Koroner arter hastalığı riskini belirlemede yeni bir index (CHOLINDEX)

Abstract

Objective: Coronary artery disease (CAD) risk increases with the elevation of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and low level high-density lipoprotein cholesterol (HDL-C) levels. However, the magnitude at which CAD risk increases with every lipid parameter is controversial. We developed a new index called CHOLINDEX, in order to evaluate CAD risk, and investigated its reliability. Methods: Three hundred and seven patients (190 males and 117 females, aged between 26-80 years, mean 53.6±10.2 years) who underwent diagnostic coronary angiography were included in the study. Risk factors and lipid profiles of all patients were noted. CHOLINDEX was calcu- lated by using a formula as follows: CHOLINDEX=LDL-C–HDL-C (TG < 400 mg/dL), LDL-C–HDL-C + 1/5 of TG (TG ≥ 400mg/dL). Results: Of the 307 patients, 180 had CAD. We found that age, male gender, hypertension, diabetes mellitus, smoking and CHOLINDEX were independent predictors of CAD. The logistic regression analysis showed that the CHOLINDEX had a much more significant relation with CAD (odds ratio=1.011, 95% CI=1.003-1.019) compared with other lipid parameters. Conclusion: CHOLINDEX is a simple index which can be used reliably in prediction of CAD like other lipid parameters in daily clinical practice.

Özet

Amaç: Düşük yoğunluklu lipoprotein kolesterol (LDL-K), trigliserid (TG) düzeyinin yüksekliği ve yüksek yoğunluklu lipoprotein kolesterol (HDL-K) düze- yinin düşüklüğü koroner arter hastalığı (KAH) riskini artırmaktadır. Ancak bu lipit parametrelerin KAH riskini oluşturmadaki miktarı ise hala tartışma- lıdır. Biz bu çalışmada KAH riskini değerlendirebilmek için geliştirdiğimiz CHOLINDEX ismindeki yeni indeksin güvenilirliğini araştırmayı amaçladık. Yöntemler: Koroner anjiyografisi yapılan 307 hasta (190 erkek ve 117 kadın, yaşları 26-80 yıl arası, ortalama 53.6±10.2 yıl) çalışmaya alındı. Tüm hastaların risk faktörleri ve lipit değerleri kaydedildi. CHOLINDEX aşağıdaki formül kullanılarak hesaplandı: CHOLINDEX=LDL-K–HDL-K (TG