ST YÜKSEKLİĞİ OLMAYAN MİYOKARD ENFARKTÜSÜ OLAN HASTALARDA GRACE SKORU YERİNE YAŞ-MODİFİYE ŞOK İNDEKSİ

Giriş: Kan basıncı ve kalp hızı ile bu parametrelerden türetilen şok indeksi ve modifiye şok indeksi, akut miyokard enfarktüsü geçiren hastalarda olumsuz sonuçları tahmin etmek için kapsamlı bir şekilde incelenmiştir. Yaş şok indeksi ve yaşa göre modifiye edilmiş şok indeksi, kan basıncını ve kalp atış hızını hesaplamalarına dahil eden ve böylece akut miyokard enfarktüsü hastalarında tek başına her bir kalp atış hızının ve kan basıncının öngörü değerini iyileştiren iki yeni ortaya çıkan parametredir. Amaç: NSTEMI ile başvuran hastalarda kalp hızının ortalama arter basıncına oranının yaş-modifiye şok indeksinin (Age MSI) kullanımı zor GRACE skoruna tercih edilip edilemeyeceğini değerlendirmeyi amaçladık. Yöntemler: Bu retrospektif çalışma, Temmuz 2019 ile Aralık 2022 tarihleri arasında, başvuru sırasında kardiyojenik şokta olmayan NSTEMI tanısı alan 495 hastayı içeren tek bir merkezde gerçekleştirildi. Bulgular: GRACE skoru ile başvuru age MSI arasında çok iyi bir korelasyon bulundu (r: 0,752, p<0,001; AUC:0,865, p<0,001 GA %95: 0,831-0,901, cutoff : 51,0, Sensitivity %88, Spesifisite %89). Sonuçlar: Tek başına age-MSI, PCI uygulanan NSTEMI hastalarında yüksek GRACE skoru olan hastaları belirleyebilir. Ayrıca yüksek GRACE skorlu hastaları öngörmede SI, MSI ve Age SI'dan daha iyidir. Ayrıca, Age MSI'ın hesaplanması GRACE skorundan daha kolaydır.

Anahtar Kelimeler:

yaş-modifiye şok indeksi, GRACE skoru, ST Yüksekliği Olmayan Miyokard Enfarktüsü

AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION

Background: Blood pressure and heart rate, as well as the shock index and modified shock index derived from these parameters, have been extensively studied to predict adverse outcomes in patients suffering from acute myocardial infarction.Age shock index and age modified shock index are two new emerging parameters that incorporate blood pressure and heart rate into their calculations, thereby improving the predictive value of each heart rate and blood pressure alone in acute myocardial infarction patients. Objective: We aimed to asses whether the age-modified shock index (Age MSI), the ratio of heart rate to mean arterial pressure, could be preferred over the difficult-to-use GRACE score in patients presenting with NSTEMI. Methods: This retrospective study was performed in a single center including 495 patients diagnosed with NSTEMI, without cardiogenic shock on admission, between July 2019 and December 2022. Results: A very good correlation was found between the GRACE score and the admission age MSI (r: 0.752, p<0.001; AUC:0.865, p<0.001 CI 95%: 0.831-0.901, cutoff : 51.0, Sensitivity 88%, Specificity 89%). Conclusions: Age MSI alone could identify patients with a high GRACE score in NSTEMI patients undergoing PCI. In addition, it is better than SI, MSI, and Age SI at predicting patients with high GRACE scores. However, Age MSI is easier to calculate than GRACE

Keywords:

Age modified shock index, GRACE score, Non-ST-segment elevation myocardial infarction yaş-modifiye şok indeksi, GRACE skoru, ST Yüksekliği Olmayan Miyokard Enfarktüsü,

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