Öz
Amaç
Bu çalışmada, acil serviste akut koroner sendrom ön tanısıyla izlenen hastalarda, normal referans aralığı içindeki kardiyak troponin I (cTnI) düzeylerindeki değişimlerin (delta troponin) 30 günlük mortalite ve ölümcül olmayan majör kardiyak olaylar (MACE) üzerindeki etkisini araştırmayı amaçladık.
Yöntem
Bu çalışmaya, etik kurul onayı alındıktan sonra göğüs ağrısı ve/veya ilişkili semptomlar ile acil servise başvuran, seri cTnI takibi yapılan ve ölçülen cTnI ≤0,05 ng/mL olan hasta grubu geriye dönük olarak alındı. Hastalar delta troponin olan ve olmayan şeklinde iki gruba ayrıldı ve 30 günlük mortalite ve mortalite dışı MACE ile ilişkili durumları incelendi.
Bulgular
Delta cTnI pozitif olan grupta olmayan gruba göre mortalite dışı MACE riski daha yüksek bulundu (p<0,001). Kardiyak tipte göğüs ağrısı ve elektrokardiyogramda iskemik ST segment değişikliğinin olması, hasta özgeçmişinde hipertansiyon, diabet, hiperlipidemi ve koroner arter hastalığı öyküsünün olması, 30 günlük mortalite ve mortalite dışı MACE riskini anlamlı olarak artırdı. Benzer anlamlılık hasta yaşı arttıkça da görüldü.
Sonuç
Çalışmamız bulguları, 99 persantil altındaki delta troponin değişiminin 30 günlük mortalite ve mortalite dışı MACE riski üzerinde etkisinin anlamlı olduğunu gösterdi.
Anahtar Kelimeler: 99 persantil, delta troponin, göğüs ağrısı, mortalite, majör kardiyak olay
Kaynakça
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