Özgür TATLI, Yunus KARACA, İSMET DURMUŞ, Sinan ŞAHİN, AHMET MENTEŞE, Süha TÜRKMEN, ABDÜLKADİR GÜNDÜZ, Süleyman TÜREDİ

Göğüs ağrısı olan hastalarda gebelikle ilişkili Plazma Protein A (PAPP-A) ve iskemi modifiye albümin değerinin karşılaştırılması

Amaç: AKS’un erken tanısında PAPP-A ve CK-MB’nin tanısal değerinin belirlenmesidir.Gereç ve Yöntemler: Tek merkezli, prospektif, klinik bir çalışma 152 vaka incelendi. Çalışmanın sonunda troponin-T, CK-MB, PAPP-A ve IMA’nın farklı gruplardaki düzeyleri kıyaslandı.Bulgular: 13 hastada STEMI tanısı kondu, 53 hastada NSTEMI/UAP ve 80 hastada non spesifik EKG bulguları mevcuttu. Kesin tanısına göre 8 hastada STEMI, 36 hastada NSTEMI, 23 hastada UAP ( unstabil njina pektoris), 17 hastada SAP (stabil anjina pektoris) 68 hastada non koroner göğüs ağrısı mevcuttu. Göğüs ağrısının ilk saatlerinde (0-2 saat, 2-4 saat) en yüksek sensitivitedeki en spesifik parametre IMA idi. (Sensitivite/spesifite; 100/30.7, 93.7/52.3). Sonuçlar: Sonuçlarımıza göre, PAPP-A ve IMA, AKS'de troponin-T ve CK-MB gibi bir tanı aracı olarak kullanılamaz. Sonuçlarımız, duyarlılık ve özgüllük özellikleriyle ilgili olarak IMA, göğüs ağrısı erken döneminde AKS tanısında ideal bir tarama testi olarak kullanılamaz. Yine de, IMA, ilk saatler boyunca AKS'yi saptamada bir tarama testi olarak troponin-T, CK-MB ve PAPP-A'ya kıyasla daha yararlı diagnostik biyokimyasal belirteçtir. Çalışma sonuçlarımız literatürde benzer bir çok araştırmanın aksine bir sonuç sergilemektedir ve bulguları daha kapsamlı bir dizi çalışma ile değerlendirilmelidir.

Anahtar Kelimeler:

PAPP-A, IMA, gögüs ağrısı, akut koroner sendrom

Comparing the value of pregnancy associated Plasma Protein A (PAPP-A) and ischemia modified albumin in the patients with chest pain

Aim: To evaluate the diagnostic value of PAPP-A and CK-MB in early diagnosis of ACS. Material and Methods: It is a single-center, prospective, clinical study. There were totally 152 cases. At the end of the study the levels of troponin-T, CK-MB, PAPP-A and IMA in the different groups were compared.Results: There were 13 patients with STEMI, 53 patients with NSTEMI/UAP and 80 patients with non-specific ECG findings. When we consider the definitive diagnosis; there were 8 patients with STEMI, 36 patients with NSTEMI, 23 patients with UAP, 17 patients with SAP and 68 patients with non-coroner chest pain. In our study, the most specific parameter at the highest sensitivity for the patients with the chest pain within the first hours (0-2 hour, 2-4 hour) was IMA. (Sensitivity/specificity; 100/30.7, 93.7/52.3 respectively). Conclusion: According to our results, PAPP-A and IMA cannot be used as an diagnostic tool like troponin-T and CK-MB in ACS. Also IMA cannot be used as an ideal screening test in the diagnosis of ACS during the early period of chest pain. Still, IMA is more useful diagnostic biochemical marker than troponin-T, CK-MB and PAPP-A as a screening test in detecting ACS during the first hours.

Keywords:

PAPP-A, IMA, chest pain, acute coronary syndrome,

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