Akut koroner sendrom ve stabil angina pektorisli hastalarda osteoprotegerin düzeyleri ile koroner arter hastalığının yaygınlığı ve geç dönem prognoz arasındaki ilişki
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Dosyalar
Tarih
2009
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma stabil angina pektoris ve anstabil angina pektoris / ST elevasyonsuz miyokard infarktüslü hastalarda serum osteoprotegerinin koroner arter hastalığının tanısı, yaygınlığı ve prognozundaki yerini değerlendirmek için yapıldı. Çalışmaya 30 kontrol grubu, 65 stabil angina pektoris grubu, 65 akut koroner sendrom grubu olmak üzere toplam 160 kişi alındı. Sonrasında 4. ayda kontrol izlemleri yapıldı. Stabil angina pektoris grubundan 4 hastaya, akut koroner sendrom grubundan 3 hastaya 4 ay sonrasında ulaşılamadı. Akut koroner sendrom grubundan 7 hastada takip süresinde ölüm gerçekleşti. Tüm hastalardan yatışlarının 1. saatinde, akut koroner sendrom grubundaki hastalardan ek olarak 24. saatte ve 5. günde osteoprotegerin için kan alındı. Kontrol gurubu ile stabil angina grubu ve kontrol grubu ile akut koroner sendrom grubu arasında 1. saat osteoprotegerin düzeylerinde istatistiksel olarak anlamlı farklılık vardı (sırasıyla p<0,01 ve p<0,001). Akut koroner sendrom grubunda 1. saat, 24. saat ve 5. gün osteoprotegerin düzeyi giderek azalmakta olup, arasında istatistiksel anlamlılık yoktu (p=0,538). 247,71 pg/ml değeri cut-off olarak alındığında bu değerin üzerindeki 1. saat osteoprotegerin düzeylerinin koroner arter hastalığını göstermedeki duyarlılığı %91,54, özgüllüğü %46,67, pozitif prediktif değeri %88,1, negatif prediktif değeri %56 olarak bulundu. 1. saat, 24. saat ve 5. gün osteoprotegerin değerleriyle Gensini değerleri arasında da korelasyon bulunmadı. Osteoprotegerin düzeyi ile hastalıklı koroner arter damar sayısı arasında ilişki gösterilmedi. Çalışmamız, stabil angina pektoris ve anstabil angina pektoris / ST elevasyonsuz miyokard infarktüslü hastalarda serum osteoprotegerinin koroner arter hastalığının şiddeti ya da yaygınlığı ile ilişkili olmadığını ve prognostik bir önem taşımadığını sadece koroner arter hastalığının bir belirteci olduğunu göstermektedir.
Abstract
The aim of this study is to evaluate the value of serum osteoprotegerin in the diagnosis, severity and prognosis of coronary artery disease in patients with stable angina pectoris and unstable angina pectoris / non ST elevation myocardial infarction. Hundred sixty patients were included in this study; 65 of them in stable angina pectoris group and 65 in acute coronary syndrome group. Followup monitoring was performed in the 4th month. Four patients of the stable angina pectoris group and 3 patients of the acute coronary syndrome group were unreachable. Seven patients of the acute coronary syndrome group died during the follow up. Blood samples were collected from the patients on the 1st hour of their hospitalization while from the acute coronary syndrome group additional samples were obtained at the 24th hour and 5th day. Statistically significant difference was observed in the 1st hour osteoprotegerin levels between the control group and both the stable angina group and acute coronary syndrome group (p<0,01 and p<0,001, respectively). In the acute coronary syndrome group the levels of osteoprotegerin seemed to be decreasing in the 1st, 24th hours and the 5th day but the result was not statistically significant (p=0,538). When the cut-off value was determined as 247,71 pg/ml, the sensitivity and spesificity of the 1st hour osteoprotegerin levels indicating the coronary artery disease were 91.54% and 46.67% respectively, while the positive predictive value was 88.1% as the negative predictive value was 56%. No corelations were observed between the 1st, 24th hour and the 5th day osteoprotegerin levels and the Gensini scores. No relation was denoted between the osteoprotegerin levels and number of the diseased coronary arteries. Our study shows that serum osteoprotegerin level is unrelated with the severity or the degree of the coronary artery disease in patients with stable angina pectoris and unstable angina pectoris / non ST elevation myocardial infarction and does not have a prognostic value as well. Osteoprotegerin may only be accepted as an indicator of the coronary artherosclerosis.
Abstract
The aim of this study is to evaluate the value of serum osteoprotegerin in the diagnosis, severity and prognosis of coronary artery disease in patients with stable angina pectoris and unstable angina pectoris / non ST elevation myocardial infarction. Hundred sixty patients were included in this study; 65 of them in stable angina pectoris group and 65 in acute coronary syndrome group. Followup monitoring was performed in the 4th month. Four patients of the stable angina pectoris group and 3 patients of the acute coronary syndrome group were unreachable. Seven patients of the acute coronary syndrome group died during the follow up. Blood samples were collected from the patients on the 1st hour of their hospitalization while from the acute coronary syndrome group additional samples were obtained at the 24th hour and 5th day. Statistically significant difference was observed in the 1st hour osteoprotegerin levels between the control group and both the stable angina group and acute coronary syndrome group (p<0,01 and p<0,001, respectively). In the acute coronary syndrome group the levels of osteoprotegerin seemed to be decreasing in the 1st, 24th hours and the 5th day but the result was not statistically significant (p=0,538). When the cut-off value was determined as 247,71 pg/ml, the sensitivity and spesificity of the 1st hour osteoprotegerin levels indicating the coronary artery disease were 91.54% and 46.67% respectively, while the positive predictive value was 88.1% as the negative predictive value was 56%. No corelations were observed between the 1st, 24th hour and the 5th day osteoprotegerin levels and the Gensini scores. No relation was denoted between the osteoprotegerin levels and number of the diseased coronary arteries. Our study shows that serum osteoprotegerin level is unrelated with the severity or the degree of the coronary artery disease in patients with stable angina pectoris and unstable angina pectoris / non ST elevation myocardial infarction and does not have a prognostic value as well. Osteoprotegerin may only be accepted as an indicator of the coronary artherosclerosis.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Osteoprotegerin, Stabil Angina Pektoris, Akut Koroner Sendrom, Prognoz, Osteoprotegerin, Stable Angina Pectoris, Acute Coronary Syndrome, Prognosis
