlarda lokal bir hasarlanma yaratarak yüzey adezyon molekülü sekresyonunda artışa yol açması beklenmektedir. Bu çalışmanın amacı balon anjiyoplasti sonrasında oluşan damar zedelenmesine yanıt olarak bir adezyon molekülü olan soluble P(sP)selektin düzeylerindeki değişiklikleri araştırmak ve restenozla ilişkisini değerlendirmekti. Yöntem: Çalışma grubu ilk kez elektif koroner anjiyoplasti endikasyonu konulan ardışık 26 olgudan oluşmakta idi. Herhangi bir infeksiyöz veya sistemik immün hastalığı olan ve immünomodülatör ilaç kullanan olgular çalışmaya alınmadı. Kontrol grubu, anjiyografik olarak koroner arter hastalığı olmayan yaş ve cinsiyeti çalışma grubu ile uyumlu 15 olgudan oluşuyordu. Tüm girişimler aynı protokol ile uygulandı. Plazma sP-selektin düzeyleri girişimden önce, hemen sonra ve 24 saat sonrasında ELISA yöntemi ile ölçüldü. Bulgular: Bazal plazma sP-selektin düzeyleri, çalışma olgularında kontrol grubuna göre anlamlı oranda daha yüksek saptandı (68±23 ng/ml'e karşın 25±7ng/ml; p<0.05). Anjiyoplasti sonrasında ise hemen yapılan ölçümlerde sP-selektin düzeylerinde bir değişiklik gözlenmezken, 24. saat ölçümlerinde anlamlı derecede yükselme mevcuttu (sırasıyla 68±23 ng/ml, 63±21 ng/ml ve 133±20 ng/ml p<0.05). İzlemde 8 olguda restenoz gelişti. Restenoz gelişenlerin bazal ve 24. saat sP-selektin düzeyleri, gelişmeyenlere göre daha yüksekti (bazal düzeyler: 84±8 ng/ml'e karşın 59±22 ng/ml, p=0,006; 24.saat düzeyleri 157±5 ng/ml'e karşın 120±13 ng/ml, p=0,001). Sonuç: Bu çalışmanın sonuçları: 1) Plazma sP-selektin düzeyi, koroner arter hastalarında yüksektir. 2) Koroner anjiyoplasti sonrasında sP-selektin düzeyinde belirgin artış olmaktadır. Bu durum, bu mediatörün balon hasarına damar duvarının verdiği yanıttaki potansiyel rolünü belirtiyor olabilir. 3) Restenoz gelişen olgularda işlem öncesi ve sonrası 24. saat P selektin düzeyleri daha yüksektir. P selektin düzeylerindeki artış restenoza giden patofizyolojik sürecin tetikleyicisi olabilir.
Coronary interventional procedures are expected to induce soluble P (sP)-selectin, a cell-adhesion molecule, release through the local injury on the coronary lesion. The aim of this study was to evaluate the magnitude of sP-selectin secretion in response to vascular injury after balloon angioplasty (PTCA) and its relationship with restenosis. Methods: The study group consisted of 26 consecutive patients undergoing successful elective first PTCA. Patients suffering from any kind of infectious disease and systemic immunological illness or receiving an immune-modulating medication were excluded. Fifteen patients (age- and sex-matched) with normal coronaries served as controls. All procedures were performed with the same protocol. Plasma sP-selectin levels were measured before and immediately and 24 hours after the invasive procedure. ELISA method was used for the quantitative laboratory measurement of sP-selectin. Results: sP-selectin levels before the invasive procedure were significantly higher when compared to control group and significantly increased 24 hours after PTCA (study group: serially 68±23 ng/ml, 63±21 ng/ml, and 133±20 ng/ml; control group 25±7ng/ml). There were no changes in sP-selectin levels immediately after the procedure. During the follow-up period, restenosis developed in 8 patients. The pre- and post 24 hour P-selectin levels were higher in patients who developed restenosis (for baseline values: 84±8 ng/ml vs 59±22 ng/ml, p=0,006;and for 24th hour values 157±5 ng/ml vs 120±13 ng/ml, p=0,001). Conclusion: 1. sP-selectin levels are increased in patients with coronary artery disease. 2. PTCA induces a significant rise in sP-selectin levels which may indicate a potential role of this mediator in the response of the vessel wall to PTCA injury. These findings suggest that PTCA triggers an inflammatory response leading to further sP-selectin secretion. 3. Patients in whom restenosis developed had higher levels of pre and post PTCA levels of P-selectin. There might be a relationship between the restenosis and P-selectin levels which is thought to be reflecting a triggering effect.
Coronary interventional procedures are expected to induce soluble P (sP)-selectin, a cell-adhesion molecule, release through the local injury on the coronary lesion. The aim of this study was to evaluate the magnitude of sP-selectin secretion in response to vascular injury after balloon angioplasty (PTCA) and its relationship with restenosis. Methods: The study group consisted of 26 consecutive patients undergoing successful elective first PTCA. Patients suffering from any kind of infectious disease and systemic immunological illness or receiving an immune-modulating medication were excluded. Fifteen patients (age- and sex-matched) with normal coronaries served as controls. All procedures were performed with the same protocol. Plasma sP-selectin levels were measured before and immediately and 24 hours after the invasive procedure. ELISA method was used for the quantitative laboratory measurement of sP-selectin. Results: sP-selectin levels before the invasive procedure were significantly higher when compared to control group and significantly increased 24 hours after PTCA (study group: serially 68±23 ng/ml, 63±21 ng/ml, and 133±20 ng/ml; control group 25±7ng/ml). There were no changes in sP-selectin levels immediately after the procedure. During the follow-up period, restenosis developed in 8 patients. The pre- and post 24 hour P-selectin levels were higher in patients who developed restenosis (for baseline values: 84±8 ng/ml vs 59±22 ng/ml, p=0,006;and for 24th hour values 157±5 ng/ml vs 120±13 ng/ml, p=0,001). Conclusion: 1. sP-selectin levels are increased in patients with coronary artery disease. 2. PTCA induces a significant rise in sP-selectin levels which may indicate a potential role of this mediator in the response of the vessel wall to PTCA injury. These findings suggest that PTCA triggers an inflammatory response leading to further sP-selectin secretion. 3. Patients in whom restenosis developed had higher levels of pre and post PTCA levels of P-selectin. There might be a relationship between the restenosis and P-selectin levels which is thought to be reflecting a triggering effect.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Cilt
29
Sayı
12
