Acil Servise ST Segment Elevasyonlu Olmayan Miyokard Enfarktüsü ve Kararsız Angina Pektoris ile Başvuran Hastalarda Perfüzyon İndeksinin Klinik Değerlendirmesi

Abstract

Amaç: segmenti yükselmesi olmayan miyokard infarktüsü (NSTEMI) ve kararsız anjina pektoris (USAP) has-talarında, acil servise başvurularının 10. dakikasında perfüzyon indeksi (PI) düzeyini değerlendirmeyi amaçladık. Ayrıca, acil serviste NSTEMI ve USAP hastalarını erken safhada ayırt etmede PI’nın bir faydalı olup olmadığını değerlendirmeyi amaçladık.
Materyal ve Metod: Kasım 2017- Mayıs 2019 tarihleri arasında acil servisimize ardışık olarak başvuran, akut koroner sendromu tanısı alan 80 NSTEMI (Grup 1) ve 50 USAP hastası (Grup 2) çalışmaya dahil edildi. Her iki hasta grubunda, Massimo-SET Root 7362A RDS7 non invazif pulse oksimetri cihazı probu yardımı ile ölçülen PI ve diğer rutin laboratuvar ölçüldü ve karşılaştırma yapıldı.
Bulgular: NSTEMI hastalarında PI ortalaması belirgin olarak düşük idi (p<0.001). 30 günlük hasta takibinde, ölen hastalarda PI seviyesi hayatta kalan hastalara göre anlamlı olarak daha düşüktü (P <0.001). Eğri altın-daki alan, NSTEMI hastalarında PI için önemli ölçüde daha düşüktü (eğri altındaki alan 0.313, p = 0.016).
Sonuç: Çalışmamız, PI'nin NSTEMI ve USAP hastalarının ayırt edilmesinde erken bir belirteç olabileceğini ve bu hastaların mortalitesini tahmin etmede faydalı olabileceğini gösterse de daha kapsamlı çalışmalar hipo-tezimizi destekleyecektir.

Keywords

• Perfusion Index
• Non ST segment elevation myocardial infarction
• Unstable angina pectoris

Clinical Assessment of Perfusion Index in Patients Presenting to the Emergency Department with Non-ST-segment Elevation Myocardial Infarction and Unstable Angina Pectoris

Abstract

Background: We aimed to evaluate the perfusion index (PI) level at the 10th minute of admission to the emergency department in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP). In addition, we aimed to evaluate whether PI is useful in differentiating NSTEMI and USAP patients in the emergency department in the early stage.
Materials and Methods: Eighty NSTEMI (Group 1) and 50 USAP (Group 2) patients who were consecutively admitted to our emergency department between November 2017 and May 2019 and diagnosed with acute coronary syndrome were included in the study. In both patient groups, PI measured with the Massimo-SET Root 7362A RDS7 non-invasive pulse oximetry probe and other routine laboratory measurements were measured and compared.
Results: The mean PI was significantly lower in NSTEMI patients (p <0.001). At 30-day patient follow-up, the PI of the reduce was significantly lower (P <0.001). The area under the curve was significantly lower for PI in NSTEMI patients (area under the curve 0.313, p = 0.016). At 30-day patient follow-up, the level of PI was significantly lower in the died patients than the survived patients (P <0.001). The area under the curve was significantly lower for PI in NSTEMI patients (area under the curve 0.313, p = 0.016).
Conclusions: Although our study shows that PI may be an early marker in the distinguish of NSTEMI and USAP patients and may be useful in predicting the mortality of these patients, more extensive studies will support our hypothesis.

Keywords

• Perfusion Index
• Non ST segment elevation myocardial infarction
• Unstable angina pectoris

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