Research Article
BibTex RIS Cite

Akut Koroner Sendromda Değiştirilebilir Risk Faktörleri ile Kan Hücresi Tipleri Arasındaki İlişki ve Acil Serviste Mortalite Tahmini

Year 2020, Volume: 3 Issue: 4, 111 - 116, 31.12.2020

Abstract

Amaç: Lökosit sayısı (WBC), nötrofil / lenfosit oranı (NLR), trombosit / lenfosit oranı (PLR), trombosit dağılım genişliği (PDW) ve C reaktif protein (CRP) gibi inflamatuar medyatörler; akut koroner sendrom (AKS) gibi iskemik olayların tahmininde kullanılmaktadır. Çalışmamızda , AKS tanısında inflamatuar mediatörler , çeşitli risk faktörleri ve mortalite arasındaki ilişki incelenmiştir.

Gereç ve Yöntem: Çalışmaya ST elevasyonlu miyokard enfarktüsü (STEMI) ve ST elevasyonu olmayan miyokard enfarktüsü (NSTEMI) tanısı olan toplam 100 hasta dahil edildi. Hastaların acile başvuru anındaki sırasında WBC, nötrofil sayımı, NLR, PLR, PDW,CRP değerleri ve diğer biokimyasal belirteçler için kan örnekleri alındı.

Bulgular: AKS tanısı konan hastaların% 49'u STEMI ve% 51'i NSTEMI idi. Kadın cinsiyetin NSTEMI grubunda STEMI grubuna göre daha yüksek olduğu ve hipertansiyon oranının NSTEMI grubunda STEMI grubuna göre daha yüksek olduğu ve istatistiksel olarak anlamlı olduğu saptandı. STEMI ve NSTEMI tanı grupları arasındaki NLR medyan değeri, NSTEMI grubunda daha yüksek ve istatistiksel olarak daha anlamlı bulundu.

Sonuç: Sonuç olarak; STEMI ve NSTEMI tanı grupları arasında troponin, kontrol troponin, lenfosit ve NLR oranının anlamlı farklılık gösterdiği bulunurken yaşın mortalite üzerinde etkili bir parametre olduğu görülmektedir.

