Mustafa ÇETİN, Sinan Altan KOCAMAN, Murtaza Emre DURAKOĞLUGİL, Aytun ÇANGA, Yüksel ÇİÇEK, Özgür AKGÜL, Mehmet GÜL, Turan ERDOĞAN

Alanin Aminotransferaz Düzeyleri ve Monosit Sayısı Primer Perkutan Koroner Girişim ile Başarılı TIMI-3 Koroner Akım Sağlanan ST Yükselmeli Miyokard İnfarktüsünde 30 Günlük Sonuçları Bağımsız Olarak Öngörür

Amaç: Primer perkutan koroner girişim (p-PKG) ile başarılı TIMI-3 koroner akım sağlananhastalarda 30 günlük sonuçlar ile kardiyak enzimlerin yanında değişik hematolojik vebiyokimyasal parametreler arasındaki ilişkinin araştırılması amaçlandı.Materyal ve metod: Çalışmaya daha önceden miyokard infarktüsü geçirmeyen, p-PKGuygulanan ve TIMI-3 koroner akım sağlanan ST yükselmeli miyokart enfarktüslü (STYMI) 200hasta alındı. Çalışmanın birincil son noktası bileşik ölüm, ölümcül ve ölümcül olmayanmiyokard infarktüsü, hedef damara tekrar girişim ve serebrovasküler olaydı. Bulgular: Çok değişkenli analizde birincil son noktanın bağımsız öngörücüleri olarak sadecealanin aminotransferaz konsantrasyonu (OR: 1.010, 95% CI: 1.003-1.018, P = 0.008), monositsayısı (OR: 1.002, 95% CI: 1.001 - 1.004, P = 0.005), hipertansiyon (OR: 3.010, 95% CI: 1.081- 8.384, p = 0.035) ve düşük sol ventrikül ejeksiyon fraksiyonu (OR: 0.926, 95% CI: 0.875 0.981, P = 0.008) bulundu.Sonuç: Hipertansiyon ve düşük sol ventrikül ejeksiyon fraksiyonu kadar serum alaninaminotransferaz düzeyi olarak tanımlanan yükselmiş karaciğer enzimleri ve monosit sayısı pPKG ile başarılı koroner akım sağlanan hastalarda 30 günlük sonuçları bağımsız olarak öngördü.Bu parametreler akut vasküler olayların patofizyolojisini ve prognozunu anlamak için yeni bakışaçısı sağlayabilir.Bu da yeni tedavi seçeneklerinin bulunmasını kolaylaştırabilir

Anahtar Kelimeler:

Miyokart enfarktüsü, Karaciğer enzimleri, Alanin aminotransferaz, Monosit sayısı, Primer PKG, Major istenmeyen kardiyak olaylar

ALANINE AMINOTRANSFERASE LEVELS AND MONOCYTE COUNT INDEPENDENTLY PREDICT 30-DAY OUTCOMES IN ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS WITH SUCCESSFULLY RESTORED CORONARY TIMI-3 FLOW BY PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Aim: To investigate the relationship of various hematological and biochemical parametersbesides the cardiac enzymes with 30-day outcomes in patients with successfully restoredcoronary TIMI-3 flow by primary percutaneous coronary intervention (p-PCI).Materials and methods: Two hundred patients with ST elevation myocardial infarction(STEMI), with no history of prior myocardial infarction (MI), who underwent p-PCI and hadTIMI-3 flow, were enrolled, consecutively. The primary endpoint of the study was defined asthe composite of death, fatal and non-fatal MI, target vessel revascularization andcerebrovascular event.Results: Only ALT concentration (OR: 1.010, 95% CI: 1.003-1.018, P = 0.008), monocytecount (OR: 1.002, 95% CI: 1.001 - 1.004, P = 0.005), hypertension (OR: 3.010, 95% CI: 1.081- 8.384, p = 0.035) and lower LVEF (OR: 0.926, 95% CI: 0.875 - 0.981, P = 0.008) wereindependent predictors of primary endpoint in multivariate logistic regression analysis.Conclusion: We found that elevated liver enzymes as determined by serum Alanineaminotransferase levels and monocyte count as well as hypertension and lower LVEFindependently predicted 30-day outcomes in patients with successfully restored coronary flowby p-PCI. These parameters may provide new aspects, to identify the pathophysiology andprognosis of acute vascular events, which in turn may facilitate discovery of new treatmentmodalities

Keywords:

STEMI, Liver enzymes, Alanine aminotransferase, Monocyte count, Primary PCI, Major adverse cardiac events,

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