Vol.14, No 2, 2007 pp. 64 - 70
UC 616.12-074
CORRELATION OF CARDIAC MARKERS VALUES
IN ACUTE CORONARY SYNDROME
WITH CORONARY DISEASE SEVERITY ASSESED BY
EXERCISE STRESS TESTING AND INVASIVE EXAMINATION
Snežana Ćirić Zdravković
Cardiovascular Clinic, Clinical Center Niš, Serbia
E-mail: sczdravkovic@yahoo.com
Summary. Strategy of combining predictive characteristics of troponin
during the first 24 hours since admission to hospital and symptoms limited
test, done before discharge, proved to be an independent predictor of adverse
events. The aim of the study: Correlation of cardiac markers values in
acute coronary syndrome with severity of coronary disease estimated by
exercise stress test and coronarography, as well as by impact of the markers
on therapy choice. The study enrolled 333 patients. Laboratory analysis
involved troponin T and I (TnT, TnI), myoglobin, CK-MB and CK-MB mass.
Ergometric and invasive examinations were done at the end of hospitalisation.
There is a significant relation in positive exercise stress tests in troponin
positive patients, which is statistically significant. The analysis of
exercise stress test showed a statistically significant increase of positive
findings in troponin positive ones (p<0.05). Out of 104 coronarographies
in group with two diseased coronary vessels there were 46.4% Tn positive,
compared to 29% troponin negative patients, what can also be seen in the
group with ?3 diseased coronary vessels (3.2 vs 14.8%). Out of 104 coronarographied
patients, 29 (8.1%) underwent PTCA, and 25 (7%) ACBG. Statistical significance
occurred in choosing patients for PTCA in comparison to Tn status (p<0.05),
while this was not the case with the group selected for ACBG. In our research
a good diagnostic and prognostic troponin value was established and it
was confirmed by statistically significant correlation of troponin values
and exercise stress tests findings on discharge. They were a reliable indicator
of degree and severity of coronarographic finding, as well as a guideline
in choosing invasive strategy treatment.
Key words: Troponin, acute
coronary syndrome, exercise stress test, coronary angiography
KORELACIJA VREDNOSTI SRČANIH MARKERA
U AKUTNOM KORONARNOM SINDROMU
SA TEŽINOM KORONARNE BOLESTI PROCENJENO TESTOM
FIZIČKIM OPTEREĆENJEM I INVAZIVNIM ISPITIVANJEM
Kratak sadržaj: Strategija kombinovanja prediktivnih svojstava
troponina tokom prvih 24 časa od prijema i predotpusni simptom ograničeni
test izveden na biciklu. su pokazala da su nezavisan prediktor nepovoljnih
događaja. Cilj rada je da se utvrdi korelacija vrednosti srčanih markera
u akutnom koronarnom sindromu sa težinom koronarne bolesti procenjenom
testom fizičkim opterećenjem i koronarografijom kao i uticajem markera
na izbor terapije. Ispitivana populacija činilo je 333 bolesnika. Laboratorijsko
ispitivanje je obuhvatilo troponin T i I (TnT, TnI),mioglobin, CK-MB i
CK-MB mass. Spovedeno je ergometrijsko ispitivanje na kraju bolničkog
lečenja i invazivno ispitivanje. Uočava se značajan odnos pozitivnih
testova fizičkim opterćenjem kod ttroponin pozitivnih bolesnika što
je stasistički značajno (p<0.05). Analizom ERGO testova pokazuje statistički
signifikantan porast pozitivnih nalaza u troponin pozitivnih (p<0.05)
Od 104 urađenih koronarografija u grupi sa 2 obolela krvna suda bilo 46,4%
Tn pozitivnih u odnosu na 29% troponin negativne bolesnika, što se uočava
i u grupi sa ?3 obolelih krvnih sudova (3,2 vs14,8%). Od 104 koronarografisanih
bolesnika 29 (8,1%) bilo je podvrgnuto PTCA, a 25 (7%) ACBG. Statistička
značajnost se pojavila kod izbora bolesnika za PTCA u onosu na Tn status
( p<0.05) dok to nije slučaj u grupi koji je selekcionirana za ACBG.
U ispitivanju je utvđena je dobra dijagnostička i prognostička vrednost
troponina koja je potvrđena kroz statistički značajnu korelaciju
vrednosti troponina sa nalazima testova fizičkim opterećenjem na otpustu
i bili su pouzdan indikator stepena i težine koronarografskog nalaza,
kao i vodič u izboru invazivne strategije lečenja.
Ključne reči: Troponin, akutni
koronarni sinrom, test fizičkim opterćenjem, koronarna angiografija
