Does the prevalence of subclinical coronary atherosclerosis increase in primary hyperparathyroidism; coronary flow reserve and plasma aterogenic index in patients with primary hyperparathyroidism?
Öz
Aims: The coronary flow reserve (CFR) is a sign of early-stage coronary artery disease (CAD). Plasma atherogenic index (PAI) is related to atherosclerosis and cardiovascular mortality. Therefore, our aim was to determine CFR and PAI in patients with primary hyperparathyroidism (PHPT) and investigate whether PAI can be used in the detection of early-stage CAD.
Methods: The sample was comprised of 44 patients with PTHT and 33 healthy volunteers. We defined CFR as the ratio of the hyperemic diastolic peak velocity to the baseline diastolic peak velocity. PAI values were calculated with the formula of log 10 triglyceride (TRG)/high-density lipoprotein (HDL).
Results: The comparison of the groups for PAI and CFR demonstrated that PAI levels were significantly higher while CFR levels were significantly lower in the PTHT patients (p<0.01, p=0.01, respectively). The correlation analysis revealed that CFR was negatively correlated with PAI and TRG (PAI- p<0.0001 r=-0.537). The multivariate logistic regression analysis showed that only a high PAI level (OR: 151.6, 95% confidence interval (CI): 4.1-5480, p=0.006) was an independent predictor of reduction in CFR in PHPT patients.
Conclusion: Overall, we found an independent correlation between PAI and CFR values. Hence, PAI may be useful in identifying PHPT patients facing a high risk of adverse cardiovascular events and may also allow early diagnosis of subclinical atherosclerosis.
Anahtar Kelimeler
Primary hyperparathyroidism plasma atherogenic index atherosclerosis coronary flow reserve
Kaynakça
- Boonen S, Bouillon R, Fagard K, Mullens A, Vlayen J, Vanderschueren D. Primary hyperparathyroidism: pathophysiology, diagnosis and indications for surgery. Acta Oto-Rhino-Laryngol Belg. 2001;55(2):119-127.
- Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997;121(3):287-294.
- Palmér M, Jakobsson S, Akerström G, Ljunghall S. Prevalence of hypercalcemia in a health survey: a 14-year follow-up study of serum calcium values. Eur J Clin Invest. 1998;18(1):39-46.
- Silverberg SJ, Bilezikian JP. Hyperparathyroidism. In: Becker KL, eds. Principles and practice of endocrinology and metabolism. 3rd ed. Lipincott Williams and Wilkins: 2001:564-573.
- Walker MD, Silverberg SJ. Cardiovascular aspects of primary hyperparathyroidism. J Endocrinol Invest. 2008;31(10):925-931.
- Caiati C, Zedda N, Montaldo C, Montisci R, Iliceto S. Contrast enhanced transthoracic second harmonic echo Doppler with adenosine: a noninvasive, rapid and effective method for coronary flow reserve assessment. J Am Coll Cardiol. 1999;34(1):122-130.
- Britten MB, Zeiher AM, Schachinger V. Microvascular dysfunction in angiographically normal or mildly diseased coronary arteries predicts adverse cardiovascular long-term outcome. Coron Artery Dis. 2004;15(5):259-264.
- Montisci R, Marchetti MF, Ruscazio M, et al. Non-invasive coronary flow velocity reserve assessment predicts adverse outcome in women with unstable angina without obstructive coronary artery stenosis. J Public Health Res. 2023;12(2):22799036231181716.
- Picano E. Stress echocardiography: a historical perspective. Am J Med. 2003;114(2):126-130.
- Won KB, Heo R, Park HB, et al. Atherogenic index of plasma and the risk of rapid progression of coronary atherosclerosis beyond traditional risk factors. Atherosclerosis. 2021;324:46-51.
- Hong SP, Kim CY, Jung HW. The comparison of the associations of lipoprotein(a) and the atherogenic index of plasma with coronary artery calcification in patients without high LDL-C: a comparative analysis. J Lipid Atheroscler. 2023;12(2):152-163.
- Zheng Y, Li C, Yang J, et al. Atherogenic index of plasma for non-diabetic, coronary artery disease patients after percutaneous coronary intervention: a prospective study of the long-term outcomes in China. Cardiovasc Diabetol. 2022;21(1):29.
- Onat A, Can G, Kaya H, Hergenç G. “Atherogenic index of plasma” (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. J Clin Lipidol. 2010;4(2):89-98.
