Acil Serviste Tanı Alan Stmı ve Nstmı Hastalarda Troponin Değerleri ve Scube 1 Değerlerinin Tanısal Karşılaştırılması

Year 2021, Volume: 13 Issue: 2, 251 - 256, 07.06.2021

Fatma Nihal Özmen Hasan Sultanoğlu , Umut Çavuş , Alpaslan Öztürk

https://doi.org/10.18521/ktd.759490

Abstract

Amaç: Bu çalışmada ST elevasyonlu miyokard ifarktüsü (STEMI) ve ST elevasyonu olmayan miyokard ifarktüsü (NSTEMI) hastalarında troponin ve serum signal peptide-CUB-EGF domain-containing protein 1 (SCUBE 1) markerlarını karşılaştırıp erken tanıdaki SCUBE 1 değerinin tanısal önemini saptamayı amaçladık.

Gereç ve Yöntem: Çalışma 01.10.2016 ve 01.02.2017 tarihleri arasında Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi acil servisinde, akut miyokard infaktüsü tanısı konan 119 hasta ve 30 kontrol grubu ile prospektif olarak gerçekleştirildi. Hastaların yaş, cinsiyet, white blood cell (WBC), nötrofil, lenfosit, nötrofil/lenfosit, red cell distribution width (RDW), trombosit, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK) , CK-MB, troponin ve AMİ alt tipinin SCUBE 1 düzeyleri olan ilişkisi incelendi. Veriler SPSS Windows 22 versiyonunda analiz edildi.

Bulgular: Hastaların yaş ortalaması 61,5±14,5 yıl olup, %68,9’u erkekti. Hastaların SCUBE 1 düzeyi 79,7ng/mL, kontrol grubunun SCUBE 1 düzeyi 63,2 ng/ml olarak saptandı. AMI’li hastalar ve kontrol grubu arasında SCUBE 1 düzeyi benzerdi (p>0,05). SCUBE 1 düzeyi ve yaş arasında korelasyon saptanmadı (p>0,05). Hasta gruptaki kadınlarda SCUBE 1 düzeyi anlamlı olarak yüksekti (p<0,05).Hastalarda WBC, CK-MB ve troponin düzeyleri SCUBE 1 arasında pozitif yönlü korelasyon saptandı. Nötrofil, lenfosit, nötrofil/lenfosit oranı RDW, platelet, AST, ALT ve CK düzeylerinin SCUBE 1 ile arasında korelasyon saptanmadı (p>0,05). İnfaktüs tipi ve SCUBE 1 düzeyi arasında ilişki saptanmadı (p>0,05).

Sonuç: AMI’li hastalarda SCUBE 1 düzeyindeki artış anlamlı değildi. Testin spesifitesi ve sensitivitesinin diğer markerlara göre düşük olması sebebiyle, pratik kullanım için yetersiz olduğu kanısı doğmaktadır.

Keywords

SCUBE 1, Akut miyokard infarktüsü, Troponin

Supporting Institution

yok

Project Number

yok

Diagnostic Comparison Of Troponin and Scube 1 Levels In Patients Diagnosed with Stemi and Nstemi In The Emergency Department

Abstract

Objective: In the present study we aimed to compare the levels of troponin and SCUBE1 markers to determine the diagnostic role of SCUBE1 in patients with STEMI-NSTEMI.

Method: This study was prospectively conducted with 119 patients diagnosed with acute myocardial infarction at the emergency department and 30 control subjects between 01.10.2016 and 01.02.2017. The relationship between age, sex, acute myocardial infarction (AMI)type, white blood cell(WBC), lymphocyte, neutrophil, neutrophil/lymphocyte ratio, red cell distribution width(RDW), thrombocyte count, aspartate aminotransferase(AST), alanine aminotransferase(ALT), CK, CK-MB, troponin, and SCUBE 1 level was examined. Age, sex, and SCUBE 1 level were compared between the patient and control groups.

Results: The patients had a mean age of 61.5±14.5 years, and 68.9% of them were male. The patients had a SCUBE 1 level of 79.7 ng/mL and the control group 53.2 ng/ml.SCUBE1 level was comparable between the patients with acute myocardial infarction and the control group. A correlation was found between the SCUBE1 level and age. Women in the patient group had a significantly higher SCUBE1 level. There was a positive correlation between the WBC, CKMB, and troponin levels, and SCUBE 1 level in the patient group. No correlation was found between SCUBE 1 level and neutrophil, lymphocyte, neutrophil/lymphocyte ratio, RDW, platelet, AST, ALT, and CK levels. There was no significant correlation between infarction type and SCUBE 1 level.

Conclusion: SCUBE1 level did not significantly rise in patients with acute myocardial infarction. As the test had lower sensitivity and specificity compared to the other markers, we believe that it is not suitable for practical use.

