Akut koroner sendrom hastalarında kardiyotropin-1 (CT-1) düzeyinin değerlendirilmesi ve kardiyak enzimlerdeki artış (CK, CK-MB, Tn-T, AST) ile arasındaki korelasyonun değerlendirilmesi
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Date
2014
Authors
Polat, Ufuk
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Koroner kalp hastalığı gelişmiş ülkelerde olduğu gibi ülkemizde de gerek mortalite, gerekse morbidite nedeni olarak ilk sıradadır. Akut koroner sendrom (AKS), aterosklerotik plaktaki rüptür ya da ülserasyon sonucu ortamda trombüs oluşmasıyla gelişmektedir. Son zamanlarda koroner arter hastalığı dahil pek çok kardiyovasküler hastalığın patogenezinde fibrinojen, C-reaktif protein (CRP), beyaz küre (BK) gibi akut faz reaktanları ile tümör nekroz faktör alfa (TNF-alfa), interlökin-6 (İL-6) gibi sitokinler ve interlökin-2 reseptörlerinin (İL-2R) rolleri üzerinde durulmaktadır. Koroner arter hastalığı erken mudehale edilmediği takdirde mortal seyri, kardiyak miyosit kaybı sonucu kalp yetmezliğine gidiş gibi ciddi sonuçlara neden olduğundan tanı koymada yeni biyobelirteçler aranmaktadır. Bu yeni biyobelirteçlerden biri de çalışmamızda yeralan Kardiyotropin-1 (CT-1) molekülüdür. CT-1 molekülünün kardiyovasküler hastalıklarda arttığı ve bu sayede kardiyak miyositleri hem termal hem de iskemik stresten koruduğu bilinmektedir. Belirgin kardiyak koruyucu etkisi vardır. Malign hastalığı olanlar, kronik böbrek yetmezlikli hastalar, karaciğer yetmezliği olan, ciddi kalp yetmezliği olan, kontrolsüz hipertansif hastalar, ciddi aort ve mitral kapak hastaları, infeksiyöz ve romatizmal hastalıklar gibi inflamatuvar belirteçleri değiştiren hastalığı olanlar, çalışmaya alınmadı. Biz de çalışmamızda akut koroner sendrom hastalarında CK, CK-MB ve kardiyak troponine (cTn) alternatif olabilecek bir biyobelirteç olan CT-1 in akut koroner sendromdaki rolünü araştırdık. Çalışmaya kararsız angina pektoris (USAP), ST elevasyonlu miyokard infarktüsü ve ST elevasyonsuz miyokard enfarktüsü tanılarını alan toplam 40 hasta dahil edildi. Çalışmaya alınan 40 akut koroner sendrom hastasının ilk başvuru anı ve 6. saat enzim (CK, CK-MB ve Troponin) değerlerine bakıldığında anlamlı bir artış saptanmaktaydı (p<0,01). Hastaların başvuru anında değerlendirilen enzim ve CT-1 kan düzeyleri ile 6. saat kontrolleri arasında yaklaşık olarak üç (3) kat artış vardı. CT-1 ile CK, CK-MB ve Tn-T parametreleri arasında istatistiksel olarak anlamlı bir korelasyon izlendi (p<0,01). Sonuç olarak çalışmamızda, CT-1 düzeyleri, AKS' de anlamlı olarak yüksek bulunmuştur.