- Edwards MK, Blaha MJ, Loprinzi PD. Atherogenic index of plasma and triglyceride/high-density lipoprotein cholesterol ratio predict mortality risk better than individual cholesterol risk factors, among an older adult population. Mayo Clin Proc. 2017;92(4):680-681.
- Caliskan M, Erdogan D, Gullu H, et al. Effects of atorvastatin on coronary flow reserve in patients with slow coronary flow. Clin Cardiol. 2007;30(9):475-479.
- Yu N, Donnan PT, Flynn RW, et al. Increased mortality and morbidity in mild primary hyperparathyroid patients. The Parathyroid Epidemiology and Audit Research Study (PEARS). Clin Endocrinol (Oxf). 2010;73(1):30-34.
- Leifsson BG, Ahren B. Serum calcium and survival in a large health screening program. J Clin Endocrinol Metab. 1996;81(6):2149-2153.
- Nilsson IL, Aberg J, Rastad J, Lind L. Endothelial vasodilatory dysfunction in primary hyperparathyroidism is reversed after parathyroidectomy. Surgery. 1999;126(6):1049-1055.
- Nilsson IL, Rastad J, Johansson K, Lind L. Endothelial vasodilatory function and blood pressure response to local and systemic hypercalcemia. Surgery. 2001;130(6):986-990.
- Rashid G, Bernheim J, Green J, Benchetrit S. Parathyroid hormone stimulates endothelial expression of atherosclerotic parameters through protein kinase pathways. Am J Physiol Ren Physiol. 2007;292(4):F1215-F1218.
- Wareham NJ, Byrne CD, Carr D, Day NE, Boucher BJ, Hales CN. Glucose intolerance is associated with altered calcium homeostasis: a possible link between increased serum calcium concentration and cardiovascular disease mortality. Metabolism. 1997;46(10):1171-1177.
- Hagström E, Ahlström T, Ärnlöv J, et al. Parathyroid hormone and calcium are independently associated with subclinical vascular disease in a community-based cohort. Atherosclerosis. 2015;238(2):420-426.
- Luboshitzky R, Chertok-Schaham Y, Lavi I, Ishay A. Cardiovascular risk factors in primary hyperparathyroidism. J Endocrinol Invest. 2009;32(4):317-321.
- Stamatelopoulos K, Athanasouli F, Pappa T, et al. Hemodynamic markers and subclinical atherosclerosis in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(8):2704-2711.
- Kosch M, Hausberg M, Vormbrock K, et al. Impaired flow-mediated vasodilation of the brachial artery in patients with primary hyperparathyroidism improves after parathyroidectomy. Cardiovasc Res. 2000;47(4):813-818.
- Sumbul HE, Koc AS. The abdominal aortic intima-media thickness increases in patients with primary hyperparathyroidism. Exp Clin Endocrinol Diabetes. 2019;127(6):387-395.
- Gullu H, Erdogan D, Caliskan M, et al. Interrelationship between noninvasive predictors of atherosclerosis: transthoracic coronary flow reserve, flow-mediated dilation, carotid intima-media thickness, aortic stiffness, aortic distensibility, elastic modulus, and brachial artery diameter. Echocardiography. 2006;23(10):835-842.
- Haude M, Baumgart D, Verna E, et al. Intracoronary Doppler- and quantitative coronary angiography-derived predictors of major adverse cardiac events after stent implantation. Circulation. 2001103(9):1212-1217.
- Serruys PW, di Mario C, Piek J, et al. Prognostic value of intracoronary flow velocity and diameter stenosis in assessing the short- and long-term outcomes of coronary balloon angioplasty: the DEBATE Study (Doppler Endpoints Balloon Angioplasty Trial Europe). Circulation. 1997;96(10):3369-3377.
- Lundgren E, Ljunghall S, Akerström G, Hetta J, Mallmin H, Rastad J. Case-control study on symptoms and signs of “asymptomatic” primary hyperparathyroidism. Surgery. 1998;124(6):980-985.
- Fernández-Macías JC, Ochoa-Martínez AC, Varela-Silva JA, Pérez-Maldonado IN. Atherogenic index of plasma: novel predictive biomarker for cardiovascular illnesses. Arch Med Res. 2019;50(5):285-294.
- Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcon-Braga EA, et al. Atherogenic index of plasma and coronary artery disease: a systematic review. Open Med (Wars). 2022;17(1):1915-1926.
- Shui X, Chen Z, Wen Z, et al. Association of atherogenic index of plasma with angiographic progression in patients with suspected coronary artery disease. Angiol. 2022;73(10):927-935.
