Anstabil Anjina Pektoris Tanılı Hastalarda Serum Copeptin Düzeylerinin ve HEART Skoru Değerinin Kısa Dönem Prognozda Etkinliğinin Araştırılması

Year 2023, , 81 - 88, 30.06.2023

Kenan Yılmaz , Ozlem Koksal , Arzu Yılmaztepe Oral , Vahide Aslıhan Durak , Murat Çetin

https://doi.org/10.54996/anatolianjem.1163597

Abstract

Amaç: Bu çalışmanın amacı Acil Serviste Anstabil Anjina Pektoris tanısı olan hastalarda, Copeptin düzeyi ve HEART skorlama sisteminin birlikte kullanılmasının klinik özellikleri öngörmedeki değerliliğinin saptanmasıdır.

Gereç ve Yöntemler: Bu çalışmaya, bir üniversite hastanesi Acil Servisi’ne Eylül 2020 – Mart 2021 tarihleri arasında kardiyak tipte göğüs ağrısı ile başvuran ve Anstabil Anjina Pektoris düşünülen erişkin hastalar (n=65) ve hastane çalışanlarından oluşan sağlıklı kontroller (n=45) dâhil edilmiştir. Hastaların kısa dönem prognoz açısından sonlanmaları, Copeptin düzeyleri, kardiyak enzimleri (CK-MB, Troponin) ve HEART risk skor değerleri kaydedilmiştir.

Bulgular: Kontrol grubu ile karşılaştırıldığında ve Anstabil Anjina Pektoris grubunda erkek cinsiyet sıklığı, yaş ve başvuruda kaydedilen troponin değerleri istatistiksel olarak anlamlı düzeyde daha fazlayken, başvuruda kaydedilen Copeptin düzeyi anlamlı düzeyde daha düşük bulunmuştur (p<0.001). Başvuru Copeptin düzeyinin sağlam olguları belirleme açısından 3.86 pmol/L kesim noktasında %57,8 sensitif, %95,4 spesifik olduğu, Troponin düzeyinin ise Anstabil Anjina Pektoris olgularını belirleme açısından 1.1 ng/mL kesim noktasında %64,6 sensitif, %80,0 spesifik olduğu belirlenmiştir (p<0.001). Başvuru anında kaydedilen Troponin ve Copeptin düzeyleri arasında istatistiksel olarak anlamlı düzeyde negatif yönde (r=-0.288, p = 0.020), HEART skoru ile başvuru troponin düzeyi arasında pozitif yönde zayıf düzeyde korelasyon ilişkisi saptanmıştır (r= 0.396, p= 0.001).

Sonuç: Copeptin düzeyi ile nihai sonuç ve HEART skoru arasında anlamlı ilişki saptanmamıştır. Anstabil Anjina Pektoris olgularında sadece Copeptin düzeyinin nihai sonucu öngörmede yeterli olmadığı, HEART skorunun ise bu açıdan klinik pratikte daha etkili olabileceği belirlenmiştir.

Keywords

Anstabil angina pektoris, copeptin, HEART skoru

Investigation of the Efficacy of Serum Copeptin Levels and HEART Scores in Short Term Prognosis in Patients Diagnosed with Unstable Angina Pectoris

Abstract

Aim: The aim of this study was to determine the value of the combined use of Copeptin levels and HEART scoring system in predicting clinical features in patients who were thought to have Unstable Angina Pectoris in the emergency department.

Material and methods: Adult patients who admitted to the emergency department of an university hospital with cardiac chest pain between September 2020 and March 2021 were included as Unstable Angina Pectoris group (n=65); and healthy control group (n = 45) which consisted of the hospital staff. The patients' short-term outcome in terms of prognosis, Copeptin levels, cardiac enzymes (CK-MB, Troponin) and HEART risk score values were recorded.

Results: Compared to the control group, the frequency of male gender, age, and troponin values recorded at admission were statistically significantly higher in the Unstable Angina Pectoris group, while copeptin levels at admission were significantly lower (p<0.001). Copeptin level at admission was 57.8% sensitive and 95.4% specific at the cut-off point of 3.86 pmol/L in terms of identifying healthy cases, whereas the troponin level was 64.6% sensitive and 80.0% specific at the cut-off point of 1.1 ng/mL for detecting Unstable Angina Pectoris cases (p<0.001). There was a weak negative correlation between troponin and copeptin levels recorded at admission (r= -0.288, p = 0.020), and a weak positive correlation between HEART score and troponin level at admission (r= 0.396, p= 0.001).

Conclusion: No significant correlation was found between the levels of Copeptin and the final result and HEART score. It was determined that the use of Copeptin level alone in USAP cases were not sufficient to predict the final result and the HEART score could be more effective in clinical practice in this respect.

Keywords

Unstable Angina Pectoris, copeptin, HEART score

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