Acil servis kan parametreleri akut miyokard infarktüsünde koroner arter oklüzyonunu öngörebilir mi?

Year 2024, Volume: 17 Issue: 3, 478 - 485, 05.07.2024

Hülya Yılmaz Başer , Alkame Akgümüş , Ahmet Balun

https://doi.org/10.31362/patd.1423299

Abstract

Amaç: Bu çalışmanın amacı acil serviste akut miyokard infarktüsü (AMİ) nedeni ile değerlendirilen ve koroner anjiografi uygulanan hastaların koroner damar darlığının acilde bakılan kan parametreleri ile saptanabilirliğini değerlendirmek.
Gereç ve yöntem: Tek merkez prospektif gözlemsel çalışmamızda 1 Eylül-31 Ekim 2023 tarihleri arasında acil serviste AMİ tanısı alan ve tek kardiyolog tarafından koroner anjiyografi yapılan hastalar dâhil edildi. Acil servis rutin değerlendirmede uygulanan kan parametreleri kayıt edildi ve anjiografi sonrası damar darlık yüzdelerine göre prediktif etkisi olan parametreler değerlendirildi.
Bulgular: Araştırmamıza çalışma kriterlerini karşılayan toplam 64 hasta (44 erkek, 20 kadın) dâhil edildi. Koroner anjiyografi sonrası herhangi bir koroner arterde en yüksek darlık yüzdesine göre yapılan değerlendirme sonrası hastalar 2 gruba ayrıldı. Grup 1 hafif darlık (darlık <%50) saptanan 15 hasta ve grup 2 ciddi darlık (%70-99 darlık) tespit edilen 49 hastadan oluşmaktadır. Grup 2’de erkek cinsiyet baskınlığı ile Troponin-I (Tn-I) düzeyinin yüksek, lenfosit ve trombosit değerlerinin düşük olduğu görüldü (sırasıyla p=0,010, p=0,004, p=0,042 ve p=0,007).
Sonuç: Erkeklerde koroner darlığa bağlı olarak Tn-I düzeylerinin daha yüksek olduğu görülmüştür. Ateroskleroz ve trombozun yanı sıra, şiddetli darlık vakalarında iltihaplanma, trombosit ve lenfosit sayısının azalmasına katkıda bulunabilir. Bu bulguları doğrulamak için daha büyük örneklem büyüklüğüne sahip, ileriye dönük, randomize kontrollü çalışmalara ihtiyaç vardır.

Keywords

Akut miyokard infarktüsü, kardiyak belirteçler, tam kan sayımı, koroner darlık, koroner anjiografi

Can emergency department blood parameters predict coronary artery occlusion in acute myocardial infarction?

Abstract

Purpose: The aim of this study is to assess the detectability of coronary artery stenosis in patients evaluated for acute myocardial infarction (AMI) in the emergency department and undergoing coronary angiography, based on blood parameters examined in the emergency setting.
Materials and methods: In our single-center prospective observational study, patients diagnosed with AMI in the Emergency Department between September 1 and October 31, 2023, and those who underwent coronary angiography by a single cardiologist were included. The blood parameters applied during routine assessment in the Emergency Department were recorded, and parameters with predictive effects based on the percentages of vessel stenosis after angiography were evaluated.
Results: A total of 64 patients (44 males and 20 females) who met the study criteria were included in our research. Following the evaluation based on the highest percentage of stenosis in any coronary artery after coronary angiography, patients were divided into two groups. Group 1 consisted of 15 patients with mild stenosis (stenosis <50%), and Group 2 comprised 49 patients with severe stenosis (70-99% stenosis). Group 2, a predominance of male gender was observed along with elevated Troponin-I (Tn-I) levels, and lower values of lymphocyte and platelet counts (p=0.010, p=0.004, p=0.042, and p=0.007, respectively).
Conclusion: In males, it has been observed that Tn-I levels are higher in association with coronary stenosis. Alongside atherosclerosis and thrombosis, inflammation may contribute to decreased platelet and lymphocyte counts in cases of severe stenosis. Further prospective, randomized controlled studies with larger sample sizes are needed to confirm these findings.

Keywords

Acute myocardial infarction, cardiac markers, whole blood count, coronary stenosis, coronary angiography

Ethical Statement

The study received approval from the XXX University Health Sciences Non-Interventıonal Research Ethıcs Commıttee (ethics committee approval no: 2023-2 Date: 12.01.2023).

Supporting Institution

None

Thanks

None

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