- Yokoyama I, Ohtake T, Momomura S, Nishikawa J, Sasaki Y,Omata M. Reduced coronary flow reserve in hypercholesterolemic patients without overt coronary stenosis. Circulation. 1996;94(12):3232-3238.
- Lee CH, Hwang J, Kim IC, et al. Effect of atorvastatin on serial changes in coronary physiology and plaque parameters. JACC Asia. 2022;2(6):691-703.
- Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-3421.
- Kul Ş, Çalışkan Z, Güvenç TS, Güvenç RÇ, Çalışkan M. Plasma lipids in patients with inflammatory bowel disease: observations on the associations between lipid indices and coronary flow reserve. Wien Klin Wochenschr. 2020;132(11):283-294.
- Cure E, Icli A, Uslu AU, et al. Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis: AIP associate with cIMT in AS. Clin Rheumatol. 2018;37(5):1273-1280.
- Frohlich J, Dobiasova M. Fractional esterification rate of cholesterol and triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography. Clin Chem. 2003;49(11):1873-1880.
- Lundman P, Eriksson M, Schenck-Gustafsson K, Karpe F, Tornvall P. Transient triglyceridemia decreases vascular reactivity in young, healthy men without risk factors for coronaryheartdisease. Circulation. 1997;96(10):3266-3268.
- Hozumi T, Eisenberg M, Sugioka K, et al. Change in coronary flow reserve on transthoracic Doppler echocardiography after a single high-fat meal in young healthy men. Ann Intern Med. 2002;136(7):523-528.
- Uslu AU, Kucuk A, Icli A, et al. Plasma Atherogenic index is an independent indicator of subclinical atherosclerosis in systemic lupus erythematosus. Eurasian J Med. 2017;49(3):193-197.
Primer hiperparatiroidizmde subklinik koroner ateroskleroz prevalansı artar mı? primer hiperparatiroidili hastalarda koroner akım rezervi ve plazma aterojenik indeks
Öz
Amaç: Koroner akım rezervi (CFR), erken evre koroner arter hastalığının (KAH) bir belirtisidir. Plazma aterojenik indeksi (PAI), ateroskleroz ve kardiyovasküler mortalite ile ilişkilidir. Bu nedenle amacımız primer hiperparatiroidizm (PHPT) hastalarında KFR ve PAI'yi belirlemek ve PAI'nin erken evre KAH'ın tespitinde kullanılıp kullanılamayacağını araştırmaktı.
Yöntemler: Örneklemi 44 PTHT hastası ve 33 sağlıklı gönüllü oluşturdu. CFR'yi hiperemik diyastolik tepe hızının başlangıç diyastolik tepe hızına oranı olarak tanımladık. PAI değerleri log 10 trigliserit (TRG) / yüksek yoğunluklu lipoprotein (HDL) formülü ile hesaplandı.
Sonuç: PAI ve CFR açısından gruplar karşılaştırıldığında PTHT hastalarında PAI düzeyleri anlamlı olarak yüksek, CFR düzeyleri ise anlamlı olarak düşüktü (sırasıyla p<0.01, p=0.01). Korelasyon analizi, CFR'nin PAI ve TRG ile negatif korelasyon gösterdiğini ortaya çıkardı (PAI- p<0,0001 r=-0,537). Çok değişkenli lojistik regresyon analizi, yalnızca yüksek PAI düzeyinin (OR: 151,6, %95 güven aralığı (CI): 4,1-5480, p=0,006) PHPT hastalarında CFR'deki azalmanın bağımsız bir öngörücüsü olduğunu gösterdi.
Sonuç: PAI ve CFR değerleri arasında bağımsız bir korelasyon bulduk. Dolayısıyla PAI, yüksek advers kardiyovasküler olay riskiyle karşı karşıya olan PHPT hastalarının belirlenmesinde yararlı olabilir ve aynı zamanda subklinik aterosklerozun erken tanısına da olanak sağlayabilir.
Anahtar Kelimeler
Primer hiperparatiroidizm Plazma aterojenik indeks Ateroskleroz Koroner akış rezervi
Kaynakça
- Boonen S, Bouillon R, Fagard K, Mullens A, Vlayen J, Vanderschueren D. Primary hyperparathyroidism: pathophysiology, diagnosis and indications for surgery. Acta Oto-Rhino-Laryngol Belg. 2001;55(2):119-127.
- Lundgren E, Rastad J, Thrufjell E, Akerström G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women. Surgery. 1997;121(3):287-294.
