Çeral Efe ARACI, Murat DUYAN, Mutlu KARTAL, Erkan GÖKSU

Akut Koroner Sendrom Şüpheli Hastalarda Mortalitenin Belirlenmesinde Ultra Duyarlı Troponin-I'in Değeri

özet: Amaç: Bu çalışmada, günlük pratikte kullanılan ultra-duyarlı troponin kitlerinin referans değerinin mortaliteyi belirlemedeki rolünü araştırıldı. Gereç-yöntem: Bu çalışma 1 Ocak 2018-30 Haziran 2019 tarihleri arasında Akdeniz Üniversitesi Hastanesi acil servisinde (AS) yapılmıştır. Acil servise on sekiz ay içinde başvuran ve sonucu olan tüm hastalar 0.06-0.1 ng/mL aralığındaki ultra-duyarlı troponin düzeyi çalışmaya dahil edildi. Hastaların acil servise tekrarlayan başvuruları dahil edildi ve hastaların sadece ilk troponin değerleri çalışma için referans olarak alındı. Bulgular: Başlangıç troponin I değeri 0.06-0.1 ng/mL aralığında olan 591 hastanın 1029 troponin değerinin ölçüldüğü belirlendi. Bu hastalardan 332'sinin acil servisten taburcu edildiği, diğerlerinin ise hastaneye kaldırıldığı öğrenildi. Hastaların 168'inin (%28,43) öldüğü belirlendi. Ölen hastaların cinsiyet dağılımına bakıldığında 101 (%60,11) hastanın erkek, 67 (%39,89) hastanın kadın olduğu görüldü. Ölen hastaların yaşları (ortalama 71.38±12.25) ile yaşayan hastaların yaşları (ortalama 61.78±15.89) arasında istatistiksel olarak anlamlı fark bulundu (p<0.019). Tek değişkenli analizde pozitif troponin değerine ek olarak DM (p<0.022) ve hiperlipidemi (p<0.018) istatistiksel olarak anlamlı bulundu. Sonuç: Acil serviste çalışılan yüksek duyarlı troponin için 0.06 ng/mL'lik üst değer etkin bir şekilde mortaliteyi belirler.

Anahtar Kelimeler:

Ultra-Sensitive Troponin-I, mortalite, akut koroner sendrom

The Value Of Ultra-Sensitive Troponin-I In Determining Mortality In Patients With Suspected Acute Coronary Syndrome

Abstract: Objective: This study investigated the role of the reference value of ultra-sensitive troponin kits used in daily practice in determining mortality. Material-methods: This study was conducted in the emergency department (ED) of Akdeniz University Hospital between January 1, 2018, and June 30, 2019. All patients admitted to the emergency department within a period of eighteen months and who had the result of the ultra-sensitive troponin level in the range of 0.06-0.1 ng/mL were included in the study. The recurrent admissions of the patients to the ED were included, and only the first troponin values of the patients were taken as s reference for the study. Result: It was determined that 1029 troponin values of 591 patients with initial troponin I value in the range 0.06-0.1 ng/mL were measured. It was found that 332 of these patients were discharged from the emergency department, and the others were hospitalized. It was found that 168 (28.43%) of the patients died. Considering the gender distribution of the patients who died, it was observed that 101 (60.11%) patients were male, and 67 (39.89%) patients were female. A statistically significant difference was found between the ages of the patients who died (mean 71.38±12.25) and the age of patients alive (mean 61.78 ± 15.89) (p <0.019). In univariate analysis, in addition to the positive troponin value, DM (p<0.022) and hyperlipidemia (p<0.018) were found to be statistically significant. Conclusion: For high-sensitive troponin worked in the ED, the upper value of 0.06 ng/mL effectively determines mortality

Keywords:

Ultra-Sensitive Troponin-I, mortality, acute coronary syndrome,

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