ST segment yükselmesi olmayan miyokard infarktüsü olgularında enoksoparin tedavisinin etkinliğinin değerlendirilmesinde AntiFXa aktivitesi ve tromboleastogram yönteminin karşılaştırılması

Year 2021, Volume: 46 Issue: 4, 1478 - 1484, 30.12.2021

Ramazan Gündüz , Bekir Serhat Yildiz , İbrahim Halil Özdemır , Mehmet Burak Özen , Nurullah Çetın , Oğuz Yavuzgil

https://doi.org/10.17826/cumj.977136

Abstract

Amaç: Tromboelastogram parametrelerindeki değişiklerin standart olarak önerilen AntiFXa aktivitesi ile karşılaştırılarak bu testin enoksaparin tedavisinin monitörizasyonundaki rolünün incelenmesidir.
Gereç ve Yöntem: ST segment yükselmesi olmayan miyokard infarktüsü tanısıyla koroner yoğun bakım ünitesine yatırılan 25 hasta çalışmaya alınmıştır. Hastalara yatış anında iki tüp kan alınmış ve 1mg/kg enoksapirinin üçüncü dozu yapıldıktan 4 saat sonra iki tüp kan daha alınmıştır. Hastalara AntiFXa, tromboelastogram, aktive koagülasyon zamanı bakılmıştır.
Bulgular: Enoksoparin uygulaması sonrası aktive koagülasyon zamanı değerinde bir miktar artış izlenmekle birlikte bunun anlamlı olmadığı görüldü (p₌0.094). Enoksoparin sonrası tromboelastogram parametrelerinden maksimum amplitüde(MA) azalmış (MA bazal 65.4±11.9 sonra 63.4±7.8), R zamanı artmış (5±1.7 den 8.4±4.6,), K zamanı artmış (1.89±1.06 dan 2.56±1.4), açı azalmıştır. (66.34±5.6 dan 57.9±11.4). AntiFXa artmıştır (0.122±0.06 dan 0.501±0.359).
Sonuç: Tromboelastogram parametreleri değerlendirildiğinde tipik artmış bir prokoagülan aktivite olmamakla birlikte kısmen artmış bir fibrinolitik aktivite saptanmıştır.

Keywords

enoksoparin, tromboleastogram, akut koroner sendrom

Comparison of anti-factorXa assay and rotational thromboelastogram in evaluating the efficacy of enoxaparine treatment in patients with acute coronary syndrome without ST- segment elevation

Abstract

Purpose: The aim of this study was to compare anti-factor Xa assay and tromboelastogram in evaluation of efficacy of enoxaparin in patients with acute coronary syndrome without ST-segment elevation.
Materials and Methods: Twenty-five patients with acute coronary syndrome were involved. Two blood samples were taken on admission and 4 hours after the subcutaneous injection of third dose of 1mg/kg enoxaparin to the patients. AntiFXa, tromboelastogram, activated coagulation time were calculated.
Results: A non-significant increase in activated coagulation time was observed after the injection of enoxaparin. After injection enoxaparin thromboelastography parameters changed maximum amplitude(MA) increased (MA basal 65.4±11.9 after 63.4±7.8), R time increased (from 5±1.7 to 8.4±4.6,), K time increased (from 1.89±1.06 to 2.56±1.4), angle increased (from 66.34±5.6 to 57.9±11.4). AntiFXa increased. (from 0.122±0.06 to 0.501±0.359).
Conclusion: Tromboelastography method can be used in assessment of efficacy of enoxaparin in patients with acute coronary syndrome without ST-Segment elevation.

Keywords

Thromboelastogram, Enoxaparin, Acute coronary syndrome

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