The Relationship Between Asymmetric Dimethylargin Level and Short and Long Term Prognosis In Patients Presented with ST Segment Elevated Myocardial Infarction

Öz

objecitves: ST segment elevation myocardial infarction (STEMI) is regarded as a type of acute coronary syndrome. However, the mortality of STEMI patients is substantial. Asymmetric dimethylarginine (ADMA) is the major inhibitor of nitric oxide biosynthesis in humans. Studies have shown that increased ADMA levels are associated with endothelial dysfunction and increased atherogenesis. It is aimed to show the relationship between ADMA and prognosis of ST elevation MI. Materials and methods: The study population was 45 (40 male, 5 female) patients with diagnosis of STEMI, who underwent primary percutaneous coronary intervention (PCI). Demographic data, blood tests and medical history of the patients were recorded. Ten cc of blood samples were collected right after sheat application. ADMA levels were studied by ELISA kit. Results: The follow-up period was 42.837±14.343 months. The mean age was 52.4±7.8. Only significant relation was observed between ADMA levels and heart rate (p=0.025). Other relations with demographic data, risk factors for STEMI, follow-up events such as major adverse cardiovascular events, heart failure, target vessel revascularization, reinfarction, ongoing myocardial ischemia, in-hospital events, intervention artery, type of intervention, Pre-TIMI, ejection fraction, use of tirobufan, anterior or inferior MI were not statistically significant (p>0.05). Although, a positive relation was observed between ADMA levels and chronic heart failure, it was not significant. Conclusions: Although, there was a relation with heart failure, the only significant relation was found between ADMA levels and heart rate. Further studies with greater number of participants should be performed for drawing strict conclusions.

Anahtar Kelimeler

• STEMI
• 42 months follow-up
• mortality and morbidity

ST Segment Yükselmeli Miyokardial Enfarktüs İle Başvuran Hastalarda Asimetrik Dimetilarjinin Düzeyinin Kisa Ve Uzun Dönem Prognoz İle İlişkisi

Öz

Amaç: ST segment yükselmeli miyokard infarktüsü (STYMI) bir akut koroner sendrom türü olarak kabul edilir. Bununla birlikte, STYMI hastalarının ölüm oranı yüksektir. Asimetrik dimetilarjinin (ADMA), insanlarda nitrik oksit biyosentezinin ana inhibitörüdür. Araştırmalar, artmış plazma ADMA seviyelerinin endotel disfonksiyonu ve artmış aterogenez ile ilişkili olduğunu göstermiştir. Bu çalışmada saptanan ADMA düzeyinin STYMI hastalarında prognoz ile ilişkisi gösterilmeye çalışılacaktır. Materyal ve Metod: Çalışma primer perkütan koroner girişim (PKG) yapılan STYMI tanısı konmuş 45 (40 erkek, 5 kadın) hastaydı. Demografik veriler, kan testleri ve hastaların tıbbi öyküleri kaydedildi. Sheat uygulamasından hemen sonra 10 cc kan örneği alındı. ADMA seviyeleri ELISA kiti ile incelendi. Anlamlılık derecesi% 95 olarak belirlendi. Bulgular: Takip süresi 42.837±14.343 aydı. Ortalama yaş 52.4 ± 7.8 idi. Ortalama taburculuk süresi 7.5 ± 3.3 gündü. ADMA düzeyleri ile kalp hızı arasında anlamlı bir ilişki gözlendi (p = 0,025). Demografik verilerle diğer ilişkiler, STYMI için risk faktörleri, major advers kardiyovasküler olay, kalp yetmezliği, hedef damar revaskülerizasyonu, reenfarktüs, devam eden miyokardial iskemi gibi takipteki olaylar, hastane içi olaylar, müdahale yapılan arter, girişim tipi, pre-TIMI, ejeksiyon fraksiyonu, tirobufan, anterior veya inferior miyokard enfarktüsü için istatistiksel olarak anlamlı değildi (p> 0.05). ADMA düzeyleri ile kronik kalp yetmezliği arasında pozitif bir ilişki gözlense de, anlamlı değildi. Sonuçlar: Kalp yetersizliği ile bir ilişki olmasına rağmen, tek anlamlı ADMA düzeyleri ile kalp hızı arasında ilişki bulundu. Daha kesin sonuçlar varmak için daha büyük ölçekte çalışmalar yapılmalıdır.

Anahtar Kelimeler

• ADMA
• ADMA
• STYMI
• 42 ay takip
• mortalite ve morbidite

Teşekkür

Makalenin yazımında ve düzenlenmesindeki yardımlarından ötürü Dr. Öğr. Üyesi Fatih Cabbar’a teşekkürlerimizi sunarız.

Kaynakça

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