Akut Miyokard İnfarktüsü ile Başvuran Hastalarda Hematolojik İnflamatuar Belirteçler ve Fragmente QRS

Giriş: İnflamasyon, akut miyokard infarktüsünün (AMI) patofizyolojisinde önemli bir rol oynamaktadır. Ya kın zamanlı veriler bazı inflamatuar belirteçlerin AMI hastalarında elektrokardiyografide (EKG) fragmente QRS (fQRS) varlığını öngördüğünü düşündürmektedir. Ancak, hangi inflamatuar belirtecin fQRS varlığını daha doğru öngördüğüne ilişkin veriler net değildir. Çalışmamızın amacı, AMI hastalarında çeşitli hematolo jik inflamatuar belirteçler arasında EKG’de fQRS varlığının en güçlü göstergesi olan belirteci tanımlamaktır. Hastalar ve Yöntem: AMI tanısı almış toplam 906 hasta çalışmaya dahil edildi. Beyaz kan hücresi sayısı, monosit sayısı, nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR) ve monosit/yüksek yoğunluklu li poprotein oranı (MHR) gibi inflamatuar belirteçler ile fQRS arasındaki ilişki araştırıldı. Bulgular: Çalışma hastalarında fQRS sıklığı %44.4 olarak saptandı. EKG’de fQRS olan hastalar, olmayanlara göre daha yüksek beyaz kan hücresi, MHR, nötrofil ve monosit sayısına sahipti. NLR ve PLR değerleri, fQRS olan ve olmayan hastalarda benzerdi. Receiver operating characteristics (ROC) curve analizinde monosit sayısı nın >0.79 (×103 /μL) olmasının, %80.36 spesifite ve %60.95 sensitivite ile EKG’de fQRS varlığını öngördürdüğü tespit edildi (AUC: 0.754, p< 0.001). Ayrıca, çok değişkenli analizde hematolojik inflamatuar belirteçler arasın dan sadece monosit sayısının EKG’de fQRS varlığının bağımsız bir göstergesi olduğu saptandı (p< 0.001, odds ratio:1.221, 95% confidence interval: 1.078-1.447). Sonuç: Monosit sayısı, hematolojik inflamatuar belirteçler arasında fQRS varlığının en güçlü göstergesi olup AMI hastalarının risk sınıflandırılmasında kullanılabilir.

Hematological Inflammatory Markers and Fragmented QRS Complexes in Patients Presenting With Acute Myocardial Infarction

Introduction: Inflammation plays a crucial role in the pathophysiology of acute myocardial infarction (AMI). Recent data suggest that some inflammatory markers may predict presence of fragmented QRS (fQRS) on elec trocardiography (ECG) in AMI patients. However, data regarding which inflammatory marker predicts the pres ence of fQRS more accurately remains unclear. In this study, we aimed to define the strongest predictor of the presence of fQRS on EGC among various hematological inflammatory markers in patients presenting with AMI. Patients and Methods: A total of 906 patients with AMI were included into the study. The association be tween fQRS and various hematological inflammatory markers such as white blood cell (WBC) count, mono cyte count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte to high density lipoprotein ratio (MHR) were investigated. Results: The frequency of fQRS was found to be 44.4% in the study population. Patients with fQRS had significantly higher values of WBC, MHR, neutrophil and monocyte counts compared to those without fQRS. The value of NLR and PLR were similar in patients with and without fQRS. In the Receiver operating charac teristics (ROC) curves analyses, a monocyte count > 0.79 (×103 /μL) was found to be a predictor of presence of fQRS on ECG with a specificity of 80.36% and a sensitivity of 60.95% (AUC: 0.754, p< 0.001). Furthermore, multivariate analysis demonstrated that only monocyte count was an independent predictor of fQRS among all hematological inflammatory markers (p< 0.001, odds ratio:1.221, 95% confidence interval:1.078-1.447). Conclusion: Monocyte count is the strongest predictor of fQRS among all hematological inflammatory markers and may be useful in risk stratification of patients with AMI.

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi