Koroner anjiyoplasti yapılan hastalarda Brain Natriüretik Peptid'in restenoz ve kardiyovasküler olayları öngördürücü değeri
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Dosyalar
Tarih
2009
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: BNP, kalp yetmezliğinin gelişimini öngörmede olduğu kadar, iskemik kalp hastalıklarında da kardiyovasküler olayları öngörmede de faydalıdır. Perkütan koroner girişim ile koroner revaskülarizasyon geçiren hastaların önemli kısmında tekrar daralma ve koroner olay gelişmektedir. Bu hastaların uzun dönem takiplerinin ve tedavilerinin daha etkin yapılabilmesi için kolay bakılabilen ve tahmin ettirici değeri olan bir parametreye ihtiyaç duyulmaktadır. Bu çalışmada, BNP'nin uzun dönem restenoz ve kardiyovasküler olaylardaki öngördürücülüğünün araştırılması amaçlandı.Materyal-Metod: Bu çalışmaya, 2006-2008 yılları arasında göğüs ağrısı şikayeti ile ardışık olarak, Düzce Üniversitesi Tıp fakültesi Kardiyoloji ve Acil polikliniklerine başvuran, klinik veya non-invaziv testlerle yüksek riskli olduğu tespit edilen stabil koroner arter hastalığı veya akut koroner sendrom tanısı konup koroner anjiyoplasti uygulanan 73 hasta dahil edildi. Tüm hastaların koroner girişimden hemen önce ve hemen sonra alınan kan örneklerinden bekletilmeden BNP çalışıldı. Altıncı ayda hastalar kardiyovasküler olay ve restenoz yönünden değerlendirilmek üzere arandıBulgular: Bu çalışmada koroner anjiyoplasti yapılan hastalarda, takipte meydana gelişebilecek ölüm ve re-infarktüsün öngörülmesinde BNP'nin faydalı olduğu bulunmuştur. BNP değerleri ?150 pg/ml olarak alındığında, altı ay takip sonrasında ölümü %100 sensitivite ve %79 spesifite ile re-infarktüsü ise %80 sensitivite ve %79 spesifite ile öngördürmekte olduğu bulundu. Koroner işlem öncesi veya işlem sonrası bakılan BNP'nin uzun dönem takipte gelişebilecek restenozun öngörülmesinde faydalı olmadığı bulundu.(p= 0.5, p= 0.4)Sonuçlar: Bu çalışmada koroner anjiyoplasti yapılan hastalarda, uzun dönem takipte meydana gelişebilecek ölüm ve re-infarktüsün öngörülmesinde BNP'nin faydalı olduğu, fakat restenozun tahmininde yeterli olmadığı bulunmuştur. Bunun için de daha ileri klinik çalışmalara ihtiyaç olduğunu düşünmekteyiz.
Introduction: Brain natriuretic peptide (BNP) is a highly sensitive and specific diagnostic tool used in heart failure. It is not only useful in diagnosis of heart failure but also in prediction of cardiovascular events in patients with coronary heart disease. Most of the patients who had undergone percutaneous coroner intervention with coronary revascularization had restenosis and coroner events during follow up. An easily applicable and commercially available diagnostic marker is needed for these patients in their long-term follow up and treatment. In this study, we sought to test the efficacy of BNP, in predicting future events and restenosis rate in patients who had undergone PCI.Research design-Method: 73 consecutive patients who had admitted to cardiology and emergency department with chest pain and diagnosed to have critical coronary lesions were included in this study. The study was performed in Düzce University School of Medicine, Dept of Cardiology from 2006 to 2008. Pre and post PCI BNP was measured in all patients. Patients were followed up for future cardiovascular events and stent restenosis.Results: In this study, BNP was found to be a useful marker for prediction of mortality and re-infarction in-patients who had coronary intervention. BNP levels ?150 pg/ml predicted the mortality with 100% sensitivity and 79% specificity and predicted the re-infarction rate with 80% sensitivity and 79% specificity. We have not found any significant predictive value for restenosis rate during the follow-up period.Conclusions: Our findings suggest that BNP is a useful marker for prediction of mortality and re-infarction in patients who had coronary intervention, but not sufficient for predicting restenosis rate during follow up. Further studies with larger cohorts are needed to determine the value of BNP for predicting restenosis rate.
Introduction: Brain natriuretic peptide (BNP) is a highly sensitive and specific diagnostic tool used in heart failure. It is not only useful in diagnosis of heart failure but also in prediction of cardiovascular events in patients with coronary heart disease. Most of the patients who had undergone percutaneous coroner intervention with coronary revascularization had restenosis and coroner events during follow up. An easily applicable and commercially available diagnostic marker is needed for these patients in their long-term follow up and treatment. In this study, we sought to test the efficacy of BNP, in predicting future events and restenosis rate in patients who had undergone PCI.Research design-Method: 73 consecutive patients who had admitted to cardiology and emergency department with chest pain and diagnosed to have critical coronary lesions were included in this study. The study was performed in Düzce University School of Medicine, Dept of Cardiology from 2006 to 2008. Pre and post PCI BNP was measured in all patients. Patients were followed up for future cardiovascular events and stent restenosis.Results: In this study, BNP was found to be a useful marker for prediction of mortality and re-infarction in-patients who had coronary intervention. BNP levels ?150 pg/ml predicted the mortality with 100% sensitivity and 79% specificity and predicted the re-infarction rate with 80% sensitivity and 79% specificity. We have not found any significant predictive value for restenosis rate during the follow-up period.Conclusions: Our findings suggest that BNP is a useful marker for prediction of mortality and re-infarction in patients who had coronary intervention, but not sufficient for predicting restenosis rate during follow up. Further studies with larger cohorts are needed to determine the value of BNP for predicting restenosis rate.
Açıklama
YÖK Tez No: 236557
Anahtar Kelimeler
Kardiyoloji, Cardiology, Anjiyoplasti-balon-koroner, Angioplasty-balloon-coronary, Kardiyoloji, Cardiology, Kardiyovasküler fizyolojik fenomen, Cardiovascular physiological phenomena, Koroner hastalık, Coronary disease, Koroner restenoz, Coronary restenosis, Koroner restenoz, Coronary restenosis, Natriüretik ajanlar, Natriuretic agents, Natriüretik ajanlar, Natriuretic agents, Stentler, Stents, Koroner anjiyoplasti, BNP, restenoz, BNP, coronary angioplasty, restenosis