Evaluation of correlation between Cardiac enzymases (CK, CK-MB, cTN-T, AST) increase and Cardiotrophin-1 (CT-1) level at Acute Coronary Syndrome (ACS) patients. Coronary heart disease is the first reason of morbidity and mortality in our country as well as developed countries. Acute coronary syndrome (ACS) is occured by thrombosis in the environment as a result of atherosclerotic plaque rupture or ulceration. Recently the importance of the roles of acute phase reactans like C reactive protein (CRP) , White blood cell (WBC), and fibrinojen; cytokines like Tumor necrosis factors-alfa (TNF-alfa) and ınterleukin-6 (IL-6) and ınterleukin-2 (IL-2) receptors in pathogenesis of cardiovascular diseases are being considered. Coronary heart disease cause congestive heart failure due to loss of miyositis and further mortis unless early recognition. Because of this researches are focused on new bio-determinants to diagnose. Cardiyotrophin-1 (CT-1) is the one of this new bio-determinant which has been studied in this research. CT-1 is known as increase in cardiovascular diseases and prevent from both thermal and ischemic stres. There are prominent cardiac protective effect. Malign disease, chronic renal failure, liver failure, severe heart failure, uncontrolled hypertension, severe aort and mitral valvuler disease, infectious or rheumatological disease that can affect inflammatory markers were excluded from the study. This study has searched for the significance of CT-1 role on acute coronary syndrome as an alternative bio-determinant to CK, CK-MB and Troponin. Studies unstable angina pectoris (USAP), ST-elevation myocardial infarction (STEMI) and non ST-elevation myocardial infarction (NSTEMI) diagnosis, 40 patients were included in the total. The study of the 40 acute coronary syndrome patients first admission memories and 6 hrs control enzyme (CK, CK-MB and Troponin) looking at the values increased significantly detected was (p<0.01). The time of admittance evaluated enzyme and CT-1 blood levels 6 hrs controls with an approximately three (3) had fold increase. Istatistically significant correlation was detected between CK, CK-MB and Tn-T parameters (p<0,01). As a result, levels of CT-1 were significantly higher in ACS patients.
Evaluation of correlation between Cardiac enzymases (CK, CK-MB, cTN-T, AST) increase and Cardiotrophin-1 (CT-1) level at Acute Coronary Syndrome (ACS) patients. Coronary heart disease is the first reason of morbidity and mortality in our country as well as developed countries. Acute coronary syndrome (ACS) is occured by thrombosis in the environment as a result of atherosclerotic plaque rupture or ulceration. Recently the importance of the roles of acute phase reactans like C reactive protein (CRP) , White blood cell (WBC), and fibrinojen; cytokines like Tumor necrosis factors-alfa (TNF-alfa) and ınterleukin-6 (IL-6) and ınterleukin-2 (IL-2) receptors in pathogenesis of cardiovascular diseases are being considered. Coronary heart disease cause congestive heart failure due to loss of miyositis and further mortis unless early recognition. Because of this researches are focused on new bio-determinants to diagnose. Cardiyotrophin-1 (CT-1) is the one of this new bio-determinant which has been studied in this research. CT-1 is known as increase in cardiovascular diseases and prevent from both thermal and ischemic stres. There are prominent cardiac protective effect. Malign disease, chronic renal failure, liver failure, severe heart failure, uncontrolled hypertension, severe aort and mitral valvuler disease, infectious or rheumatological disease that can affect inflammatory markers were excluded from the study. This study has searched for the significance of CT-1 role on acute coronary syndrome as an alternative bio-determinant to CK, CK-MB and Troponin. Studies unstable angina pectoris (USAP), ST-elevation myocardial infarction (STEMI) and non ST-elevation myocardial infarction (NSTEMI) diagnosis, 40 patients were included in the total. The study of the 40 acute coronary syndrome patients first admission memories and 6 hrs control enzyme (CK, CK-MB and Troponin) looking at the values increased significantly detected was (p<0.01). The time of admittance evaluated enzyme and CT-1 blood levels 6 hrs controls with an approximately three (3) had fold increase. Istatistically significant correlation was detected between CK, CK-MB and Tn-T parameters (p<0,01). As a result, levels of CT-1 were significantly higher in ACS patients.
Description
Keywords
Kardiotropin-1, Akut koroner sendrom, Kalp koruyucu etki, Cardiotrophin-1, Acute coronary syndrome (ACS), Cardiac protective effect
Citation
Polat, U. (2014). Akut koroner sendrom hastalarında kardiyotropin-1 (CT-1) düzeyinin değerlendirilmesi ve kardiyak enzimlerdeki artış (CK, CK-MB, Tn-T, AST) ile arasındaki korelasyonun değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.