Canbaz Hayri, Görmel Suat
Department of Emergency Medicine, Yıldırım Beyazıt University, Yenimahalle Training and Research Hospital, Ankara, Türkiye.
Department of Cardiology, Gülhane Training and Research Hospital, Ankara, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jan 30;31(1):11-18. doi: 10.5606/tgkdc.dergisi.2023.24249. eCollection 2023 Jan.
The aim of this study was to investigate the prognostic value of the troponin/creatinine ratio in patients presenting with chest pain and to identify laboratory values affecting mortality.
Between October 1st, 2016 and April 30th, 2019, a total of 5,079 patients (2,844 males, 2,235 females; median age: 65 years; range, 49 to 83 years) who presented to the emergency department with chest pain and whose troponin and creatinine measurements were done were retrospectively analyzed. Laboratory data and 28-day mortality rates were evaluated. The patients were divided into two groups according to 28-day mortality rates after the initial emergency department admission as survivors (n=4,793) and non-survivors (n=286).
There were statistically significant differences in the white blood cell count, C-reactive protein, creatinine, high-sensitivity troponin I, and troponin/creatinine ratio between the groups (p<0.05). The high-sensitivity troponin I ≥31.96 pg/dL, creatinine ≥1.11 mg/dL, C-reactive protein ≥43.94 mg/L, and troponin/creatinine ratio ≥25.12 were independent predictors of 28-day mortality (p<0.05). A C-reactive protein value of ≥43.94 mg/L was found to be more specific (81.14%) than the other markers for mortality.
Troponin/creatinine ratio is a predictor of mortality in patients presenting to the emergency department with chest pain and high-sensitivity troponin I, creatinine, and C-reactive protein seem to be independent risk factors for 28-day mortality.
本研究旨在探讨肌钙蛋白/肌酐比值对胸痛患者的预后价值，并确定影响死亡率的实验室指标。
回顾性分析2016年10月1日至2019年4月30日期间，因胸痛就诊于急诊科且进行了肌钙蛋白和肌酐检测的5079例患者（男性2844例，女性2235例；中位年龄65岁；范围49至83岁）。评估实验室数据和28天死亡率。根据首次急诊科入院后28天死亡率，将患者分为幸存者（n = 4793）和非幸存者（n = 286）两组。
两组之间白细胞计数、C反应蛋白、肌酐、高敏肌钙蛋白I和肌钙蛋白/肌酐比值存在统计学显著差异（p < 0.05）。高敏肌钙蛋白I≥31.96 pg/dL、肌酐≥1.11 mg/dL、C反应蛋白≥43.94 mg/L和肌钙蛋白/肌酐比值≥25.12是28天死亡率的独立预测因素（p < 0.05）。发现C反应蛋白值≥43.94 mg/L对死亡率的预测比其他标志物更具特异性（81.14%）。
肌钙蛋白/肌酐比值是胸痛就诊于急诊科患者死亡率的预测指标，高敏肌钙蛋白I、肌酐和C反应蛋白似乎是28天死亡率的独立危险因素。
