You are here

Aterosklerozis prevalansı ile Hepatit B Virüs seropozitifliği arasındaki C-Reaktif Protein bağlantılı ilişki

Relatıonshıp between Hepatitis B Virus seropositivity and atherosclerosıs through C-Reactıve Protein

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Objective: To determine the relation between coronary artery disease and immunoglobulin G type anti-HBs antibodies in detecting chronic inflammation through C-reactive protein. Material and Method: This study was performed between June 2001 and May 2004. A total of 320 cases with chest pain, suspected coronary artery disease existed during non-invasive tests and the patients, coronary angiography were applied; were included in the study. Results: The ratio of the patients who were seropositive for anti-HBs was 43% (n:138), 57% of them (n:182) were found to be negative. 59.4% of patients (n:190) had angiographic evidence of coronary artery disease during the coronary angiography assessment. 73% of these 190 patients (n:138) who were angiographically diagnosed as coronary artery disease, CRP>0,5 mg/dl; whereas 60% of the 130 patients (n:78) who were not diagnosed as coronary artery disease, CRP>0.5 mg/dl (p:0.018). 60% of the anti-HBs seropositive 138 patients (n:83), and %60 of the anti-HBs seronegative 182 patients (n:109) were angiographically diagnosed as coronary artery disease. Conclusion: As the amount of antibody synthesis during chronic hepatitis B infection is quite high, its contribution to the formation of atherosclerotic plaque is meaningful. Connection between hepatitis A seropositivity and coronary artery disease can not seen between hepatitis B seropositivity and coronary artery disease (such as found in this study results). This is because of the prevalance of hepatitis A in the society is nearly two times more than the prevalance of hepatitis B.
Abstract (Original Language): 
Amaç: Koroner arter hastalığı ile immunglobulin G tipi anti-HBs antikorlar arasındaki ilişkiyi kronik inflamasyonun saptanması açısından C-reaktif protein aracılığı ile saptamak. Gereç ve Yöntem: Çalışma, 2001 Haziran-2004 Mayıs tarihleri arasında yapılmış olup; gögüs ağrısı olan veya non-invaziv testlerde koroner arter hastalığı şüphesi bulunan, koroner anjiyografi yapılmış, toplam 320 olgu çalışmaya dahil edilmiştir. Bulgular: Hastaların %43’ünde (n:138) anti-HBs seropozitifliği mevcut iken, %57’sinde (n:182) negatif olarak bulunmuştur. Koroner anjiyografi değerlendirmesinde, %59,4’ünde (n:190) koroner arter hastalığının anjiyografik kanıtları mevcuttur. Anjiyografik koroner arter hastalığı tanılı 190 hastanın %73’ünde (n:139) CRP>0.5 mg/dl saptanırken, tanı almayan 130 hastanın %60’ında (n:80) CRP>0,5 mg/dl saptanmıştır (p:0.018). Anti-HBs seropozitifliği saptanan 138 hastanın %60’ında (n:83), 182 anti-HBs seronegatif hastanın da %60’ında (n:109) anjiyografik koroner arter hastalığı tanısı konulmuştur. Sonuç: Kronik hepatit B enfeksiyonu esnasındaki antikor sentezi daha yüksek miktarda olduğundan aterosklerotik plak oluşumuna katkısı daha anlamlı olacaktır. Hepatit A seropozitifliği ile koroner arter hastalığı arasındaki bağlantının, hepatit B ile koroner arter hastalığı arasında saptanamamasının (çalışmamızda saptanan sonuç gibi) sebebi, toplumda hepatit A prevalansının hepatit B prevalansına oranla yaklaşık iki kat daha fazla olmasına bağlanmaktadır.
1-4

REFERENCES

References: 

