Akut Koroner Sendromda Fibrozis-4 İndeksinin Yüksek Troponin Düzeyleri için Öngördürücü Değeri

Öz

Amaç: Non-alkolik yağlı karaciğer hastalığı nüfusun yaklaşık üçte birini etkiler. Kardiyovasküler hastalıklar, non-alkolik yağlı karaciğer hastalığı olan hastalarda ölümün başlıca nedenidir. Çalışmalar, zirve troponin seviyesinin akut koroner sendrom sonrası tüm nedenlere bağlı ölümün ve sol ventrikül infarkt alanı genişliğinin güçlü bir öngörücüsü olduğunu göstermiştir. Fibrozis-4 (FIB-4) indeksi, karaciğer fibrozunu ölçmek için dört laboratuvar parametresini birleştiren invaziv olmayan bir klinik araçtır. FIB-4 indeksi ile zirve troponin seviyesi arasındaki ilişki bilinmemektedir. Yüksek FIB-4 indeks seviyesinin kardiyovasküler hastalıklar ile bağlantılı olduğu bilindiği için zirve troponin seviyelerinin de FIB-4 indeks ile ilişkili olabileceğini varsaydık. Bu çalışmada akut koroner sendrom hastalarında zirve troponin seviyesi ile FIB-4 indeksi arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve Yöntemler: Bu çalışma gözlemsel, kesitsel bir kohort çalışmasıydı. Haziran ve Eylül 2023 arasında kliniğimize kabul edilen akut koroner sendrom hastalarından toplam 302 hasta çalışmaya dahil edildi. FIB-4 indeksi ve zirve troponin seviyeleri değerlendirildi. Ortalama zirve troponin seviyesi belirlendi ve hastalar bu seviyenin altında veya üstünde olup olmamasına göre iki gruba ayrıldı ve birbirleriyle karşılaştırıldı. Bulgular: FIB-4 indeksinin akut koroner sendrom hastalarında zirve troponin seviyelerinin güçlü bir öngörücüsü olduğunu gösterdik (Odds oranı: 2.301, %95 CI 1.667-3.172, p<0.001). Sonuç: Akut koroner sendrom hastalarında daha yüksek bir FIB-4 indeksi, daha yüksek troponin seviyeleri ile ilişkilidir. Daha yüksek bir FIB-4 indeksi olan akut koroner sendrom hastalarında daha fazla önleyici tedbir almanın klinisyenler için faydalı olabileceği düşünülebilir.

Anahtar Kelimeler

• FIB-4 indeks
• akut koroner sendrom
• troponin

Destekleyen Kurum

Çalışma için herhangi bir kurumdan finansal destek alınmamıştır.

Etik Beyan

Araştırmayı yapmadan önce kurumumuz etik kurulundan etik onay aldık (26.05.2023 / E-64960800-799-216481811/).

PREDICTIVE VALUE OF FIBROSIS-4 INDEX FOR HIGHER TROPONIN LEVELS IN ACUTE CORONARY SYNDROME

Öz

Objective: Non-alcoholic fatty liver disease, a condition that affects nearly one-third of the population, is associated with cardiovascular disease and is the leading cause of death. Studies have found that peak troponin level is a strong predictor of all- cause death and infarct area width in the left ventricle after acute coronary syndrome. The fibrosis-4 (FIB-4) index is a noninvasive clinical tool that combines four laboratory parameters to measure liver fibrosis. The relationship between the FIB-4 index and peak troponin level is unclear. We speculated that a higher FIB-4 index might be associated with higher peak troponin levels, as it is linked to cardiovascular disease. We aimed to explore the relationship between peak troponin levels and the FIB-4 index in patients with acute coronary syndrome. Material and Methods: This was an observational, cross- sectional cohort study. A total of 302 inpatients with acute coronary syndrome admitted to our clinic between June and September 2023 were enrolled. The FIB-4 index and peak troponin levels were evaluated. The maximum mean troponin level was determined, and two patient groups were formed and compared according to whether it was below or above this level. Results: We demonstrated for the first time that the FIB-4 index is a strong indicator of peak troponin levels in patients with acute coronary syndrome (odds ratio: 2.301, 95% CI 1.667-3.172, p<0.001). Conclusion: A higher FIB-4 index in patients with acute coronary syndrome was associated with higher troponin levels. It may be beneficial for clinicians to take more preventive measures in patients with acute coronary syndrome with a higher FIB-4 index.

Anahtar Kelimeler

• FIB-4 index
• acute coronary syndrome
• troponin

Destekleyen Kurum

This research received no grants from any funding agency in the public, commercial, or not-for-profit sectors.

Etik Beyan

Prior to conducting the study, we obtained ethical approval from the ethics committee at our institution (Health Directorate Scientific Research Application Review Commission / 26.05.2023 / E-64960800-799-216481811/).

Kaynakça

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