Akut inferior miyokard infarktüslü hastaların izleminde Osteoprotegerinin prognostik değeri
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Tarih
2008
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info:eu-repo/semantics/openAccess
Özet
Bu çalışma ilk kez miyokard infarktüsü geçiren hastalarda osteoprotegerinin prognostik değerini göstermek için yapıldı. Çalışmaya Koroner Yoğun Yoğun Bakım Ünitesi'ne inferior miyokard infarktüsü tanısıyla yatan 77 hastayı aldık. Sonrasında 6. hafta ve 6.ayda kontrol izlemleri yapıldı. 77 olgunun 29 (%37.6) tanesi 6. hafta kontrolüne, 32 (%41.5) tanesi ise 6. aylık kontrollerine gelmedi. Takip süresinde 3 (%3.9) hasta öldü. Çalışmaya alınan tüm hastalardan osteoproptegerin, açlık kan şekeri ve insülin için yatışının ilk 24 saati içinde, 6. hafta ve 6. ayında olmak üzere kan alındı. Hastaların yatışının 5. günde, 6. hafta ve 6. ayda efor testi ve transtorasik ekokardiyografileri yapıldı. Miyokard infarktüsünün akut döneminde osteoprotegerinin yükseldiği kronik dönemde ise giderek azaldığı ve bu düşüşün 6. aya kadar devam ettiğini gösterdik (Yatış ? 6. hafta p < 0.0001, 6. hafta ? 6. ay p = 0.0001, yatış ?6. ay p = 0.0001). Sol ventrikül diyastolik disfonksiyonu parametrelerinden E/A ile osteoprotegerinin serum seviyesi arasında 6. hafta ve 6. ay arasında anlamlı bir pozitif ilişki saptandı (6. hafta: r = 0.344, p = 0.021, 6. ay: r = 0.322, p = 0.031). Yatış ²heart rate recovery² değerinin yatış osteoprotegerinin serum seviyesi ile ilişkili olduğunu bulduk (r = 0.304, p = 0.043). Fakat takiplerdeki osteoprotegerinin serum seviyesi ile ²heart rate recovery² değerleri ilişkili değildi. Çalışmamız akut miyokard infarktüsünün sonrası osteoprotegerin serum seviyesinin plak stabilizasyonu süresince azaldığını, takipte osteoprotegerin serum seviyesinin diyastolik disfonksiyonu düzeltmede olumlu rolü olabileceğeni, yatış osteoprotegerin değerinin kardiyovasküler olaylar ve ölümü predikte edici özelliği olabileceğini göstermektedir.
This study was made to show prognostic value of osteoprotegerin in patients with firstly diagnosed myocardial infarction. We involved 77 patients hospitalized in Trakya University Faculty of Medicine Coronary Unit with acute inferior myocardial infarction in the study. Follow-up period, we evaluated the patients on the 6th week and 6th month after the infarction. 29(37.6 %) of 77 patients on the 6th week and 32 (41.5 %) on the 6th month, didnt come follow-up examinations. During the follow-up, 3 (3.9 %) patients died. In the first 24 hours admission of patients, and follow-up period 6th week and 6th month, blood samples were taken for osteoprotegerin, fasting blood glucose and insulin. On the following 5th day of admission and follow-up period, we made exercise test and transthoracic echocardiography. We showed that osteoprotogerin increased during the acute phase of myocardial infarction and decreased in the chronic phase and continued to decrease until the 6th month (initial ? 6th week p < 0.0001, 6th week ? 6th month p = 0.0001, initial ? 6th month p=0.0001). We found significant relationship between the serum osteoprotegerin levels on 6th week and 6th month and E/A of left ventricul diastolic dysfunction parameter (6th week r = 0.344, p=0.021, 6th month: r = 0.322, p = 0.031). We found relationship between initial heart rate recovery and initial osteoprotegerin level (r = 0.304, p = 0.043). But osteoprotogerin levels in follow-up period were not related with heart rate recovery values. Our study shows that osteoprotegerin levels after acute myocardial infarction decrease during the plaque stabilization period and osteoprotegerin levels in the follow up period may have a positive role on improving the diastolic dysfunction and initial osteoprotegerin levels may have a predictible value on cardiovasculer events and deaths.
This study was made to show prognostic value of osteoprotegerin in patients with firstly diagnosed myocardial infarction. We involved 77 patients hospitalized in Trakya University Faculty of Medicine Coronary Unit with acute inferior myocardial infarction in the study. Follow-up period, we evaluated the patients on the 6th week and 6th month after the infarction. 29(37.6 %) of 77 patients on the 6th week and 32 (41.5 %) on the 6th month, didnt come follow-up examinations. During the follow-up, 3 (3.9 %) patients died. In the first 24 hours admission of patients, and follow-up period 6th week and 6th month, blood samples were taken for osteoprotegerin, fasting blood glucose and insulin. On the following 5th day of admission and follow-up period, we made exercise test and transthoracic echocardiography. We showed that osteoprotogerin increased during the acute phase of myocardial infarction and decreased in the chronic phase and continued to decrease until the 6th month (initial ? 6th week p < 0.0001, 6th week ? 6th month p = 0.0001, initial ? 6th month p=0.0001). We found significant relationship between the serum osteoprotegerin levels on 6th week and 6th month and E/A of left ventricul diastolic dysfunction parameter (6th week r = 0.344, p=0.021, 6th month: r = 0.322, p = 0.031). We found relationship between initial heart rate recovery and initial osteoprotegerin level (r = 0.304, p = 0.043). But osteoprotogerin levels in follow-up period were not related with heart rate recovery values. Our study shows that osteoprotegerin levels after acute myocardial infarction decrease during the plaque stabilization period and osteoprotegerin levels in the follow up period may have a positive role on improving the diastolic dysfunction and initial osteoprotegerin levels may have a predictible value on cardiovasculer events and deaths.
Açıklama
Anahtar Kelimeler
Kardiyoloji, Cardiology
