| Abstract | CILJ ISTRAŽIVANJA: Usporediti serumske koncentracije visoko osjetljivog troponina I i vrijednosti upalnog parametra hsCRP u STEMI i NSTEMI pacijenata. Utvrditi postoji li statistički značajna razlika u broju leukocita, diferencijalnoj krvnoj slici, aktivnosti serumskog enzima AST-a i glukoze u obje ispitivane skupine.
ISPITANICI I METODE: Ovo istraživanje uključilo je 60 ispitanika sa simptomima srčanog zatajenja, a bili su liječeni na Klinici za bolesti srca i krvnih žila KBC-a Split u periodu siječnja 2018. do veljače 2019. godine. Uzorci su obrađeni i analizirani na Zavodu za medicinsko laboratorijsku dijagnostiku KBC Split. Prikupljeni su klinički podaci o dijagnozi ispitanika te su napravljena različita mjerenja i biokemijska ispitivanja.
REZULTATI: Pacijenti su podijeljeni na STEMI (50%) i NSTEMI akutni infarkt miokarda (50%). Svim pacijentima izmjeren je sistolički i dijastolički tlak, kao i indeks tjelesne mase koji je pokazao pretilost kod 13,3% uključenih u istraživanje. Kod 78,3% pacijenata već je izvedena PCI. Lijekovi korišteni tijekom terapije su statini, varfarin, aspirin, a najčešće korišteni su ACE-inhibitori (50%) i beta blokatori (33,3%). Uspoređuju se komorbiditeti kao što su: šećerna bolest, pušenje, pretilost, a najčešće prisutna je arterijska hipertenzija (60%). Mjerenjem aktivnosti enzima AST-a u krvi uočene su značajne razlike kod STEMI (90,1 ± 108,9 IU/L) i NSTEMI (41,4 ± 28,3 IU/L), kao i kod broja neutrofila: STEMI (8,4 ± 2,9 x10^9/L) i NSTEMI(6,4 ± 2,3 x10^9/L). Značajne razlike uočene su i kod broja limfocita i leukocita. Ostali biokemijski parametri nisu ukazivali na značajne statističke razlike: hsCRP (STEMI (11,2 ± 17,0 mg/L) i NSTEMI (16,1 ± 26,8 mg/L), protrombinsko vrijeme, glukoza, natrij, eritrociti. Jedan od parametara bez značajne razlike je i visoko osjetljivi srčani troponin I: STEMI (417,8 ± 617,6 ng/L) i NSTEMI (314,9 ± 406,6 ng/L), iako je vidljiva njegova viša koncentracija kod STEMI ispitivane skupine.
ZAKLJUČAK:
Bez obzira na rezultate laboratorijskih pretraga, dijagnoza se mora postaviti zajedno s kliničkom prezentacijom pacijenta i zajedno s ostalim dijagnostičkim testovima. |
| Abstract (english) | OBJECTIVES: To compare the serum concentrations of highly sensitive troponin I and the values of the inflammatory parameter hsCRP in STEMI and NSTEMI patients. To determine whether there was a statistically significant difference in leukocyte count, differential blood count, serum AST enzyme activity, and glucose in both study groups.
PATIENTS AND METHODS: This study included 60 subjects with symptoms of heart failure, and were treated at the Clinic for Cardiovascular Diseases of the Clinical Hospital Center Split in the period from January 2018 to February 2019. The samples were processed and analyzed at the Department of Medical Laboratory Diagnostics, University Hospital Center Split. Clinical data on the diagnosis of the subjects were collected and various measurements and biochemical tests were performed.
RESULTS: Patients were divided into STEMI (50%) and NSTEMI acute myocardial infarction (50%). All patients had systolic and diastolic blood pressure measured, as well as body mass index, which showed obesity in 13.3% of those included in the study. PCI has already been performed in 78.3% of patients. Medicaments used during therapy are statins, warfarin, aspirin, and the most commonly used are ACE inhibitors (50%) and beta blockers (33.3%). Comorbidities such as diabetes, smoking, obesity are compared, and arterial hypertension is most common (60%). By measuring the activity of AST in the blood, significant differences were observed in STEMI (90.1 ± 108.9 IU / L) and NSTEMI (41.4 ± 28.3 IU / L), as well as by measuring the number of neutrophils: STEMI (8, 4 ± 2.9 x10 ^ 9 / L) and NSTEMI (6.4 ± 2.3 x10^9/ L). Significant differences were also observed in the number of lymphocytes and leukocytes. Other biochemical parameters did not indicate significant statistical differences: hsCRP (STEMI (11,2 ± 17,0 mg/L) i NSTEMI (16,1 ± 26,8 mg/L), prothrombin time, glucose, sodium, erythrocytes. One of the parameters without significant difference is the highly sensitive cardiac troponin I: STEMI (417.8 ± 617.6 ng / L) and NSTEMI (314.9 ± 406.6 ng / L), although its higher concentration is visible in STEMI study groups.
CONCLUSION:
Regardless of the results of laboratory tests, the diagnosis should be established with the clinical presentation of the patient and other diagnostic tests. |
