Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2013
Student: HASAN ATA BOLAYIR
Supervisor: NURİ BÜLENT BOYACI
Abstract:Aim: Recently, the deaths related to cardiovascular diseases are responsible approximately half of all deaths in developed countries and quarter of all deaths in developing countries. Inflammation plays an important role in development of atherosclerotic vessel disease. So that; in our study, to examine the effect of proinflammatory and antiinflammatory cytokines on the progression of atherosclerotic coronary artery disease, firstly we aim to show that presence of traditionally risk factors (hypertension, diabetes mellitus, smoking and hiperlipidemia) that are under controlled by medical treatment can cause accretion of serum oxidized LDL and hs-CRP levels. Secondly we aim to show that, in this oxidative environment that is proved to be formed, disequilibrium between IL-12 and TGF-Beta1 can determine the progression of atherosclerosis and extent of atherosclerotic coronary artery disease. Method: Eighty patients, over twenty five years old, who applied between December 2011-December 2012 to Gazi University Hospital Cardiology Policlinic because of typically characterized chest pain and who have at least one traditionally risk factor and had positive exercise test or myocardial perfusion scintigraphy including evidence of ischemia and finally have been performed coronary angiography because of these reasons are included our study. Traditional risk factor(s) present in patients should be under controlled by medical therapy and patients who had acut coronary syndrome were excluded from this study. Findings: Patients were seperated into three groups according to their CASS 20 scores as patients had no atherosclerotic lesion, patients had low grade extend of atherosclerosis and patients had high grade extend of atherosclerosis. There was no significant differance between the groups in terms of characteristic and demographic properties. While the extend of atherosclerosis increased, average of serum oxidized LDL levels (73,6±3,24 / 144,4±4,45 / 243±9,3 ng/ml), average of serum hs-CRP levels (4,21±0,25 / 11,1±0,2 / 17,7±0,32 mg/lt) and average of serum IL-12 levels (3,33±0,15 / 9,70±0,22 / 23,60±0,46 pg/ml) increased too, average of serum TGF-Beta1 levels (32,1±0,59 / 18±0,28 / 6,74±0,42 ng/ml) decreased, contrastly. This synergy was statistically meaningful. Result: We have shown that even with medical treatment under control, presence of traditional risk factors can elevate serum oxidized LDL and hs-CRP levels and this accretion is compatible with extent of atherosclerotic coronary artery disease. In this way, presence of oxidative and inflammatory environment has been argued and we have shown that in this environment the dominant cytokine in related vessel intima designates the attendant of atherosclerosis. While the proinflammatory cytokines that are secreted by T helper cells are proatherogenic, the antiinflammatory cytokines, like TGF-Beta1 secreted by Treg cells, are antiatherogenic.