Assessment of the Relatıonshıp Between the Adropın Levels and the Coronary Collateral Cırculatıon in Patıents wıth Chronıc Coronary Syndrome

Abstract Background Coronary collateral circulation (CCC) provides an alternative blood flow to myocardial tissue exposed to ischemia and helps to preserve myocardial functions. Endothelial-derived nitric-oxide (NO) production and vascular endothelial growth factor (VEGF) have been suggested as the most important factors in the development of CCC. Adropin is a peptide hormone responsible for energy hemostasis, and is known for its positive effects on the endothelium through NO and VEGF. Objective The aim of this study is to investigate the association between adropin and the presence of CCC in patients with chronic coronary syndrome (CCS). Methods A total of 102 patients with CCS, who had complete occlusion of at least one major epicardial coronary artery, were included in the study and were divided into two groups: the group of patients (n:50) with poor CCC (Rentrop 0-1) and the group of patients (n:52) with good CCC (Rentrop 2-3). The level of significance adopted in the statistical analysis was 5%. Results Mean adropine levels were found as 210.83±17.76 pg/mL and 268.25±28.94 pg/mL in the poor and good CCC groups, respectively (p<0.001). Adropin levels proved to be positively correlated with neutrophil-to-lymphocyte ratios (r:0.17, p:0.04) and the rentrop scores (r:0.76, p<0.001), and negatively correlated with age (r:-0.23, p:0.01) and Gensini scores (r:-0.19, p:0.02). Adropin level is a strong independent predictor of good CCC development (OR:1.12, 95% CI:(1.06–1.18), p<0.001). Conclusion This study suggests that adropin levels may be a possible factor associated with the presence of CCC in CCS patients.

摘要 背景
冠状动脉侧支循环（Coronary collateral circulation, CCC）可为处于缺血状态的心肌组织提供替代性血流，有助于维持心肌功能。内皮源性一氧化氮（endothelial-derived nitric-oxide, NO）的生成与血管内皮生长因子（vascular endothelial growth factor, VEGF）被认为是CCC形成过程中最为关键的调控因素。Adropin是一种参与能量稳态调控的肽类激素，其可通过NO与VEGF途径对内皮细胞发挥正向调控作用。
目的
本研究旨在探讨慢性冠状动脉综合征（chronic coronary syndrome, CCS）患者体内adropin水平与CCC形成情况的相关性。
方法
本研究共纳入102例确诊CCS且至少一支主要心外膜冠状动脉完全闭塞的患者，将其分为两组：CCC不良组（n=50，Rentrop分级0~1级）与CCC良好组（n=52，Rentrop分级2~3级）。本研究统计分析采用的显著性水平为5%。
结果
不良CCC组与良好CCC组患者的平均adropin水平分别为210.83±17.76 pg/mL与268.25±28.94 pg/mL（p<0.001）。相关性分析显示，adropin水平与中性粒细胞与淋巴细胞比值（r=0.17，p=0.04）、Rentrop评分（r=0.76，p<0.001）呈正相关，与年龄（r=-0.23，p=0.01）及Gensini评分（r=-0.19，p=0.02）呈负相关。Adropin水平是良好CCC形成的强独立预测因子（优势比OR=1.12，95%置信区间CI：1.06~1.18，p<0.001）。
结论
本研究结果表明，adropin水平或可作为CCS患者CCC形成情况的潜在相关因素。