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2020, vol. 77, br. 1, str. 35-40
Značaj C-reaktivnog proteina u predviđanju ukupnog nepovoljnog kliničkog ishoda kod bolesnika sa akutnom plućnom embolijom
aVojnomedicinska akademija, Klinika za pulmologiju, Beograd + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
bUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd
cVojnomedicinska akademija, Klinika za urgentnu internu medicinu, Beograd
dUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd + Vojnomedicinska akademija, Klinika za kardiologiju, Beograd
eUniverzitet u Beogradu, Medicinski fakultet, Institut za medicinsku statistiku i informatiku
fUniverzitet u Kragujevcu, Medicinski fakultet, Katedra za internu medicinu

e-adresarade.milic1975@gmail.com
Sažetak
Uvod/ Cilj. Akutna plućna embolija (APE) može imati različite kliničke manifestacije. Takođe, njen ishod može varirati od potpunog oporavka do rane smrti. Za sada nije poznato koji su najbolji prediktori kratkoročnog mortaliteta i velikih krvarenja među nekolicinom najčešće upotrebljavanih biomarkera. Cilj ovog istraživanja bio je da se utvrdi značaj C-reaktivnog proteina (CRP) i drugih biomarkera u predviđanju neželjenih kliničkih ishoda. Metode. Ova klinička, opservaciona, retrospektivno-prospektivna studija, obuhvatila je 219 uzastopnih odraslih bolesnika sa APE. Rezultati. Od 219 bolesnika 22 (10%) je umrlo unutar prvog meseca od postavljanja dijagnoze. Dvadeset sedam bolesnika (12.3%) imalo je najmanje jednu epizodu velikog krvarenja. Kompozitni cilj (ukupni neželjeni klinički ishod) utvrđen je kod 47 (21.5%) bolesnika. Srednje vrednosti svih biomarkera bile su veće u grupi umrlih bolesnika, a razlika je bila statistički značajna. Slični rezultati su utvrđeni za kompozitni cilj. U pogledu velikih krvarenja, nijedan biomarker nije pokazao značajnost, mada je CRP imao trend ka značajnosti. Rezultati univarijantne regresione analize pokazali su da je troponin značajan prediktor 30-dnevnog mortaliteta. Međutim, posle prilagođavanja sa drugim varijablama, multivarijantni logistički regresioni model nije potvrdio da je troponin značajan nezavisani prediktor 30-dnevnog mortaliteta. Za razliku od troponina, CRP i B-tip natriuretskog peptida (BNP) su značajni u svim modelima, univarijantnim i multivarijantnim (oni su nezavisni prediktori 30-dnevnog mortaliteta). Zaključak. Biomarker CRP ima dobru prediktivnu vrednost za 30-dnevni mortalitet i ukupan neželjeni klinički ishod, kao i potencijalnu prediktivnu vrednost za velika krvarenja kod bolesnika lečenih zbog APE.
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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/VSP171213037M
objavljen u SCIndeksu: 08.02.2020.
metod recenzije: dvostruko anoniman
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