ST SEGMENT YÜKSELMESİZ MİYOKART ENFARKTÜS HASTALARINDA SİSTEMİK İMMÜN ENFLAMASYON İNDEKSİ VE MORTALİTE İLİŞKİSİ

Yıl 2023, Cilt: 30 Sayı: 3, 388 - 395, 23.09.2023

Sercan Çayırlı Ömer Faruk Rahman Berk Mutlu Sevil Gülaştı

https://doi.org/10.17343/sdutfd.1292723

Öz

Amaç
Akut koroner sendrom mortalitesi ve morbiditesi yüksek
bir sendromdur. Yüksek riskli hastaların hastane
yatışı esnasında belirlenmesi ve gerekli durumlarda
erken revaskülarizasyon stratejilerinin uygulanması
hastalarda hayati önem arz etmektedir. Klinik pratikte
bu hastaların hızlıca belirlenmesine yönelik basit, etkili,
maliyeti ucuz bir indeks ihtiyacı olduğu aşikardır.
Tüm bu nedenlerden dolayı bu çalışmada tarafımızca
SII’nın, AKS alt grubu olan NSTEMI geçiren hastalarda
mortaliteyi ön görmedeki yerinin araştırılması
amaçlanmıştır.
Gereç ve Yöntem
01.01.2022-31.12.2022 tarihleri arasından Aydın Adnan
Menderes Üniversitesi Tıp Fakültesi Uygulama
ve Araştırma Hastanesi koroner anjiyografi ünitesinde
koroner anjiyografi işlemi uygulanan hastalar geçmişe
dönük olarak tarandı. St segment yükselmesiz miyokart
enfarktüsü geçiren hastalarda ve normal koroner
arterler saptanan hastalarda SII [(nötrofil x platelet) /
lenfosit] hesaplandı. Bu indeks ile tüm nedenlere bağlı
mortalite gelişimi arasında ilişki olup olmadığı araştırıldı.
Bulgular
Grup 1 olarak değerlendirilen NSTEMI grubu SII indeks
ortancası Grup II’ye göre anlamlı düzeyde yüksek
bulundu (p<0.001). Mortalite gözlenen gruba ait
nötrofil ve SII indeksi değerleri ortalaması, sağkalım
grubuna göre istatistiksel olarak anlamlı derecede
yüksek bulundu (sırasıyla p=0.002 ve p=0.019). Çok
yönlü lojistik regresyon sonucunda, NSTEMI varlığı
yaş (odds ratio [OR]: 9.891; 95% CI: 2.096-46.671,
p<0.001) ve SII indeksinin (odds ratio [OR]: 1.001;
95% CI: 1.000-1001, p=0.039) tüm nedenlere bağlı
mortaliteyi bağımsız olarak öngördüğü saptandı. NSTEMI
grubunda SII indeksi 609.98 değerinden yüksek
olguların sağkalım beklentisi 18 ay için %68.1, SII indeksi
609.98 değerinden düşük olgular için ise %79.3
olarak hesaplandı ancak fark istatistiksel olarak anlamlı
bulunmadı (p=0.426).
Sonuç
SII, NSTEMI hasta grubunda mortaliteyi ön görmede
faydalı bir indeks olmasına rağmen sağ kalımı öngörmede
yeterli değildir.

Anahtar Kelimeler

SII, mortalite, miyokart enfarktüsü

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

YOK

ASSOCIATION BETWEEN SYSTEMIC IMMUNEINFLAMMATION INDEX AND MORTALITY IN PATIENTS WITH NON-ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

Öz

Objective
Acute coronary syndrome (ACS) is a disease associated
with high mortality and morbidity. It is essential to
identify high-risk patients during hospitalization and
to implement early revascularization strategies if
necessary. There is a clear need for a simple, effective
and cost-effective index for rapid identification of these
patients in clinical practice. The aim of this study was
to investigate the clinical significance of the systemic
immune inflammation index (SII) in non-ST-segment
elevation myocardial infarction (NSTEMI), a subgroup
of ACS, and to evaluate its association with mortality.
Material and Method
Patients who underwent coronary angiography at the
Coronary Angiography Unit of Aydın Adnan Menderes
University Faculty of Medicine Research and Training
Hospital between January and December 2022 were
retrospectively reviewed. Individuals with a diagnosis
of NSTEMI were included as group I, and individuals
with normal coronary arteries during coronary
angiography were included as group II (control group).
Clinical variables and calculated SII values of the
groups were recorded. The role of SII in predicting
all-cause mortality and its effect on expected survival
were evaluated.
Results
The median value of the SII index was significantly
higher in the NSTEMI group (group I) than in the control
group (group II) (p<0.001). The mean neutrophil and
SII index values of the mortality group were significantly
higher than those of the survival group (p=0.002 and
p=0.019, respectively). Multivariate logistic regression
showed that the presence of NSTEMI (odds ratio [OR]:
9.891; 95% CI: 2.096-46.671, p<0.001) and SII index
(odds ratio [OR]: 1.001; 95% CI: 1.000-1001, p=0.039)
independently predicted all-cause mortality. The cutoff
point for the SII index was 609.98 using ROC
curve analysis. Survival expectancy at 18 months was
68.1% for group I patients with SII >609.98 and 79.3%
for group I patients with SII <609.98, but the difference
was not statistically significant (p=0.426).
Conclusion
The SII score can help predict all-cause mortality in
NSTEMI patients, but it is unsuitable for predicting
survival.

Anahtar Kelimeler

SII, mortality, myocardial infarction

Proje Numarası

yok

Kaynakça

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