Non-kardiyak iskemik inmeli hastalarda prognoz ile troponin ilişkisi

Amaç: İnme prognozunun tahmin edilebilmesi için inme şiddet ölçekleri, iskemi hacmi ve bazı biyo-belirteçler kullanılmıştır.Ulusal Sağlık İnme Skalasının (NIHSS) inme prognozu ile ilişkili olduğu bildirilmiştir. İskemi hacmi ve prognoz arasında farklıyorumlar vardır. Uzun dönem prognoz ile ilişkisi olmadığı bildirilmiştir. Ayrıca miyokard infarktüsü tanısı için çok önemli biryeri olan troponinin iskemi prognozu ile ilişkili olabileceği bildirilmiştir. Çalışmamızda yaklaşık 5 yıllık takibi yapılan nonkardiyakiskemik inmeli olgularda inme şiddeti ölçeği, iskemi hacmi ve troponin I seviyelerinin sağ kalım ile ilişkisiniincelemeyi amaçladık.Materyal ve Metod: Ocak 2012-Mart 2013 tarihleri arasında nöroloji kliniğinde non-kardiyak iskemik inme tanısı alan 18yaşından büyük hastaların dosyaları retrospektif olarak incelendi. TC. Sağlık Bakanlığı Halk Sağlığı Müdürlüğü Ölüm BildirimSistemi (https://obs.gov.tr/) üzerinden sağ kalımı değerlendirildi. NIHS sklası, inme hacmi, troponin I seviyeleri ölen ve sağhasta grupları arasında incelendi ve 5 yıllık sağ kalım ile ilişkileri değerlendirildi.Bulgular: İleri yaş, erkek cinsiyet, NIHS skalası değerleri 5 yıllık sağ kalım ile ilişkiliydi. İskemi hacmi ve Troponin I 5 yıllıksağ kalım ile ilişkili değildi.Tartışma: Literatürde iskemik inme prognozunu yansıtabileceği bildirilen troponin düzeylerinin, non-kardiyak inmelihastalarda uzun dönem prognoz tahmini için kullanılamayacağını tespit ettik. Ayrıca benzer sonuç iskemi hacmi içindegeçerlidir. Bunun yanında ileri hasta yaşının ve geliş NIHS skorlarının uzun dönem prognozu belirlemede etkin olduğunutespit ettik.

Anahtar Kelimeler:

Serebral Infarkt, Prognoz, Troponin I

Prognosis and troponin relationship in non-cardiac ischemic stroke patients

Background: Various markers such as severity scales, infarct volume and biomarkers were used to predict the strokeprognosis. National Institute of Health Stroke Scale (NIHSS) was reported to be associated with stroke prognosis whereasconflicting statements were present regarding the association of infarct volume. Volume is thought to be unrelated with longterm prognosis. Furthermore, troponin which is an important biomarker for myocardial infarction is suggested to be relatedwith stroke prognosis. In this study, we aim to investigate the relationship between factors such as NIHS scale, infarctvolume, troponin I and 5 year survival of patients with non-cardiac stroke.Material and Methods: Between January2012 and March 2013, files of patients over 18 years of age with non-cardiacstroke were investigated retrospectively. Death reporting system as a web service given by National Health Ministry(https://obs.gov.tr/) was used to determine the survival status. Data regarding the NIHS score, infarct volume and troponin Ilevels were acquired. Relationship of those factors with 5-year survival was evaluated statistically.Results: Old age, male gender and NIHS score were independently associated with 5-year survival whereas there was noassociation between troponin I and infarct volume.Conclusions: We found that troponin I which was reported as it might be associated with long term survival in patients withnon-cardiac stroke could not predict 5-year survival. Results were also same for infarct volume. Furthermore, we found thatold age and NIHS score can be used to predict the 5-year survival.

Keywords:

Cerebral infarction, Prognosis, Troponin I,

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