Turab YAKIŞAN, Mehmet GÜL, Muhammet Hulusi SATILMIŞOĞLU, Abdurrahman EREN

Akut ST Segment Yükselmeli Miyokard Infarktüsü Olan Hastalarda Prokalsitonin Düzeyinin Uzun Dönem Prognostik Değeri

Giriş: Önceki çalışmalar, koroner arter hastalığı (KAH) ile prokalsitonin (PCT) seviyeleri arasında bir ilişki olduğunu göstermişti. ST segment yükselmeli miyokard infarktüsü (STEMI) olan hastalarda PCT düzeyleri ile uzun dönem majör kardiyovasküler olaylar (MACE) ve tüm nedenlere bağlı mortalite arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntem: Hastalar serum PCT değerlerine göre iki gruba ayrıldı. PCT düzeyi 0.05 ng / ml olanlar yüksek PCT grubu (n=87) olarak kabul edildi. MACE, kardiyovasküler mortalite, reinfarktüs veya hedef damar revaskülarizasyonu (TVR) olarak tanımlandı. Çalışmaya dahil edilen hastaların ortalama 55 aylık takip süreleri boyunca MACE ve tüm nedenlere bağlı mortalite geriye dönük olarak dosyalarından tarandı. Demografik ve laboratuvar değerleri SPSS’ye kaydedildi. Bulgular: MACE ve tüm nedenlere bağlı mortalite, yüksek PCT grubunda düşük PCT grubuna göre anlamlı olarak daha yüksek bulundu (sırasıyla p=0.003 ve p=0.002). Çok değişkenli analizde, yüksek PCT seviyeleri ve yaş, diğer risk faktörleri için ayarlama yapıldıktan sonra uzun vadeli tüm nedenlere bağlı ölümlerin anlamlı bağımsız prediktörleri olarak tanımlandı. Ayrıca, yüksek PCT grubunda beyaz kan hücresi, C-reaktif protein, glukoz ve Hemoglobin A1c daha yüksekti. Sonuç: STEMI’li hastalarda hastaneye yatış sırasında yüksek PCT seviyeleri, uzun süreli MACE ve tüm nedenlere bağlı mortalite ile ilişkilidir. PCT, enfeksiyon hastalıklarda yaygın olarak kullanılmasına rağmen, STEMI’li hastalarda uzun vadeli olumsuz sonuçlar için ideal bir inflamasyon belirtecidir.

Long-Term Prognostic Value of Procalcitonin Level in Patients with Acute ST Segment Elevation Myocardial Infarction

Objective: Previous studies have suggested that there is a relationship between coronary artery disease (CAD) and procalcitonin (PCT) levels. We aimed to evaluate the relationship between PCT levels and long-term major adverse cardiovascular events (MACE) and all-cause mortality in patients with ST segment elevation myocardial infarction (STEMI). Method: Patients were divided into two groups based on their serum PCT values. Patients with PCT levels 0.05 ng/ml as high-PCTgroup (n=87). MACE were defined as cardiovascular mortality, reinfarction, or target vessel revascularization (TVR). MACE and all-cause mortality were retrospectively screened from their files during the mean follow-up of 55 months of the patients included in the study. Demographic and laboratory values were recorded in SPSS. Results: MACE and all-cause mortality were found to be significantly higher in the high-PCT group than in the low-PCT group (p=0.003 and p=0.002, respectively). In multivariate analysis, high PCT levels and age were identified as significant independent predictors of long-term all-cause mortality after adjusting for other risk factors. Moreover, white blood cell, C-reactive protein, glucose, and Hemoglobin A1c were higher in the high-PCT group. Conclusion: High PCT levels during hospitalization in patients with STEMI are associated with long-term MACE and allcause mortality. Although PCT is widely used in infectious diseases, it is an ideal inflammation marker for long-term adverse outcomes in patients with STEMI.

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