Early Prognostic Values of Cardiac Biomarkers in STEMI patients that underwent Percutaneous Coronary Intervention

Year 2018, Volume: 1 Issue: 2, 13 - 17, 28.12.2018

Can Aktaş , Gökçe Akgül Karadana , Elif Değirmenci Yoldaş Demirtaş Şevki Hakan Eren

Abstract

Aim: To assess the early prognostic values of admission cardiac biomarkers (CKMB, hs-Troponin T, BNP) in patients with STEMI by determining the association of these markers with mortality, Gensini scores and LAD involvement prospectively.

Materials and Method: The current study was performed through the six-month period on 70 STEMI patients admitted to ED who had chest pain for the first time in their lives and underwent to percutaneous coronary intervention (PCI). Admission first cardiac biomarker values measured within 6 hours, patient demographics and clinical characteristics (age, gender, PCI results, LAD involvement) and Gensini scores calculated in regards to PCI results were recorded. Association of each cardiac biomarker (CKMB, hs-Troponin T, BNP) with the presence of mortality and LAD involvement was calculated. Correlation between biomarker levels and gensini scores were sought with Spearman correlation coefficients test.

Results: BNP (p=0.005) and hs-Troponin T (p=0.002) were associated with increased mortality. There was no association between mortality and the first admission value of cardiac biomarkers (BNP, CK-MB, hs-troponin T) with Gensini score (p>0.05). Higher BNP values indicated higher LAD (+) lesion probability (p<0.05) while no association between LAD(+) lesion and the other biomarkers (CKMB, hs- Troponin T) (p>0.05).

Conclusions: Acute STEMI with high BNP and hs-Troponin T levels predict increased mortality and needs more serious treatment and close follow-up. Additionally, higher BNP levels suggest a potential LAD (+) lesion which is closely related with mortality. Admission BNP and hs-Troponin T values indicate early prognostic outcome in STEMI patients, however they don’t point out the severity of the lesions.

Keywords

Myocardial infarction, Biomarkers, Percutaneous Coronary Intervention, Mortality

Perkutanöz Girişim Yapılan STEMI hastalarındaki Kardiyak Biyomarkerların Erken Prognostik Önemi

Abstract

Amaç: ST segment elevasyonlu miyokard infarktüsü olan
hastalarda başvuru anındaki kardiyak biyomarkerların
(CKMB, hs-Troponin T, BNP) prospektif olarak mortalite,
Gensini skoru ve LAD lezyonun varlığını belirleyerek erken
prognostik önemini değerlendirmektir.
Materyal ve Metod: Bu çalışma altı aylık bir periyotta acil
servise ilk kez göğüs ağrısı ile başvurup perkutan koroner
girişim (PCI) yapılan 70 hastada yapılmıştır. Başvuru anında
ilk kardiyak biyomarkerlar ölçülmleri, hastaların demografik ve
klinik özellikleri ve PCI sonuçlarına göre Gensini skorları
hesaplanarak kaydedilmiştir. Her bir kardiyak biyomarker ile
ilişkili mortalite varlığı ve LAD tutulumu hesplanmıştır.
Biyomarker düzeyleri ile Gensini skoru arasındaki korelasyon
Spearman korelasyon analizi ile test edilmiştir.
Bulgular: BNP (p=0.005) ve hs-Troponin T (p=0.002) artmış
mortalite ile ilşkliydi. Gensini skoru ile mortalite ve ilk başvuru
anındaki kardiyak biyomarkerlar arsında herhangi bir ilişki
tespit edilmemiştir (p>0.05). Yüksek BNP düzeylerinde
yüksek oranda LAD tutulumu tespit edilmiştir (p<0.05) ancak
diğer biyomarkerlar (CKMB, hs-Troponin T) ile LAD lezyonu
varlığı arasında bir ilişki tespit edilmemiştir (p>0.05).
Sonuç: Akut ST segment elevasyonu MI ile başvuran
hastalarda yüksek BNP ve hs-Troponin düzeyleri artmış
mortalitenin bir göstergesi olabilir bu nedenle daha ciddi bir
yaklaşım ve takibe gereksinim vardır. Buna ilaveten yüksek
BNP düzeyleri potansiyel olarak LAD tutulumunu
gösterebilmekte olup bu da mortalite ile sıkı bir ilişki
içerisindedir. Başvuru anındaki BNP ve hs-Troponin T
değerleri ST segmen elevasyonu olan MI’ lü hastalarda erken
prognostic sonuçları gösterebilmektedir ancak lezyonun
ciddiyeti hakkında bir fikir vermemektedir. 

Keywords

Miyokard İnfarktüsü, Biyomarker, Perkutan koroner girişim, Mortalite

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