Akut ST Yüksekliği Olmayan Miyokard İnfarktüsü Tanısında Erken Diyagnostik Belirteç Olarak Kalp Tipi Yağ Asidi Bağlayıcı Protein’in Kalitatif Ölçümünün, Diğer Kardiyak Belirteçler İle Karșılaștırılması

Year 2013, Volume: 66 Issue: 3, 107 - 113, 13.11.2014

Demet Menekse Gerede Uludağ , Sadi Güleç Veysel Kutay Vurgun , Özgür Ulaş Özcan , Hüseyin Göksülük , Çetin Erol

Abstract

Objective: Heart type fatty acid binding protein (H-FABP) is a new cardiac marker which is used in early diagosis (within the first two hours) of acute myocardial infarction (MI) and which shows myocyte injury. In our study, it was aimed to compare bed-side H-FABP measurement with routinely used CK-MB and troponin I for early diagnosis of non ST elevation MI (NSTEMI) and for determining its exclusion capacity.

Material and Method: A total of 48 patients who were admitted to emergency room with ischemic type chest pain lasting for more than 30 minute within the first 12 hours and who did not have ST segment elevation on electrocardigraphy (ECG) were included in the study. Definite diagnosis of NSTEMI was made in 24 patients as the result of 24-hour follow up, remaining 24 patients did not develop MI.

Results: When various subgroups were analysed according to admission hours, H-FABP was detected to be a beter diagnostic marker (accuracy 85%) comparedto CK-MB and troponin with high sensitivity (79%) and specifity (93%) in early diagnosis (≤6 hours) (p<0,05).

Conclusion: Bed-side H-FABP measurement may be considered to contribute to correct and early diagnosis as it elevated early following MI, its measurement is easy and it provides a rapid result.

Keywords

Acute Coronary syndrome , Non ST Elevation Myocardial Infarction , H-FABP , CK-MB , troponin

Ethical Statement

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Akut ST Yüksekliği Olmayan Miyokard İnfarktüsü Tanısında Erken Diyagnostik Belirteç Olarak Kalp Tipi Yağ Asidi Bağlayıcı Protein’in Kalitatif Ölçümünün, Diğer Kardiyak Belirteçler İle Karșılaștırılması

Abstract

Amaç: Kalp tipi serbest yağ asidi bağlayıcı protein (H-FABP), akut miyokardinfarktüsünün (MI) erken dönem (ilk iki saat) tanısında kullanılan ve miyosit hasarını gösteren yeni bir kardiyak belirteçdir. Çalıșmamızda yatak bașı kalitatif H-FABP ölçümünün, ST yükselmesiz MI (NSTEMI)’nü erken tanıma ve dıșlama kabiliyetini belirlemek için rutinde kullanılan CK-MB kütle ve troponin I ile karșılaștırılması amaçlanmıștır.

Gereç ve yöntem: Çalıșmaya 30 dakikadan fazla süren iskemik tipte göğüs ağrısı yakınmasıyla ilk 12 saat içinde acil servise bașvuran ve elektrokardiyografi (EKG)’de ST yüksekliği bulunmayan 48 hasta alınmıștır. 24 saatlik takip sonucunda bu hastaların 24’ünde NSTEMI tanısı kesinleșmiș, kalan 24 hastada ise MI gelișmemiștir.

Bulgular: Hastaneye bașvuru saatlerine göre değișik altgruplar incelendiğinde H-FABP’nin erken tanıda (≤6 saat) yüksek sensitivite (%79) ve spesifisite (%93) ile CK-MB ve troponine kıyasla daha iyi bir diyagnostik belirteç olduğu (geçerlilik indeksi %85) tesbit edilmiștir (p<0,05).

Sonuç: H-FABP’ininfarkt sonrası erken yükselmesi, ölçümünün kolay olması ve hızlı sonuç vermesi gibi nedenlerle acil servislerde yatak bașı kullanımının doğru ve erken tanıda katkı sağlayacağı düșünülebilir..

Keywords

Akut Koroner Sendrom , ST YükselmesizMiyokardİnfaktüsü , H-FABP , CK-MB , Troponin

Ethical Statement

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Supporting Institution

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Project Number

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Thanks

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