Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome
Yıl: 2011 Cilt: 11 Sayı: 7 Sayfa Aralığı: 588 - 594 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome
Öz: Amaç: Akut koroner sendromlu hastalarda serum nötrofil aktive peptit 2 (NAP2) ve pentraksin 3 (PTX3) düzeylerini araştırmak ve bunların tanısal doğruluğu kardiyak troponin I (cTnI) ile karşılaştırılması amaçlandı. Yöntemler: Dicle Üniversitesi Tıp Fakültesi, Acil Servisine ani başlayan göğüs ağrısı şikayetiyle, ağrının başlangıcından itibaren ilk 6 saatte başvuran ardışık 83 hasta çalışmaya alındı. Akut koroner sendrom (AKS) tanısı alanlar hasta grubu (n=70), kalp dışı bir nedene bağlı göğüs ağrısı tanısı alanlar kontrol grubu (n=13) olarak belirlendi. Hasta grubu da kendi arasında kararsız anjina pektoris (n=9), ST elevasyonu olmayan miyokart enfarktüsü (n=5) ve ST elevasyonu olan miyokart enfarktüsü (n=56) grubu olarak 3 gruba ayrıldı. Serum PTX3, NAP2 ve cTnI düzeylerinin ortalaması kontrol grubu ile hasta grubu ve hasta grubunun subtipleri arasında karşılaştırıldı. Markırların tanısal doğruluğunu belirlemek için ROC analizi kullanıldı ve eğri altında kalan alanlar (EAA) karşılaştırıldı.. NAP2 ve PTX3’ün AKS’deki duyarlılık ve özgüllük değerleri belirlendi. Bulgular: Hasta grubunda NAP-2 (53.03+22.77 ng/ml) ve PTX-3 (1.73+0.82 ng/ml) ortalama serum konsantrasyonları kontrol grubuna göre önemli derecede yüksekti (sırası ile 24.54+9.50 ve 0.50+0.39 ng/ml) (p<0.01). Kontrol grubu ile kıyaslandığında PTX-3 seviyeleri tüm AKS subtiplerinde ((kararsız anjina pektoris (USAP) - 1.62+0.41 ng/ml, ST- elevasyonsuz miyokart enfarktüsü - 1.63+0.31 ng/ml, ve ST- elevasyonlu miyokart enfarktüsü (STEMI) - 1.75+0.89 ng/ml)) olmak üzere yüksek ve NAP-2 seviyeleri USAP (56.29+22.60 ng/ml) ve STEMI (52.05+20.99 ng/ml) hastalarında daha yüksekti (p<0.01). AKS hastaları için ilk altı saatte PTX-3 duyarlılığı %98.5 ve özgüllüğü %92.3 ve NAP-2 duyarlılığı %98.1 ve %41.3 idi. ROC eğrisinin EAA değerleri: PTX-3 (%95 GA 0.802-1.073) için 0.962, NAP-2 (%95 GA 0.684-0.991) için 0.840 ve cTnI (%95 GA 0.610 -0.940) için 0.683 idi. Sonuç: Bizim sonuçlarımıza göre acil servise göğüs ağrısı ile gelen hastalarda ilk 6 saat içinde kardiyak belirteçleri özgüllük ile duyarlılıkla birlikte değerlendirildiğinde acil servis hekimine AKS tanısında en faydalı olabilecek belirteç PTX3’dür.
