Şüpheli Miyokard Enfarktüsü Hastalarında High Sensitive Troponin I ve Troponin T Değerlerinin Koroner Anjiyografi Sonuçları ile Uyumu

Year 2022, Volume: 5 Issue: 2, 81 - 87, 29.12.2022

Bilal İlanbey , Süleyman Ersoy , Alp Yıldırım

https://doi.org/10.56728/dustad.1182955

Abstract

EKG’de ST segment yükselmesi olmayan miyokard enfarktüsü (NSTEMI) hastalarının tanısında high-sensitive troponinler önemlidir. Seri troponin ölçümleri ve belirli cut-off değerlerin kullanıldığı algoritmalar sayesinde miyokard enfarktüsü için dahil etme ya da dışlama yapılabilmektedir. Bazı hastalar dahil etme veya dışlamaya uymamakta ve şüpheli miyokard enfarktüsü düşünülerek gözlem altına alınmaktadır. Gözlem altına alınan ve klinik olarak miyokard enfarktüsü olasılığı yüksek hastalara koroner anjiyografi yapılmaktadır. Amacımız ESC 2020 kılavuzuna göre gözlem altına alınan hastalarda high-sensitive troponin I ve T’nin koroner anjiyografi ile uyumunu değerlendirmekti. 0-1 saat için hs-cTnI 6-50 ng/L arası ve delta 1s değişikliği <15ng/L; hs-cTnT 13-52 ng/L arası ve delta 1s değişikliği <5 ng/L olan ve koroner anjiyografi yapılan 113 hastanın dosyaları ile anjiografi sonuçları retrospektif olarak incelendi. Koroner anjiyografide %50 üzerinde olan darlıklar lezyon olarak kabul edildi. Hastaların %75,2’sinde koroner anjiyografide en az bir lezyon vardı. High-sensitive troponin I grubunda lezyonu olan hastaların oranı, high-sensitive troponin T grubuna göre istatistiksel olarak anlamlı yüksekti. Lojistik regresyon analizinde koroner arter hastalığı risk göstergesi açısından high-sensitive troponin I, high-sensitive troponin T ye göre yaklaşık 3 kat daha üstündü. ESC 2020 klavuzuna göre şüpheli miyokard enfarktüsü tanısını alan hastaların high-sensitive troponin I sonuçları, high-sensitive troponin T sonuçlarına göre anjiyografideki lezyonu öngörmede daha değerlidir.

Keywords

: esc 2020 kılavuzu, high sensitive troponin, koroner anjiyografi, şüpheli miyokard enfarktüsü

Supporting Institution

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Project Number

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Thanks

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Compatibility of High-Sensitive Troponin I and Troponin T Values with Coronary Angiography Results in Patients with Suspected Myocardial Infarction

Abstract

High-sensitive troponins are important in the diagnosis of myocardial infarction patients without ST-segment elevation (NSTEMI) on ECG. Myocardial infarction can be included or excluded using serial troponin assays and algorithms with specific cut-off values. Some patients don’t comply with inclusion or exclusion and are observed for suspected myocardial infarction. Patients who are being monitored and have a high clinical probability of myocardial infarction undergo coronary angiography. We aimed to evaluate the compatibility of high-sensitive troponin I and T with coronary angiography in patients under observation according to the ESC 2020 guideline. According to the 0-1 hour algorithm, those who had coronary angiography had a hs-cTnI value between 6-50 ng/L and a delta 1-hour change <15ng/L; The files and angiography results of 113 patients with a hs-cTnT value between 13-52 ng/L and delta 1-hour change <5 ng/L were analyzed retrospectively. Stenosis greater than 50% on coronary angiography was considered as a lesion. 75.2% of the patients had at least one lesion on coronary angiography. The proportion of patients with lesions in the high-sensitive troponin I group was statistically significantly higher than in the high-sensitive troponin T group. In logistic regression analysis, high-sensitive troponin I was approximately 3 times superior to high-sensitive troponin T in terms of coronary artery disease risk indicator. High-sensitive troponin I results of patients diagnosed with suspected myocardial infarction stated in the ESC 2020 guideline are more valuable in predicting the lesion on angiography than high-sensitive troponin T results.

Keywords

esc 2020 guideline, high sensitive troponin, coronary angiography, suspected myocardial infarction

Project Number

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