1. National Center for Health Statistics. Annual summary
of births, marriages, divorces, and deaths, United
States, 1994. Monthly Vital Stat Rep 1995;43(13):1-41.
2. Gordon T, Kannel WB. Premature mortality from
coronary heart disease. The Framingham study. JAMA
1971; 215(10):1617-1625.
3. Fuster V, Badimon L,Badimon JJ, Chesebro JH. The
pathogenesis of coronary artery disease and the acute
coronary syndromes (1). N Engl J Med 1992;
326(4):242-250.
4. Ross R. The pathogenesis of atherosclerosis-un update.
N Engl J Med 1986; 314(8):488-500.
5. Alexander RW. Inflammation and coronary artery
disease. N Engl J Med 1994; 331(7):468-469.
6. Ernst E. Fibrinogen as a cardiovascular risk factor:
interrelationship with infections and inflammation. Eur
Heart J 1993; 14:82-87.
7. Thompson SG, Kienast J, Pyke SD, Haverkate F, van
de Loo JC. Hemostatic factors and the risk of
myocardial infarction or sudden death in patients with
angina pectoris. N Engl J Med 1995; 332(10):635-641.
8. Kuller LH, Tracy RP, Shaten J, Meilahn EN. Relation
of C-reactive protein and coronary hearth disease in
the MRFIT nested case-control study. Am J Epidemiol
1996; 144(6):537-547.
9. Haverkate F, Thompson SG,Pyke SD, Gallimore JR,
Pepys MB. Production of C-reactive protein and risk of
coronary events in stable and unstable angina. Lancet
1997; 349(9050):462-466.
10. Libby P, Egan D, Skarlatos S. Roles of infectious
agents in atherosclerosis and restenosis. Circulation
1997; 96(11):4095-4103.
11. Danesh J, Collins R, Peto R. Chronic infections and
coronary heart disease: is there a link? Lancet 1997;
350(9075):430-436.
12. Grayston JT, Campbell LA, Kuo CC, et al. A new
respiratory tract pathogen: Chlamydia pneumoniae
strain TWAR. J Infect Dis 1990; 161(4):618-625.
13. Zhu J, Quyyumi AA, Norman JE, Csako G, Epstein SE.
Cytomegalovirus in the pathogenesis of atherosclerosis:
the role of inflammation as reflected by elevated Creactive
protein levels. J Am Coll Cardiol 1999;
34(6):1738-1743.
14. Mendall MA, Goggin PM, Molineaux N, et al. Relation
of Helicobacter pylori infection and coronary hearth
disease. Br Heart J 1994; 71(5):437-439.
15. Zhu J, Quyyumi AA, Norman JE, Costello R, Csako G,
Epstein SE. The possible role of hepatitis A virus in the
pathogenesis of atherosclerosis. J Infect Dis 2000;
182(6):1583-1587.
16. Kılıçturgay K, Badur S (Eds). Viral Hepatit 2001. Viral
Hepatitle Savaş Derneği, Deniz Ofset, Ankara, 2001
17. Harrison TJ, Dusheiko GM, Zuckerman AJ. Hepatitis
viruses. In Zuckerman AJ, Banatvala JE, Pattison JE
(eds). Principles and Practice of Clinical Virology. 4th
ed. John Wiley and Sons Ltd, West Sussex, England,
2000: 187-233.
18. Quyyumi AA, Dakak N, Mulcahy D, et al. Nitric oxide
activity in the atherosclerotic human coronary
circulation. J Am Coll Cardiol 1997; 29(2):308-317.
19. Thom DH, Grayston JT, Siscovick DS, Wang SP,
Weiss NS, Daling JR. Association of prior infection
with Chlamydia pneumoniae and angiographycally
demonstrated coronary artery disease. JAMA 1992;
268(1):68-72.
20. Saikku P, Leinonen M, Mattila K, et al. Serological
evidence of an association of a novel Chlamydia,
TWAR, with chronic coronary heart disease and acute
myocardial infarction. Lancet 1988; 2(8618):983-986.
21. Adam E, Melnick JL, Probtsfield JL, et al. High levels
of cytomegalovirus antibody in patients requiring
vascular surgery for atherosclerosis. Lancet 1987;
2:291-293.
22. Mendall MA, Goggin PM, Molineaux N, et al. Relation
of Helicobacter pylori infection and coronary hearth
disease. Br Heart J 1994; 71(5):437-439.
23. Yamashiroya HM, Ghosh L, Yang R, Robertson AL Jr.
Herpesviridae in the coronary arteries and aorta of
young trauma victims. Am J Pathol 1998; 130(1):71-
79.
24. ECAT angina pectoris study: baseline associations of
haemostatic factors with extent of coronary risk factors
in 3000 patients with angina pectoris undergoing
coronary angiography. Eur Heart J 1993; 14(1):8-17.
25. Zhu J, Shearer GM, Norman JE, et al. Host response to
cytomegalovirus infection as a determinant of
susceptibility to coronary artery disease: sex-based
differences in inflammation and type of immune
response. Circulation 2000; 102(20):2491-2496.
26. Ishizaka N, Ishizaka Y, Takahashi E, et al. Increased
prevalence of carotid atherosclerosis in Hepatitis B
virus carries. Circulation 2002; 105(9):1028-1030.
İletişim:
Uzm.Dr. Hüseyin Can
11 no.’lu Aile Sağlığı Merkezi, Batman, Türkiye
Tel: +90.530.692 7878
e-mail: mdhuseyincannlp@gmail.com

Thank you for copying data from http://www.arastirmax.com