Anahtar Kelime: Konular:
Akut koroner sendromda troponin-I ile nötrofil-etkinleştirici peptit-2 ve pentraksin-3'ün serum düzeylerinin karşılaştırmalı tanısal değerleri
Öz: Objective: We measured the levels of neutrophil activating peptide-2 (NAP-2) and pentraxin-3 (PTX-3) in acute coronary syndromes (ACS) patients and compared their diagnostic accuracy with cardiac troponin I (cTnI). Methods: We conducted a prospective cohort study to determine the diagnostic accuracy of PTX-3, NAP-2 and cTnI for the prediction of ACS. Consecutively eighty-three patients with sudden chest pain admitted to Dicle University Emergency Department within the first six hours of symptom onset were included in our study. Mean serum levels of PTX-3, NAP-2 and cTnI were compared between control and patient groups and ACS subgroups. Their sensitivities and specificities in early diagnosis of ACS were identified. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic validity of the markers, and areas under the ROC curve (AUC) were compared. Results: In the patient group, mean serum concentrations of NAP-2 (53.03+22.77 ng/ml) and PTX-3 (1.73+0.82 ng/ml) were considerably higher than those of the control group (24.54+9.50 and 0.50+0.39 ng/ml, respectively) (p<0.01). When compared with the control group, PTX-3 levels of all three ACS subtypes (unstable angina pectoris (USAP) - 1.62+0.41 ng/ml, non-ST elevation myocardial infarction (NSTEMI) -1.63+0.31 ng/ml and ST-elevation myocardial infarction (STEMI) - 1.75+0.89 ng/ml) were higher, whereas NAP-2 levels were higher in USAP (56.29+22.60 ng/ml) and STEMI (52.05+20.99 ng/ml) patients (p<0.01). For diagnosing ACS within the first six hours of presentation, PTX-3 sensitivity was 98.5% and specificity was 92.3%, and NAP-2 sensitivity - 98.1% and specificity - 41.3%. The ROC curve AUC values were: 0.962 for PTX-3 (95% CI 0.802 - 1.073), 0.840 for NAP-2 (95% CI 0.684 - 0.991), and 0.683 for cTnI (95% CI 0.610 - 0.940). Conclusion: Pentraxin-3 is a sensitive and specific marker for ACS diagnosis when compared with cardiac markers in patients admitted to the emergency department (ED) within the first six hours of onset of chest pain.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | ÜSTÜNDAĞ M, ORAK M, GÜLOĞLU C, Sayhan M, ALYAN Ö, KALE E (2011). Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. , 588 - 594. |
| Chicago | ÜSTÜNDAĞ Mehmet,ORAK MURAT,GÜLOĞLU Cahfer,Sayhan Mustafa Burak,ALYAN Ömer,KALE Ebru Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. (2011): 588 - 594. |
| MLA | ÜSTÜNDAĞ Mehmet,ORAK MURAT,GÜLOĞLU Cahfer,Sayhan Mustafa Burak,ALYAN Ömer,KALE Ebru Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. , 2011, ss.588 - 594. |
| AMA | ÜSTÜNDAĞ M,ORAK M,GÜLOĞLU C,Sayhan M,ALYAN Ö,KALE E Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. . 2011; 588 - 594. |
| Vancouver | ÜSTÜNDAĞ M,ORAK M,GÜLOĞLU C,Sayhan M,ALYAN Ö,KALE E Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. . 2011; 588 - 594. |
| IEEE | ÜSTÜNDAĞ M,ORAK M,GÜLOĞLU C,Sayhan M,ALYAN Ö,KALE E "Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome." , ss.588 - 594, 2011. |
| ISNAD | ÜSTÜNDAĞ, Mehmet vd. "Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome". (2011), 588-594. |
| APA | ÜSTÜNDAĞ M, ORAK M, GÜLOĞLU C, Sayhan M, ALYAN Ö, KALE E (2011). Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. Anadolu Kardiyoloji Dergisi, 11(7), 588 - 594. |
| Chicago | ÜSTÜNDAĞ Mehmet,ORAK MURAT,GÜLOĞLU Cahfer,Sayhan Mustafa Burak,ALYAN Ömer,KALE Ebru Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. Anadolu Kardiyoloji Dergisi 11, no.7 (2011): 588 - 594. |
| MLA | ÜSTÜNDAĞ Mehmet,ORAK MURAT,GÜLOĞLU Cahfer,Sayhan Mustafa Burak,ALYAN Ömer,KALE Ebru Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. Anadolu Kardiyoloji Dergisi, vol.11, no.7, 2011, ss.588 - 594. |
| AMA | ÜSTÜNDAĞ M,ORAK M,GÜLOĞLU C,Sayhan M,ALYAN Ö,KALE E Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. Anadolu Kardiyoloji Dergisi. 2011; 11(7): 588 - 594. |
| Vancouver | ÜSTÜNDAĞ M,ORAK M,GÜLOĞLU C,Sayhan M,ALYAN Ö,KALE E Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome. Anadolu Kardiyoloji Dergisi. 2011; 11(7): 588 - 594. |
| IEEE | ÜSTÜNDAĞ M,ORAK M,GÜLOĞLU C,Sayhan M,ALYAN Ö,KALE E "Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome." Anadolu Kardiyoloji Dergisi, 11, ss.588 - 594, 2011. |
| ISNAD | ÜSTÜNDAĞ, Mehmet vd. "Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome". Anadolu Kardiyoloji Dergisi 11/7 (2011), 588-594. |