- Palmér M, Jakobsson S, Akerström G, Ljunghall S. Prevalence of hypercalcemia in a health survey: a 14-year follow-up study of serum calcium values. Eur J Clin Invest. 1998;18(1):39-46.
- Silverberg SJ, Bilezikian JP. Hyperparathyroidism. In: Becker KL, eds. Principles and practice of endocrinology and metabolism. 3rd ed. Lipincott Williams and Wilkins: 2001:564-573.
- Walker MD, Silverberg SJ. Cardiovascular aspects of primary hyperparathyroidism. J Endocrinol Invest. 2008;31(10):925-931.
- Caiati C, Zedda N, Montaldo C, Montisci R, Iliceto S. Contrast enhanced transthoracic second harmonic echo Doppler with adenosine: a noninvasive, rapid and effective method for coronary flow reserve assessment. J Am Coll Cardiol. 1999;34(1):122-130.
- Britten MB, Zeiher AM, Schachinger V. Microvascular dysfunction in angiographically normal or mildly diseased coronary arteries predicts adverse cardiovascular long-term outcome. Coron Artery Dis. 2004;15(5):259-264.
- Montisci R, Marchetti MF, Ruscazio M, et al. Non-invasive coronary flow velocity reserve assessment predicts adverse outcome in women with unstable angina without obstructive coronary artery stenosis. J Public Health Res. 2023;12(2):22799036231181716.
- Picano E. Stress echocardiography: a historical perspective. Am J Med. 2003;114(2):126-130.
- Won KB, Heo R, Park HB, et al. Atherogenic index of plasma and the risk of rapid progression of coronary atherosclerosis beyond traditional risk factors. Atherosclerosis. 2021;324:46-51.
- Hong SP, Kim CY, Jung HW. The comparison of the associations of lipoprotein(a) and the atherogenic index of plasma with coronary artery calcification in patients without high LDL-C: a comparative analysis. J Lipid Atheroscler. 2023;12(2):152-163.
- Zheng Y, Li C, Yang J, et al. Atherogenic index of plasma for non-diabetic, coronary artery disease patients after percutaneous coronary intervention: a prospective study of the long-term outcomes in China. Cardiovasc Diabetol. 2022;21(1):29.
- Onat A, Can G, Kaya H, Hergenç G. “Atherogenic index of plasma” (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. J Clin Lipidol. 2010;4(2):89-98.
- Edwards MK, Blaha MJ, Loprinzi PD. Atherogenic index of plasma and triglyceride/high-density lipoprotein cholesterol ratio predict mortality risk better than individual cholesterol risk factors, among an older adult population. Mayo Clin Proc. 2017;92(4):680-681.
- Caliskan M, Erdogan D, Gullu H, et al. Effects of atorvastatin on coronary flow reserve in patients with slow coronary flow. Clin Cardiol. 2007;30(9):475-479.
- Yu N, Donnan PT, Flynn RW, et al. Increased mortality and morbidity in mild primary hyperparathyroid patients. The Parathyroid Epidemiology and Audit Research Study (PEARS). Clin Endocrinol (Oxf). 2010;73(1):30-34.
- Leifsson BG, Ahren B. Serum calcium and survival in a large health screening program. J Clin Endocrinol Metab. 1996;81(6):2149-2153.
- Nilsson IL, Aberg J, Rastad J, Lind L. Endothelial vasodilatory dysfunction in primary hyperparathyroidism is reversed after parathyroidectomy. Surgery. 1999;126(6):1049-1055.
- Nilsson IL, Rastad J, Johansson K, Lind L. Endothelial vasodilatory function and blood pressure response to local and systemic hypercalcemia. Surgery. 2001;130(6):986-990.
- Rashid G, Bernheim J, Green J, Benchetrit S. Parathyroid hormone stimulates endothelial expression of atherosclerotic parameters through protein kinase pathways. Am J Physiol Ren Physiol. 2007;292(4):F1215-F1218.
- Wareham NJ, Byrne CD, Carr D, Day NE, Boucher BJ, Hales CN. Glucose intolerance is associated with altered calcium homeostasis: a possible link between increased serum calcium concentration and cardiovascular disease mortality. Metabolism. 1997;46(10):1171-1177.
- Hagström E, Ahlström T, Ärnlöv J, et al. Parathyroid hormone and calcium are independently associated with subclinical vascular disease in a community-based cohort. Atherosclerosis. 2015;238(2):420-426.
- Luboshitzky R, Chertok-Schaham Y, Lavi I, Ishay A. Cardiovascular risk factors in primary hyperparathyroidism. J Endocrinol Invest. 2009;32(4):317-321.
