Evaluating the diagnostic value of three early cardiac markers tanisal performansinin STYME hastalarinda degerlendirilmesi

• Published in: Turkish Journal of Emergency Medicine Vol. 13; no. 3; p. 127
• Main Authors: Cevik, Erdem, Yilmaz, Banu Karakus, Acar, Yahya Ayhan, Hakligor, Aylin, Cinar, Orhan
• Format: Journal Article
• Language: Turkish
• Published: Medknow Publications and Media Pvt. Ltd 01.09.2013
• ISSN: 1304-7361
• DOI: 10.5505/1304.7361.2013.48243

Objectives The aim of this study is to determine the ideal early cardiac marker (myoglobin, IMA, and copeptin) by evaluating them in cardiac troponin (cTn) negative ST segment elevation myocardial infarction (STEMI) patients. Methods STEMI patients admitted to the emergency department with chest pain were enrolled in the study. Venous blood samples were obtained a short time after admission in order to measure cTnI, creatine kinase MB (CK-MB) mass, myoglobin, ischemia modified albumin (IMA) and copeptin levels. The patients' demographics and electrocardiogram (ECG) results were recorded. Results Twenty six STEMI patients were enrolled in the study. Four of them had normal cTnl levels at admission. Although copeptin levels were elevated in all of the patients, myoglobin levels were not elevated in any of them, and IMA levels were elevated in just one patient. The sensitivity of cTn increased from 84% to 100% with copeptin, and from 84% to 88% with IMA. There was no increase in cTn sensitivity with myoglobin. Conclusions Copeptin levels were elevated earlier in STEMI patients than were IMA and myoglobin. These findings support the concomitant use of cTn and copeptin in the early phase of STEMI. Key words: Acute coronary syndrome; copeptin; ischemia modified albumin; cardiac marker; myoglobin. OZET Amac Bu calismanin amaci kardiyak troponinin (cTn) henuz yukselmedigi ST yukselmeli miyokart enfarktusu (STYME) hastalarinda hangi erken belirteclerin oncelikli olarak yukseldigini saptamak ve troponin ile birlikte calisilacak ideal erken belirteclerin tespit edilmesine katki saglamaktir. Gerec ve Yontem Calismaya acil servise gogus agrisi sikayeti ile basvuran STYME hastalari alindi. Hastalardan basvuru aninda kan ornegi alinarak cTnI, kutle kreatin kinaz MB (CKMB), miyoglobin, iskemik modifiye albumin (IMA) ve copeptin degerleri olculdu. Ayrica hastalarin demografik verileri ve elektrokardiyogram (EKG) bulgulari kaydedildi. Bulgular Calismaya katilan 26 STYME hastasinin dordunde basvuru aninda cTnI normal sinirlarda idi. Bu hastalarin hepsinde copeptin duzeylerinin artmis oldugu, bir tanesinde IMA'nin yukseldigi, miyoglobin duzeylerinin ise hicbirinde yukselmedigi gozlendi. cTn'nin duyarliliginin copeptin ile birlikte kullanildiginda %84'den %100'e ciktigi, bu degerin IMA icin %88'e yukseldigi ancak miyoglobinle bir artis gostermedigi tespit edilmistir. Sonuc STYME'li hastalarda erken belirteclerden copeptin'in, IMA ve miyoglobine gore erken donemde yukseldigi saptanmistir. Bu sonuc cTn ile birlikte erken donemde copeptin kullanimini destekler niteliktedir. Anahtar sozcukler: Akut koroner sendrom; copeptin; iskemik modifiye albumin; kardiyak belirtec; miyoglobin.