CHEST PAIN AND SINGLE TROPONIN

Yıl 2020, , 562 - 566, 30.12.2020

Süha Serin , Bahadir Çağlar

https://doi.org/10.16899/jcm.790433

Öz

Aim: It is important to exclude the diagnosis of acute coronary syndrome quickly and accurately. This study aims to exclude the diagnosis of acute myocardial infarction (AMI) with a single troponin value in patients with appropriate clinical evaluation and electrocardiography (ECG)
Materials and Methods: Among the patients who were followed up with a pre-diagnosis of AMI and for whom a HEART score was calculated, patients whose high sensitive troponin I result was found below the limit of detection (LoD) value and who were discharged is included in study. All patients were contacted on the 30th day of discharge. The status of "major adverse cardiac events" (MACE-30) in the last 30 days was questioned.
Results: The HEART score of 122 patients (73.1%) in the study was found to be at low risk while 45 (26.9%) as moderate. MACE-30 developed in only 5 patients (3%). Of the 5 patients who developed Mace; The HEART score of 3 (60%) was determined as 5, whereas the heart score of 2 (40%) was 6. p <0.001. It was observed that no mace was detected in any patient with a low risk HEART score (p <0.001). The cut off value for the heart score was found to be ≤4 (p<0,001) while the cut off value for age was found to be ≤69 (p<0,001).
Conclusion: We think that patients presenting to the emergency with chest pain, a troponin value below LoD and a low HEART score can be discharged from the emergency department with a single troponin.

Anahtar Kelimeler

Emergency service, Angina, Acute coronary syndrome, Troponin

GÖĞÜS AĞRISI VE TEK TROPONİN

Öz

Amaç: Akut koroner sendrom tanısını hızlı ve doğru şekilde dışlamak önemlidir. Çalışmanın amacı, klinik değerlendirme ve elektrokardiyogarfisi (EKG) uygun hastalarda, tek troponin değeri ile akut miyokard enfarktus (AMI) tanısını dışlamaktır.
Gereç ve Yöntem: Acil serviste AMI ön tanısı ile izlenen ve HEART score hesaplanan hastalar arasından; high sensitive troponin I sonucu limit of detection (LoD) değeri altında saptanan ve taburcu edilen hastalar çalışmaya alındı. Tüm hastalar taburculuğun 30. gününde telefon ile arandı. Son 30 gün içinde “major adverse cardiac events” (MACE-30) durumları sorgulandı.
Bulgular: Çalışmadaki 122 hastanın (73.1%) HEART score low risk, 45 hastanın (26.9%) HEART score moderate risk olarak bulundu. MACE-30 sadece 5 hastada (3%) gelişmiştir. Mace gelişen toplam 5 hastadan; 3 ünün (60%) HEART score 5, 2 sinin (40%) heart skoru 6 olarak saptandı. p<0,001. HEART score low risk olan hiçbir hastada mace saptanmadığı görüldü. (p<0,001). Heart skoruna yönelik cut off değeri ≤4 olarak bulundu. (p<0,001). Yaş için cut off değeri ≤69 bulunmuştur. (p<0,001).
Sonuç: Göğüs ağrısı ile acil servise başvuran, troponin LoD değerinin altında olan ve düşük HEART skorlu hastaların acil servisten tek troponin ile taburcu edilebileceğini düşünüyoruz.

Anahtar Kelimeler

Acil servis, Anjina, Akut koroner sendrom, Troponin

Kaynakça

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