- Stamatelopoulos K, Athanasouli F, Pappa T, et al. Hemodynamic markers and subclinical atherosclerosis in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(8):2704-2711.
- Kosch M, Hausberg M, Vormbrock K, et al. Impaired flow-mediated vasodilation of the brachial artery in patients with primary hyperparathyroidism improves after parathyroidectomy. Cardiovasc Res. 2000;47(4):813-818.
- Sumbul HE, Koc AS. The abdominal aortic intima-media thickness increases in patients with primary hyperparathyroidism. Exp Clin Endocrinol Diabetes. 2019;127(6):387-395.
- Gullu H, Erdogan D, Caliskan M, et al. Interrelationship between noninvasive predictors of atherosclerosis: transthoracic coronary flow reserve, flow-mediated dilation, carotid intima-media thickness, aortic stiffness, aortic distensibility, elastic modulus, and brachial artery diameter. Echocardiography. 2006;23(10):835-842.
- Haude M, Baumgart D, Verna E, et al. Intracoronary Doppler- and quantitative coronary angiography-derived predictors of major adverse cardiac events after stent implantation. Circulation. 2001103(9):1212-1217.
- Serruys PW, di Mario C, Piek J, et al. Prognostic value of intracoronary flow velocity and diameter stenosis in assessing the short- and long-term outcomes of coronary balloon angioplasty: the DEBATE Study (Doppler Endpoints Balloon Angioplasty Trial Europe). Circulation. 1997;96(10):3369-3377.
- Lundgren E, Ljunghall S, Akerström G, Hetta J, Mallmin H, Rastad J. Case-control study on symptoms and signs of “asymptomatic” primary hyperparathyroidism. Surgery. 1998;124(6):980-985.
- Fernández-Macías JC, Ochoa-Martínez AC, Varela-Silva JA, Pérez-Maldonado IN. Atherogenic index of plasma: novel predictive biomarker for cardiovascular illnesses. Arch Med Res. 2019;50(5):285-294.
- Ulloque-Badaracco JR, Hernandez-Bustamante EA, Alarcon-Braga EA, et al. Atherogenic index of plasma and coronary artery disease: a systematic review. Open Med (Wars). 2022;17(1):1915-1926.
- Shui X, Chen Z, Wen Z, et al. Association of atherogenic index of plasma with angiographic progression in patients with suspected coronary artery disease. Angiol. 2022;73(10):927-935.
- Yokoyama I, Ohtake T, Momomura S, Nishikawa J, Sasaki Y,Omata M. Reduced coronary flow reserve in hypercholesterolemic patients without overt coronary stenosis. Circulation. 1996;94(12):3232-3238.
- Lee CH, Hwang J, Kim IC, et al. Effect of atorvastatin on serial changes in coronary physiology and plaque parameters. JACC Asia. 2022;2(6):691-703.
- Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-3421.
- Kul Ş, Çalışkan Z, Güvenç TS, Güvenç RÇ, Çalışkan M. Plasma lipids in patients with inflammatory bowel disease: observations on the associations between lipid indices and coronary flow reserve. Wien Klin Wochenschr. 2020;132(11):283-294.
- Cure E, Icli A, Uslu AU, et al. Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis: AIP associate with cIMT in AS. Clin Rheumatol. 2018;37(5):1273-1280.
- Frohlich J, Dobiasova M. Fractional esterification rate of cholesterol and triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography. Clin Chem. 2003;49(11):1873-1880.
- Lundman P, Eriksson M, Schenck-Gustafsson K, Karpe F, Tornvall P. Transient triglyceridemia decreases vascular reactivity in young, healthy men without risk factors for coronaryheartdisease. Circulation. 1997;96(10):3266-3268.
- Hozumi T, Eisenberg M, Sugioka K, et al. Change in coronary flow reserve on transthoracic Doppler echocardiography after a single high-fat meal in young healthy men. Ann Intern Med. 2002;136(7):523-528.
- Uslu AU, Kucuk A, Icli A, et al. Plasma Atherogenic index is an independent indicator of subclinical atherosclerosis in systemic lupus erythematosus. Eurasian J Med. 2017;49(3):193-197.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Kardiyoloji |
| Bölüm | Research Articles [en] Araştırma Makaleleri [tr] |
| Yazarlar | |
| Yayımlanma Tarihi | 29 Şubat 2024 |
| Gönderilme Tarihi | 11 Aralık 2023 |
| Kabul Tarihi | 18 Ocak 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 5 Sayı: 1 |
Kaynak Göster
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