References

  • Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105:1135-43.
  • Pereira IA, Borba EF. The role of inflammation, humoral and cell mediated autoimmunity in the pathogenesis of atherosclerosis. Swiss Med Wkly. 2008;138: 534-9.
  • Kaya H, Ertas ̧ F, Islamoglu Y, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost. 2014;20:50-4.
  • Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Journal of the American College of Cardiology. 2000;36(3):959-69.
  • Yılmaz E. Akut Koroner sendrom: Tanı ve Tedavide Yenilikler. 7. Ulusal İç hastalıkları Kongresi.http://www.tihud.org.tr/oploads/content/ /kongre/7/7.2.pdf (Erişim tarihi: 10.10.2017).
  • Taşın V. Akut Koroner Sendromlu Hastalarda Anjiografik Trombüsü Öngörmede İnflamatuar Mediatörlerin Yeri. (Uzmanlık Tezi). Hatay: Mustafa Kemal Üniversitesi; 2013.
  • Kristian Thygesen, Joseph S. Alpert, Allan S. Jaffe, et al. White. Üçüncü Evrensel Miyokard Enfarktüsü Tanımı. Türk Kardiyol Dern ArĢ 2013, Suppl. 3
  • Eraslan S. Akut St Elevasyonlu Miyokard İnfarktüsü Geçiren Hipertansif Hastalarda Hospitalizasyonun Erken Döneminde ve Taburculuk Sonrası Günlük Aktiviteler Sırasındaki Kan Basıncı ve Kalp Hızı Değişkenliği. (Uzmanlık Tezi). Eskişehir: Osmangazi Üniversitesi; 2017.
  • Mandelzweig L, Battler A, Boyko V, et al. The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004. Eur Heart J 2006;27:2285-2293.
  • Aktimur R, Cetinkunar S, Yildirim K, et al. Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia. Eur J TraumaEmergSurg. 2016;42(3):363-8.
  • Montalescot G, Dallongeville J, Van Belle E, et al. for the OPERA Investigators. STEMI and NSTEMI: are they so different? 1 year outcomes in acute myocardial infarction as defined by the ESC/ACC definition (the OPERA registry). Eur Heart J 2007;28:1409-17.
  • Kumar A, Cannon CP. Acute Coronary Syndromes: Diagnosis and Management, Part I. Mayo ClinProc. 2009;84(10):917-38.
  • Aksoy H, Aytemir K. Yaşlıda Akut Koroner Sendroma Yaklaşım. Akad Geriatri 2009; 1: 98-106.
  • Özel M, Serinken M, Yılmaz A, Özen Ş. Acil Servise Başvuran Akut Koroner Sendrom Tanılı Hastaların Sosyodemografik ve Klinik Özellikleri. Türkiye Acil Tıp Dergisi- Tr J EmergMed 2012;12(3):117-22.
  • Özel Coşkun S, Parlak İ, Değerli V, at al. Acil Servise Göğüs Ağrısı ile Başvuran Hastaların Akut Koroner Sendrom Oranlarının Değerlendirilmesi. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2015; 19(2): 84-94.
  • Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC Kararlı Koroner Arter Hastalığı Yönetimi Kılavuzu. Türk KardiyolDern Arş 2014, Suppl. 4: 73-134.
  • Fox KA, Dabbous OH, Goldberg RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ 2006;333:1091.
  • Bugiardini R. Risk Stratification in acute coronary syndrome: focus on unstable angina/non-ST segment elevation myocardial infarction. Heart 2004;90:729-31.
  • Roger VL, Weston SA, Gerber Y, et al. Trends in Incidence, Severity, and Outcome of Hospitalized Myocardial Infarction. Circulation. 2010;121:863-9.
  • Yazıcı S, Kırış T, Akyüz Ş, ve ark. ST-Elevasyonsuz Akut Koroner Sendrom Tanılı Hastaların Tedavilerinin Kılavuz Uyumluluk ve Hastane İçi Mortalite Oranları. MN Kardiyoloji 2014;21:222-6.
  • Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? Journal of the American College of Cardiology. 2005;45(10):1638-43.
  • Shen X-H, Chen Q, Shi Y, Li H-W. Association of neutrophil/ lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Chinese medical journal. 2010;123(23):3438-43.
  • 2Akpek M, Kaya MG, Lam YY, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. The American journal of cardiology. 2012;110(5):621-7.
  • Özmen Nihal F. Acil Serviste Tanı Alan Stemi ve Nstemi Hastalarında Troponin ve SCUBE-1’in Tanısal Değerlerinin Karşılaştırılması. (Uzmanlık Tezi). Ankara: Sağlık Bilimleri Üniversitesi; 2017.
  • Oncel RC, Ucar M, Karakas MS, et al. Relation of neutrophil-to-lymphocyte ratio with GRACE risk scoreto in-hospital cardia cevents in patient swith ST-segment elevated myocardial infarction. Clinical and Applied Thrombosis/Hemostasis. 2015;21(4):383-8.
  • O'Donoghue M, Morrow DA, Cannon CP, et al. Association between baseline neutrophil count, clopidogrel therapy, and clinical and angiographic outcomes in patients with ST-elevation myocardial infarction receiving fibrinolytic therapy. Eur Heart J. 2008;29(8):984-91.
  • Kirtane AJ, Bui A, Murphy SA, et al. Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction. Am J Cardiol. 2004;93(5):532-6.
  • Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality afternon ST elevation myocardial infacrtion. Am J Cardiol 2010;106(4): 470-6.