Keywords

SCUBE 1, acute myocardial infarction, Troponin

Project Number

yok

References

• 1.World Health Organization. Cardiovascular diseases (CVDs). Fact sheet N°317. Updated January2015.SonErişimTarihi:17.10.2016 http://www.who.int/mediacentre/factsheets/fs317/en/
• 2.Antman E, Bassand J-P, Klein W, Ohman M, Sendon JLL, Rydén L, et al. Myocardial infarction redefined-a consensus document of The Joint European Society of Cardiology/American College of Cardiology committee for the redefinition of myocardial infarction: The Joint European Society of Cardiology/American College of Cardiology Committee∗∗ A list of contributors to this ESC/ACC Consensus Document is provided in Appendix B. Journal of the American College of Cardiology. 2000;36(3):959-69.
• 3.Hollander JE, Diercks DB. Acute coronary syndromes. In: Tintinalli JE (Eds), Emergency Medicine:A Comprehensive Study Guide (7th ed ) Chapter 49. McGraw-Hill 2016; Pp: 332-48.
• 4.Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined-a concensus document of the Joint European Society of Cardiology / American College of Cardiology Committee for the Redefinition of Myocardial Infarction. J Am Cardiol 2000;36: 959-69.
• 5.Dai D-F, Thajeb P, Tu C-F, Chiang F-T, Chen C-H, Yang R-B, et al. Plasma concentration of SCUBE1, a novel platelet protein, is elevated in patients with acute coronary syndrome and ischemic stroke. Journal of the American College of Cardiology. 2008;51(22):2173-80.
• 6.Turkmen S, Mentese S, Mentese A, Sumer AU, Saglam K, Yulug E, et al. The value of signal peptide-CUB-EGF domain containing protein 1 and oxidative stress parameters in the diagnosis of acute mesenteric ischemia. Academic Emergency Medicine. 2013;20(3):257-64.
• 7. Şahin A, Türkmen S, Menteşe A, Karahan S C, Günaydın M5, Türedis, Gündüz A. Angina Pektoris Nedeniyle Acile Başvuran Hastaların Tanısında Scube1’in Değeri. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 2018;20(2):131-137.
• 8.Tanrıkulu CŞ, Tanrıkul Y, Karaman S. Acil Servis ve Hasta Başvuruları. J Clin Anal Med 2014;5(2): 128-3.
• 9.Trip MD, Cats VM, van Capelle FJ, Vreeken J. Platelet hyperreactivity and prognosis in survivors of myocardial infarction. The New England journal of medicine. 1990;322(22):1549-54.
• 10.Huisse MG, Ajzenberg N, Feldman L, Guillin MC, Steg PG. Microparticle-linked tissue factor activity and increased thrombin activity play a potential role in fibrinolysis failure in ST-segment elevation myocardial infarction. Thrombosis and haemostasis. 2009;101(4):734-40.
• 11.Steppich B, Mattisek C, Sobczyk D, Kastrati A, Schomig A, Ott I. Tissue factor pathway inhibitor on circulating microparticles in acute myocardial infarction. Thrombosis and haemostasis. 2005;93(1):35-9.
• 12.Turkmen S, Eryigit U, Karaca Y, Mentese A, Sumer UA, Yulug E, et al. Diagnostic value of plasma signal peptide-Cub-Egf domain-containing protein-1 (SCUBE-1) in an experimental model of acute ischemic stroke. The American journal of emergency medicine. 2015;33(2):262-5.
• 13.Chiva-Blanch G, Laake K, Myhre P, Bratseth V, Arnesen H, Solheim S, et al. Platelet-, monocyte-derived and tissue factor-carrying circulating microparticles are related to acute myocardial infarction severity. PLoS One. 2017;12(2):e0172558.
• 14.Karakas MS, Korucuk N, Tosun V, Altekin RE, Koc F, Ozbek SC, et al. Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction. Journal of the Saudi Heart Association. 2016;28(3):152-8.
• 15.Feistritzer HJ, Reinstadler SJ, Klug G, Reindl M, Wohrer S, Brenner C, et al. Multimarker approach for the prediction of microvascular obstruction after acute ST-segment elevation myocardial infarction: a prospective, observational study. BMC cardiovascular disorders. 2016;16(1):239.
• 16.Ulusoy S, Ozkan G, Mentese A, Yavuz A, Karahan SC, Sumer AU. Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1) level in hemodialysis patients and parameters affecting that level. Clinical biochemistry. 2012;45(16-17):1444-9.
• 17.Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Which white blood cell subtypes predict increased cardiovascular risk? Journal of the American College of Cardiology. 2005;45(10):1638-43.
• 18.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.
• 19.Oncel RC, Ucar M, Karakas MS, Akdemir B, Yanikoglu A, Gulcan AR, et al. Relation of neutrophil-to-lymphocyte ratio with GRACE risk score to in-hospital cardiac events in patients with ST-segment elevated myocardial infarction. Clinical and Applied Thrombosis/Hemostasis. 2015;21(4):383-8.
• 20.Isik T, Kurt M, Ayhan E, Tanboga IH, Ergelen M, Uyarel H. The impact of admission red cell distribution width on the development of poor myocardial perfusion after primary percutaneous intervention. Atherosclerosis. 2012;224(1):143-9.
• 21.Günaydın M, Türkmen S, Sahin A, Sümer A, Menteşe A, Türedi S, et al. The diagnostic value of SCUBE1 levels in acute ischemic stroke. Türk Biyokimya Dergisi [Turkish Journal of Biochemistry–Turk J Biochem]. 2014;39(1):107-12.
• 22.Kälsch J, Bechmann LP, Heider D, Best J, Manka P, Kälsch H, et al. Normal liver enzymes are correlated with severity of metabolic syndrome in a large population based cohort. Scientific reports. 2015;5:13058.
• 23.Baars T, Neumann U, Jinawy M, Hendricks S, Sowa JP, Kalsch J, et al. In Acute Myocardial Infarction Liver Parameters Are Associated With Stenosis Diameter. Medicine. 2016;95(6):e2807.
• 24.Pernet K, Ecarnot F, Chopard R, Seronde MF, Plastaras P, Schiele F, et al. Microvascular obstruction assessed by 3-tesla magnetic resonance imaging in acute myocardial infarction is correlated with plasma troponin I levels. BMC cardiovascular disorders. 2014;14:57.
• 25.Neizel M, Futterer S, Steen H, Giannitsis E, Reinhardt L, Lossnitzer D, et al. Predicting microvascular obstruction with cardiac troponin T after acute myocardial infarction: a correlative study with contrast-enhanced magnetic resonance imaging. Clinical research in cardiology. 2009;98(9):555.