Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients

EKEN, Cenker; ÇİÇEK, Metin; ÇAKIRLI, Bingöl Başak; MANİSALI, Metin; YANTURALI, Sedat; ATİLLA, Rıdvan; Kuralay, Filiz; DUMAN, Özge

Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients

Rıdvan ATİLLA, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Özge DUMAN, (SB Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Türkiye)

Filiz KURALAY, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, İzmir, Türkiye)

Sedat YANTURALI, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Metin ÇİÇEK, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, İzmir, Türkiye)

Metin MANİSALI, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, İzmir, Türkiye)

Bingöl Başak ÇAKIRLI, (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, İzmir, Türkiye)

Cenker EKEN (Akdeniz Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Antalya, Türkiye)

Türkiye Acil Tıp Dergisi

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Yıl: 2008 Cilt: 8 Sayı: 2 Sayfa Aralığı: 53 - 58 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients

Öz:

Giriş: Akut iskemik inme ve kardiyovasküler sistemde meydana gelen değişiklikler arasındaki ilişki daha önce kanıtlanmıştı. Sağ serebral heminsferde bulunan insula, kalbin otonomik kontrolünde önemli rol oynar. Bu çalışmada kardiyak hasarın belirteçleri olan troponin T (cTnT) ve troponin I’nın (cTnI) sağ serebral heminsfer inmelerinde hastane içi mortaliteyi tahmin etmedeki etkinliklerini belirlemeyi amaçladık. Gereç ve Yöntem: ‹leriye dönük olarak sekiz aylık periyotta bir üniversite hastanesinde gerçekleştirilen bu çalışmaya sağ heminsferden kaynaklanan iskemik inme nedeniyle başvuran 66 hasta alındı. Kardiyak belirteç seviyeleri belirlenerek hastane içi mortalite ile ilişkisine bakıldı. Bulgular: Hastane içi mortalite cTnT >0,1 ng/ml (4 [%44,4] ve 5 [%8,8]; p=0,016) olan hastalarda anlamlı olarak yüksek iken, cTnI >1,5 ng/ml (3 [%33,3] ve 6 [%10,5]; p=0,098) olan hastalarda mortalite oranı yüksek olmasına rağmen istatistiksel anlamlılık saptanmadı. Hastanede ölen hastalarda başlangıç National Institute of Health Stroke Scale (NIHSS) ve Glasgow Coma Scale skorları anlamlı olarak daha yüksekti (median: 16 ve 6; p=0,00, ile median: 11 ve 15; p=0,007, sırasıyla). Lojistik regresyon analizinde başlangıçtaki cTnT ve NIHSS skoru hastane içi mortaliteyi belirlemede istatistiksel olarak anlamlı bağımsız değişkenler olarak saptandı (p=0,04, [OR 0,03, %95 CI 0,0-0,8]; p=0,046, [OR 2,8, %95 CI 1,082-7,433], sırasıyla). Sonuç: Sağ serebral heminsferden kaynaklanan inme nedeniyle başvuran hastalarda cTnT hastane içi mortaliteyi belirlemede anlamlı iken aynı anlamlılık cTnI için geçerli değildir.

Anahtar Kelime: Troponin İleriye dönük çalışma Troponin I Hastane ölüm oranı Troponin T Serebrum İnme

Konular: Cerrahi

Sağ tutulumlu iskemik inmelerde hastane içi mortalite ve kardiyak troponinler arasındaki ilişki

Öz:

Objectives: The association between acute ischemic strokes and cardiovascular disturbances has been established previously. The insula of the right cerebral hemisphere may have a major role in cardiac autonomic control. We investigated if elevated troponin T (cTnT) and troponin I (cTnI), the specific biomarkers of cardiac damage, are independent predictors of in-hospital mortality in right-sided stroke patients. Materials and Methods: Sixty-six patients with acute ischemic right hemispheric involvement who were admitted to a university hospital during an eight-month period were included in this prospective observational clinical study. The levels of cardiac biomarkers were measured and compared with the in-hospital mortality rates. Results: Hospital mortality was significantly higher in patients with cTnT>0.1 ng/ml (4 [44.4%] vs 5 [8.8%]; p=0.016) but not in patients with cTnI>1.5 ng/ml (3 [33.3%] vs 6 [10.5%]; p=0.098). Initial National Institute of Health Stroke Scale (NIHSS) scores and Glasgow Coma Scale scores were also significantly higher in patients who were dead in-hospital (median: 16 vs 6; p=0.00, and median: 11 vs 15; p=0.007, respectively). Logistic regression analysis have revealed that elevated cTnT values and NIHSS scores at admission were independent predictors of death in-hospital (p=0.04, [OR 0.03, 95% CI 0.0-0.8]; p=0.046, [OR 2.8, 95% CI 1.082-7.433, respectively). Conclusion: We conclude that elevated CTnT, but not CTnI, may be an independent predictor of in-hospital mortality in acute ischemic right-sided stroke patients.