Relationship Between Modifiable Risk Factors and Blood Cell Types in Acute Coronary Syndrome and Estimation of Mortality in Emergency Department

Year 2020, Volume: 3 Issue: 4, 111 - 116, 31.12.2020

Abstract

Aim: Inflammatory mediators such as leukocyte count (WBC), neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio(PLR), platelet distribution width (PDW) and C reactive protein (CRP) are used for the prediction of ischemic vascular events such as acute coronary syndrome (ACS).In this study, the relationship between inflammatory mediators and modifiable risk factors in the diagnosis of ACS and mortality was examined.

Material and methods: A total of 100 patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) were included in the study. Blood samples for WBC, neutrophil count, NLR, PLR, PDW and CRP and routine blood laboratory studies were taken at the time of admission of the patients.

Results: Of the patients diagnosed with ACS,49% was STEMI and 51% was NSTEMI. Female gender was found to be higher in the NSTEMI group than in the STEMI group and also the hypertension ratio was found to be higher in the NSTEMI group than in the STEMI group and it was found to be statistically significant. The NLR median value between the STEMI and NSTEMI diagnostic groups was found to be higher in the NSTEMI group and statistically more significant.

Conclusions: In conclusion; troponin, control troponin, lymphocyte and NLR ratio were found to be statistically significant between STEMI and NSTEMI diagnostic groups.In addition to this; age was found as an effective parameter on mortality.

