Mustafa ÇELİK, Erdoğan SÖKMEN, Murat ERER, Serkan SİVRİ, Alp YILDIRIM, Yalçın BODUROĞLU, Kenan GUCLU, Sinan Cemgil ÖZBEK

Akut st-elevasyonlu miyokart infarktüsü hastalarinda 6 aylik mortalite ve thiol / disulfid ilişkisi

Amaç: Akut ST yükselmeli miyokard infarktüsü (STMI) mortalitenin önemli bir belirleyicisidir ve uzun dönem ölüm oranları son yirmi yılda önemli ölçüde değişmemiştir. Tiyoller vücutta önemli bir antioksidan mekanizmadır ve aşırı reaktif oksijen türleri tiyolü disülfür formlarına okside eder. Bu nedenle daha yüksek seviyedeki disülfid oksidatif stresin bir göstergesi olarak kabul edilir. Bu yazıda STMI sağ kalanları arasında tiyol / disülfid homeostazı ve 6 aylık tüm nedenlere bağlı ölüm arasındaki olası ilişkiyi araştırmaya çalıştık. Gereç ve Yöntemler: Çalışmaya perkütan koroner girişim uygulanan STMI' li 238 hasta dahil edildi. Giriş sırasındaki tiyol / disülfit homeostazı için kan örnekleri alındı. Syntax I ve II skorları sineanjiyografik görüntüler ve ilgili hasta demografik özellikleri kullanılarak hesaplandı. Bulgular:25 hastada (mortalite grubu) 6 aylık takibinde mortalite izlendi, 213 hastada mortalite izlenmedi (mortalite dışı grup) . Total tiyol, nativ tiyol, disülfid, disülfid / toplam tiyol, disülfid / nativ tiyol ve nativ tiyol / toplam tiyol, mortalite ve mortalite dışı gruplar arasında farklı değildi (p> 0.05). Syntax I ve II skorları mortalite grubunda anlamlı olarak daha yüksekti (26.11 ± 8.06 - 19.12 ± 9.80, Syntax I için p = 0.029; Syntax II için 50.13 ± 14.59 ve 30.63 ± 9.79, p <0.001). Sonuç: Syntax II skoru, glomerüler filtrasyon hızı (GFR) ve beyaz kan hücre sayımının (WBC) 6 aylık mortaliteyi öngördüğü bulundu.

Anahtar Kelimeler:

thiol-disülfid, akut miyokart infatktüsü, mortalite

The association of thiol/disulphide homeostasis with 6-month mortality in patients with acute st-elevation myocardial infarction

Aim: Acute ST-elevation myocardial infarction (STMI) is significant determinant of mortality and long-term mortality rates has not changed significantly over the last two decades. Thiols are an important anti-oxidant mechanism in the body, and excessive reactive oxygen species oxidize the thiol into their disulphide forms. Hence, higher level of disulphide is regarded as an indicator of oxidative stress. In the present paper, we sought to investigate any probable relationship between thiol/disulphide homeostasis and 6-month all-cause mortality among STMI survivors.Material and Methods: 238 consecutive patients with STMI undergoing percutaneous coronary intervension were included. Blood samples for thiol/disulphide homeostasis were drawn on admission. Syntax I and II scores were calculated using the cineangiographic views and relevant patient demographics. Results: 6-month mortality occurred in 25 patients (mortality group), while 213 patients remained alive (non-mortality group). Total thiol, native thiol, disulphide, disulphide/total thiol , disulphide/native thiol and native thiol/total thiol were not different between the mortality and non-mortality groups (p>0.05). Syntax I and II scores were significantly greater in mortality group (26.11±8.06 vs 19.129.80, p=0.029 for Syntax I; 50.1314.59 vs 30.639.79, p<0.001 for Syntax II). Conclusion: Syntax II score, glomerular filtration rate (GFR) and white blood cell count (WBC) were found to predict 6-month mortality.

Keywords:

thiol disülfide, acute myocardial infarction, mortality,

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