A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I

KARAKARÇAYILDIZ, Ahmet; Demir, Ali; Ataseven, Huseyin; biyik, murat; Keskin, Muharrem; ASIL, MEHMET; Yolacan, Ramazan; Polat, Hakki; Dertli, Ramazan; kayar, yusuf

doi:10.4274/imj.galenos.2020.45403

A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I

Ramazan DERTLİ, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Murat BIYIK, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Ramazan YOLACAN, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Muharrem KESKİN, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Ahmet KARAKARCAYILDIZ, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Yusuf KAYAR, (Sağlık Bilimleri Üniversitesi, Van Eğitim ve Araştırma Hastanesi, Dahiliye Kliniği, Gastroenteroloji Anabilim Dalı, Van, Türkiye)

Hüseyin ATASEVEN, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Hakkı POLAT, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Ali DEMİR, (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

Mehmet AŞIL (Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Gastroenteroloji Anabilim Dalı, Konya, Türkiye)

İstanbul Medical Journal

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Yıl: 2021 Cilt: 22 Sayı: 1 Sayfa Aralığı: 38 - 44 Metin Dili: İngilizce DOI: 10.4274/imj.galenos.2020.45403 İndeks Tarihi: 16-06-2021

A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I

Öz:

Introduction: Acute non-variceal upper gastrointestinalbleeding (ANVUGIB) is an important public health problemwith high rates of morbidity and mortality. ANVUGIB resultsin hypovolemia, hypotension, and shock, increasing cardiacoxygen use and may cause elevated serum levels of cardiactroponin (cTn). In this study, we aimed to evaluate whetherelevated cTnI has clinical significance in patients with ANVUGIB.Methods: A total of 62 patients diagnosed with ANVUGIBwhose serum cTnI levels were studied at the time of admissionand follow-up in our clinic from January 2015 to January 2016were included in the study. Patients with acute cardiac diseasesthat may cause elevated cTn were excluded from the study.Results: Forty-three of the patients were male (69.4%), and themean age of all patients was 71.52±13.30 years. The meancTnI level was 0.042±0.097 in all patients, with cTnI levelshigher than the reference value in nine (14.5%) patients. Inlogistic regression analysis, the factors found to contribute tocTnI were tachycardia, chronic kidney disease, and coronaryartery disease. In receiver operating characteristic analysis, cutoff values of 0.025 and 6.5 were found for cTnI and the Rockallscore, respectively. In addition, cTnI and the Rockall score wereshown to affect survival [log-rank (Mantel-Cox) test: p=0.011;log-rank (Mantel-Cox) test: p=0.014; respectively].Conclusion: We believe that serum cTnI levels studied duringthe first admission will be found useful as a biomarker inaddition to the other existing risk determination systems,in order to identify patients at risk, even if findings of acutecoronary syndrome are not observed in patients presentingwith ANVUGIB

Anahtar Kelime:

Akut Varis Dışı Üst Gastrointestinal Kanamada Sağkalımı Etkileyen Yeni Bir Belirteç: Kardiyak Troponin I

Öz:

Amaç: Akut varis dışı üst gastrointestinal sistem kanaması (AVDÜGSK) yüksek mortalite ve morbiditeye sahip önemli bir sağlık sorunudur. AVDÜGSK’leri hipovolemi, hipotansiyon ve şok tablosu oluşturarak kardiyak oksijen kullanımını artırır ve serum kardiyak troponin (kTn) düzeyinin yükselmesine neden olabilir. Biz bu çalışmada AVDÜGSK’si olan hastalarda kTnI yüksekliğinin klinik bir öneme sahip olup olmadığını değerlendirmeyi planladık. Yöntemler: Kliniğimize Ocak 2015-Ocak 2016 tarihleri arasında başvuran, AVDÜGSK tanısı konan, başvuru anında serum kTnI bakılmış olan 62 hasta çalışmaya dahil edildi. kTn yüksekliğine sebep olabilecek akut kardiyak hadisesi olan tüm hastalar çalışma dışı bırakıldı. Bulgular: Çalışmaya alınan hastaların 43’ü erkek (%69,4) olup tüm hastaların ortalama yaşı 71,52±13,30 (25-92) idi. Tüm hastaların ortalama kTnI düzeyi 0,042±0,097 olup 9 (%14,5) hastanın kTnI düzeyi referans aralığının üzerinde idi. Yapılan lojistik regresyon analizinde kTnI düzeyi yüksekliğine katkı yapan faktörler taşikardi, kronik böbrek yetmezliği ve koroner arter hastalığı idi. Yapılan alıcı işletim karakteristiği analizinde kTnI ve rockall skoru için eşik değeri sırasıyla; 0,025 ve 6,5 olarak saptandı ve kTnI ile rockall skorunun yükseliğinin sağkalım üzerinde etkili olduğu gösterildi [sırasıyla; logrank (Mantel-Cox) testi: p=0,011, log-rank (Mantel-Cox) testi: p=0,014]. Sonuç: AVDÜGSK ile başvuran hastalarda akut koroner sendrom bulguları olmasa bile ilk başvuruda serum kTnI düzeyinin bakılmasının riskli hastaların belirlenmesi açısından mevcut diğer risk belirleme yöntem ve skorlama sistemleriyle birlikte, bir biyobelirteç olarak kullanım alanı bulabileceği kanaatindeyiz.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Dertli R, biyik m, Yolacan R, Keskin M, KARAKARÇAYILDIZ A, kayar y, Ataseven H, Polat H, Demir A, ASIL M (2021). A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. , 38 - 44. 10.4274/imj.galenos.2020.45403
Chicago	Dertli Ramazan,biyik murat,Yolacan Ramazan,Keskin Muharrem,KARAKARÇAYILDIZ Ahmet,kayar yusuf,Ataseven Huseyin,Polat Hakki,Demir Ali,ASIL MEHMET A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. (2021): 38 - 44. 10.4274/imj.galenos.2020.45403
MLA	Dertli Ramazan,biyik murat,Yolacan Ramazan,Keskin Muharrem,KARAKARÇAYILDIZ Ahmet,kayar yusuf,Ataseven Huseyin,Polat Hakki,Demir Ali,ASIL MEHMET A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. , 2021, ss.38 - 44. 10.4274/imj.galenos.2020.45403
AMA	Dertli R,biyik m,Yolacan R,Keskin M,KARAKARÇAYILDIZ A,kayar y,Ataseven H,Polat H,Demir A,ASIL M A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. . 2021; 38 - 44. 10.4274/imj.galenos.2020.45403
Vancouver	Dertli R,biyik m,Yolacan R,Keskin M,KARAKARÇAYILDIZ A,kayar y,Ataseven H,Polat H,Demir A,ASIL M A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. . 2021; 38 - 44. 10.4274/imj.galenos.2020.45403
IEEE	Dertli R,biyik m,Yolacan R,Keskin M,KARAKARÇAYILDIZ A,kayar y,Ataseven H,Polat H,Demir A,ASIL M "A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I." , ss.38 - 44, 2021. 10.4274/imj.galenos.2020.45403
ISNAD	Dertli, Ramazan vd. "A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I". (2021), 38-44. https://doi.org/10.4274/imj.galenos.2020.45403

APA	Dertli R, biyik m, Yolacan R, Keskin M, KARAKARÇAYILDIZ A, kayar y, Ataseven H, Polat H, Demir A, ASIL M (2021). A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. İstanbul Medical Journal, 22(1), 38 - 44. 10.4274/imj.galenos.2020.45403
Chicago	Dertli Ramazan,biyik murat,Yolacan Ramazan,Keskin Muharrem,KARAKARÇAYILDIZ Ahmet,kayar yusuf,Ataseven Huseyin,Polat Hakki,Demir Ali,ASIL MEHMET A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. İstanbul Medical Journal 22, no.1 (2021): 38 - 44. 10.4274/imj.galenos.2020.45403
MLA	Dertli Ramazan,biyik murat,Yolacan Ramazan,Keskin Muharrem,KARAKARÇAYILDIZ Ahmet,kayar yusuf,Ataseven Huseyin,Polat Hakki,Demir Ali,ASIL MEHMET A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. İstanbul Medical Journal, vol.22, no.1, 2021, ss.38 - 44. 10.4274/imj.galenos.2020.45403
AMA	Dertli R,biyik m,Yolacan R,Keskin M,KARAKARÇAYILDIZ A,kayar y,Ataseven H,Polat H,Demir A,ASIL M A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. İstanbul Medical Journal. 2021; 22(1): 38 - 44. 10.4274/imj.galenos.2020.45403
Vancouver	Dertli R,biyik m,Yolacan R,Keskin M,KARAKARÇAYILDIZ A,kayar y,Ataseven H,Polat H,Demir A,ASIL M A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I. İstanbul Medical Journal. 2021; 22(1): 38 - 44. 10.4274/imj.galenos.2020.45403
IEEE	Dertli R,biyik m,Yolacan R,Keskin M,KARAKARÇAYILDIZ A,kayar y,Ataseven H,Polat H,Demir A,ASIL M "A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I." İstanbul Medical Journal, 22, ss.38 - 44, 2021. 10.4274/imj.galenos.2020.45403
ISNAD	Dertli, Ramazan vd. "A Novel Marker Affecting Survival in Acute Non-variceal Upper Gastrointestinal Bleeding: Cardiac Troponin I". İstanbul Medical Journal 22/1 (2021), 38-44. https://doi.org/10.4274/imj.galenos.2020.45403