References

  • Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105:1135-43.
  • Pereira IA, Borba EF. The role of inflammation, humoral and cell mediated autoimmunity in the pathogenesis of atherosclerosis. Swiss Med Wkly. 2008;138: 534-9.
  • Kaya H, Ertas ̧ F, Islamoglu Y, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost. 2014;20:50-4.
  • Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Journal of the American College of Cardiology. 2000;36(3):959-69.
  • Yılmaz E. Akut Koroner sendrom: Tanı ve Tedavide Yenilikler. 7. Ulusal İç hastalıkları Kongresi.http://www.tihud.org.tr/oploads/content/ /kongre/7/7.2.pdf (Erişim tarihi: 10.10.2017).
  • Taşın V. Akut Koroner Sendromlu Hastalarda Anjiografik Trombüsü Öngörmede İnflamatuar Mediatörlerin Yeri. (Uzmanlık Tezi). Hatay: Mustafa Kemal Üniversitesi; 2013.
  • Kristian Thygesen, Joseph S. Alpert, Allan S. Jaffe, et al. White. Üçüncü Evrensel Miyokard Enfarktüsü Tanımı. Türk Kardiyol Dern ArĢ 2013, Suppl. 3
  • Eraslan S. Akut St Elevasyonlu Miyokard İnfarktüsü Geçiren Hipertansif Hastalarda Hospitalizasyonun Erken Döneminde ve Taburculuk Sonrası Günlük Aktiviteler Sırasındaki Kan Basıncı ve Kalp Hızı Değişkenliği. (Uzmanlık Tezi). Eskişehir: Osmangazi Üniversitesi; 2017.
  • Mandelzweig L, Battler A, Boyko V, et al. The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004. Eur Heart J 2006;27:2285-2293.
  • Aktimur R, Cetinkunar S, Yildirim K, et al. Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia. Eur J TraumaEmergSurg. 2016;42(3):363-8.
  • Montalescot G, Dallongeville J, Van Belle E, et al. for the OPERA Investigators. STEMI and NSTEMI: are they so different? 1 year outcomes in acute myocardial infarction as defined by the ESC/ACC definition (the OPERA registry). Eur Heart J 2007;28:1409-17.
  • Kumar A, Cannon CP. Acute Coronary Syndromes: Diagnosis and Management, Part I. Mayo ClinProc. 2009;84(10):917-38.
  • Aksoy H, Aytemir K. Yaşlıda Akut Koroner Sendroma Yaklaşım. Akad Geriatri 2009; 1: 98-106.
  • Özel M, Serinken M, Yılmaz A, Özen Ş. Acil Servise Başvuran Akut Koroner Sendrom Tanılı Hastaların Sosyodemografik ve Klinik Özellikleri. Türkiye Acil Tıp Dergisi- Tr J EmergMed 2012;12(3):117-22.
  • Özel Coşkun S, Parlak İ, Değerli V, at al. Acil Servise Göğüs Ağrısı ile Başvuran Hastaların Akut Koroner Sendrom Oranlarının Değerlendirilmesi. İzmir Eğitim ve Araştırma Hastanesi Tıp Dergisi, 2015; 19(2): 84-94.
  • Montalescot G, Sechtem U, Achenbach S, et al. 2013 ESC Kararlı Koroner Arter Hastalığı Yönetimi Kılavuzu. Türk KardiyolDern Arş 2014, Suppl. 4: 73-134.
  • Fox KA, Dabbous OH, Goldberg RJ, et al. Prediction of risk of death and myocardial infarction in the six months after presentation with acute coronary syndrome: prospective multinational observational study (GRACE). BMJ 2006;333:1091.
  • Bugiardini R. Risk Stratification in acute coronary syndrome: focus on unstable angina/non-ST segment elevation myocardial infarction. Heart 2004;90:729-31.
  • Roger VL, Weston SA, Gerber Y, et al. Trends in Incidence, Severity, and Outcome of Hospitalized Myocardial Infarction. Circulation. 2010;121:863-9.
  • Yazıcı S, Kırış T, Akyüz Ş, ve ark. ST-Elevasyonsuz Akut Koroner Sendrom Tanılı Hastaların Tedavilerinin Kılavuz Uyumluluk ve Hastane İçi Mortalite Oranları. MN Kardiyoloji 2014;21:222-6.
  • Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? Journal of the American College of Cardiology. 2005;45(10):1638-43.
  • Shen X-H, Chen Q, Shi Y, Li H-W. Association of neutrophil/ lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Chinese medical journal. 2010;123(23):3438-43.
  • 2Akpek M, Kaya MG, Lam YY, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. The American journal of cardiology. 2012;110(5):621-7.
  • Özmen Nihal F. Acil Serviste Tanı Alan Stemi ve Nstemi Hastalarında Troponin ve SCUBE-1’in Tanısal Değerlerinin Karşılaştırılması. (Uzmanlık Tezi). Ankara: Sağlık Bilimleri Üniversitesi; 2017.
  • Oncel RC, Ucar M, Karakas MS, et al. Relation of neutrophil-to-lymphocyte ratio with GRACE risk scoreto in-hospital cardia cevents in patient swith ST-segment elevated myocardial infarction. Clinical and Applied Thrombosis/Hemostasis. 2015;21(4):383-8.
  • O'Donoghue M, Morrow DA, Cannon CP, et al. Association between baseline neutrophil count, clopidogrel therapy, and clinical and angiographic outcomes in patients with ST-elevation myocardial infarction receiving fibrinolytic therapy. Eur Heart J. 2008;29(8):984-91.
  • Kirtane AJ, Bui A, Murphy SA, et al. Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction. Am J Cardiol. 2004;93(5):532-6.
  • Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality afternon ST elevation myocardial infacrtion. Am J Cardiol 2010;106(4): 470-6.
There are 28 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Habip Leylek This is me 0000-0002-9945-4103

Vahide Aslıhan Durak 0000-0003-0836-7862

Ozlem Koksal 0000-0003-2271-5659

Publication Date December 31, 2020
Published in Issue Year 2020 Volume: 3 Issue: 4

Cite

AMA Leylek H, Durak VA, Koksal O. Relationship Between Modifiable Risk Factors and Blood Cell Types in Acute Coronary Syndrome and Estimation of Mortality in Emergency Department. Anatolian J Emerg Med. December 2020;3(4):111-116.