Anahtar Kelime: Troponin I Hospital Mortality Troponin T Cerebrum Stroke Troponin Prospective Studies

Konular: Cerrahi

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

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APA	ATİLLA R, DUMAN Ö, Kuralay F, YANTURALI S, ÇİÇEK M, MANİSALI M, ÇAKIRLI B, EKEN C (2008). Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. , 53 - 58.
Chicago	ATİLLA Rıdvan,DUMAN Özge,Kuralay Filiz,YANTURALI Sedat,ÇİÇEK Metin,MANİSALI Metin,ÇAKIRLI Bingöl Başak,EKEN Cenker Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. (2008): 53 - 58.
MLA	ATİLLA Rıdvan,DUMAN Özge,Kuralay Filiz,YANTURALI Sedat,ÇİÇEK Metin,MANİSALI Metin,ÇAKIRLI Bingöl Başak,EKEN Cenker Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. , 2008, ss.53 - 58.
AMA	ATİLLA R,DUMAN Ö,Kuralay F,YANTURALI S,ÇİÇEK M,MANİSALI M,ÇAKIRLI B,EKEN C Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. . 2008; 53 - 58.
Vancouver	ATİLLA R,DUMAN Ö,Kuralay F,YANTURALI S,ÇİÇEK M,MANİSALI M,ÇAKIRLI B,EKEN C Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. . 2008; 53 - 58.
IEEE	ATİLLA R,DUMAN Ö,Kuralay F,YANTURALI S,ÇİÇEK M,MANİSALI M,ÇAKIRLI B,EKEN C "Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients." , ss.53 - 58, 2008.
ISNAD	ATİLLA, Rıdvan vd. "Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients". (2008), 53-58.

APA	ATİLLA R, DUMAN Ö, Kuralay F, YANTURALI S, ÇİÇEK M, MANİSALI M, ÇAKIRLI B, EKEN C (2008). Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. Türkiye Acil Tıp Dergisi, 8(2), 53 - 58.
Chicago	ATİLLA Rıdvan,DUMAN Özge,Kuralay Filiz,YANTURALI Sedat,ÇİÇEK Metin,MANİSALI Metin,ÇAKIRLI Bingöl Başak,EKEN Cenker Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. Türkiye Acil Tıp Dergisi 8, no.2 (2008): 53 - 58.
MLA	ATİLLA Rıdvan,DUMAN Özge,Kuralay Filiz,YANTURALI Sedat,ÇİÇEK Metin,MANİSALI Metin,ÇAKIRLI Bingöl Başak,EKEN Cenker Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. Türkiye Acil Tıp Dergisi, vol.8, no.2, 2008, ss.53 - 58.
AMA	ATİLLA R,DUMAN Ö,Kuralay F,YANTURALI S,ÇİÇEK M,MANİSALI M,ÇAKIRLI B,EKEN C Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. Türkiye Acil Tıp Dergisi. 2008; 8(2): 53 - 58.
Vancouver	ATİLLA R,DUMAN Ö,Kuralay F,YANTURALI S,ÇİÇEK M,MANİSALI M,ÇAKIRLI B,EKEN C Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients. Türkiye Acil Tıp Dergisi. 2008; 8(2): 53 - 58.
IEEE	ATİLLA R,DUMAN Ö,Kuralay F,YANTURALI S,ÇİÇEK M,MANİSALI M,ÇAKIRLI B,EKEN C "Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients." Türkiye Acil Tıp Dergisi, 8, ss.53 - 58, 2008.
ISNAD	ATİLLA, Rıdvan vd. "Relation between cardiac troponins and in-hospital mortality in right-sided stroke patients". Türkiye Acil Tıp Dergisi 8/2 (2008), 53-58.