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2017, vol. 34, br. 3, str. 213-220
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Troponin i C-reaktivni proteini u stratifikaciji rizika nakon infarkta miokarda
Troponin and C-reactive protein in risk stratification after myocardial infarction
aKlinički centar Univerziteta Sarajevo, Federacija BiH bUniverzitet u Sarajevu, Prirodno-matematički fakultet, Federacija BiH cUniverzitet u Sarajevu, Fakultet zdravstvenih studija, Federacija BiH
e-adresa: mfocak10@gmail.com
Sažetak
Cilj ove studije bio je da se ispita prognostički značaj troponina I, C-reaktivnog proteina I faktora rizika za pojave komplikacija nakon infarkta miokarda. Vrednosti troponina I I C-reaktivnog proteina analizirane su kod 38% bolesnika sa komplikacijama (postinfarktna angina, ventrikularna fibrilacija, srčana insuficijencija I fatalni ishod) I kod 62% bolesnika bez komplikacija. Vrednosti su zabeležene nakon prijema I između osmog I desetog dana hospitalizacije. Utvrđeno je da je sa komplikacijama značajno bio udružen veći broj faktora rizika(p = 0,00), dijabetes melitus (p = 0,02) i pušenje (p = 0,01). Pokazalo se da hipertenzija povecava rizik od razvoja srčane insuficijencije nakon akutnog infarkta miokarda (p = 0,02). Rezultat je statistički značajna razlika u posmatranim vrednostima troponina I između grupe bolesnika sa komplikacijama i bez njih (p = 0,22; p = 0,327). Utvrđena je statistički značajna razlika u posmatranim vrednostima C-reaktivnog proteina kod obe grupe bolesnika (p = 0,00; p = 0,01). Može se zaključiti da vrednosti troponina I nisu imale prognostički značaj u stratifikaciji rizika,dok su vrednosti C-reaktivnog proteina, pojedinačnih faktora rizika i veci broj faktora rizika imali značaj u stratifikaciji rizika nakon infarkta miokarda.
Abstract
The aim of this study was to investigate the prognostic significance of troponin I, C-reactive protein and risk factors for the occurrence of complications after myocardial infarction. Troponin I and C-reactive protein values were analyzed in 38% of patients with complications (postinfarction angina, ventricular fibrillation, heart failure and fatal outcome) and in 62% of patients without complications. Values were recorded on admission and between the eighth and tenth day of hospitalization. It was found that a larger number of risk factors (p = 0.00), diabetes mellitus (p = 0.02) and smoking (p = 0.01) were significantly associated with the complications. It was shown that hypertension increases the risk of developing heart failure after acute myocardial infarction (p = 0.02). It resulted with statistically non-significant difference in the observed values of troponin I between the group of patients with complications and the group without them (p = 0.22, p = 0.327).There was a statistically significant difference in the observed values of C-reactive protein in the two groups of patients (p = 0.00, p = 0.01). It can be concluded that the values of troponin I had no prognostic significance in risk stratification, while the values of C-reactive protein, individual risk factors and a large number of risk factors had significance in risk stratification after myocardial infarction.
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