Abstract
Amac : Kardiyak belirtecler; kardiyak ve nonkardiyak hastalarin dogru triajinda fizik muayene bulgulari, Elektrokardiyografi (EKG) ve Ekokardiyografi (ECHO)’ya ek olarak onemini korumaktadir. Bu calismada, koroner yogun bakim unitesindeki Akut Miyokard Infarktusu (AMI) ve Anstabil Angina Pektoris (ASAP) olan hastalarin kardiyak troponin ve Kreatin Kinaz MB (CKMB) test sonuclarini ve klinik verilerini degerlendirerek kabul edilebilir bir strateji gelistirmeyi amacladik. Gerec ve Yontem: Koroner yogun bakim unitesinde yatan 208 hastanin (yas:61±12) klinik ve laboratuvar verileri retrospektif olarak incelendi. Hastalar tanilarina gore uc gruba ayrildi. Grup 1, AMI olan 132 hastadan olustu; Grup 2, AMI olmayan ASAP'li 28 hastadan olustu; Grup 3, nonkardiyak hastaligi olan 48 hastadan (kronik kalp yetmezligi, bobrek yetmezligi, sepsis, vb.) olustu. CKMB seviyeleri Dimension Xpand Plus (Dade Behring Inc, Newark, ABD) marka biyokimya otoanalizorunde immunoinhibisyon yontemiyle olculdu. CTnT (Kardiyak Troponin T) olcumu icin Cardiac T Quantitative Rapid Assay (Roche Diagnostics GmbH, Mannheim, Almanya) hasta basi cihazi kullanildi. Bulgular: Gruplari degerlendirmede biyolojik belirtecler CKMB ve cTnT icin ROC analizi yapildi. AMI grubu icin; CKMB'nin Egri Altindaki Alan (EAA):0.724 (SE=0.041, p<0.001), cTnT'nin EAA:0.741 (SE=0.038, p<0.001); ASAP grubu icin; CKMB'nin EAA:0.536 (SE=0.067, p=0.601), cTnT'nin EAA:0.637 (SE=0.067, p=0.047) olarak tespit edildi. Sonuc: ROC analizi sonuclari ve EAA degerlendirmeleri AMI ve ASAP hastalarinin ayriminda kardiyak belirtecler CKMB ve cTnT’nin tanisal gucunu ortaya koydu. Bu kardiyak belirteclerin birlikte kullanilmasi tanisal gucu artirmaktadir. Nonkardiyak hasta gruplari icin buyuk orneklemli calismalarda ROC analizi faydali olabilir.
Highlights
Result: ROC analysis was performed for biomarkers creatine kinase MB (CKMB) and cTnT in evaluating the groups
The ROC analysis results and the Area under the curve of CKMB (AUC) evaluations revealed the diagnostic power of cardiac markers CKMB and cTnT in the discrimination between acute myocardial infarction (AMI) and unstable angina pectoris (USAP) patients
ROC analysis may be useful in large sample studies for noncardiac patient groups
Summary
ROC analysis was performed for biomarkers CKMB and cTnT in evaluating the groups. For the AMI group; Area under the curve of CKMB (AUC): 0.724 (SE=0.041, p
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