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AKUT MİYOKARD İNFARKTÜSÜ GEÇİREN HASTALARDA ERKEN MORTALİTEYİ BELİRLEMEDE ÜR‹NER ALBÜM‹N ATILIM ORANI

THE URINARY ALBUMIN EXCRETION RATE IN THE PREDICTION OF EARLY MORTALITY IN PATIENTS WITH ACUTE MYOCADIAL INFARCTION

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2005

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Objective: Urinary albumin excretion rate (AER) increases in acute myocardial infarction (MI). The purpose of this study was to evaluate whether the increase of urinary AER was an important factor for predicting early mortality and heart failure in patients with acute MI. Materials and methods: 116 patients with acute MI (Male / Female: 96/20, mean age 59.8 ± 11.3 years) and 21 patients (Male / Female:17/4, mean age 60.2 ± 11.9 years) with ischemic heart disease but without MI were included in this study. The patients were divided into two groups according to whether left ventricular ejection fraction (LVEF) was >50% or <50%. Urinary AER was measured on the first and third days after admission to the hospital. Results: Urinary AERs on the first and third days were significantly higher in patients with acute MI than in those without acute MI (1st day: 75.30 vs 13.00 mg/day, p<0.0001; 3rd day: 21.50 vs 6.80 mg/day, p<0.0001). Eleven patients with acute MI died in the first week. In these patients, urinary AERs on the 1st and 3rd days were significantly higher than in those who survived (1st day: 124.00 vs 69.30 mg/day, p<0.001; 3rd day: 89.40 vs 18.90 mg/day, p<0.001).It was also found that AERs on the 1st and 3rd days were higher in patients with LVEF <50% than those in patients with LVEF >50% (1st day: 81.90 vs 26.45 mg/day, p=0.003; 3rd day: 22.70 vs 8.45 mg/day, p=0.001). Conclusion: Urinary AER increases in the early phase of acute MI. The increase observed in patients who had left ventricular dysfunction was more prominent. We can conclude that urinary AER might be an important factor for predicting early mortality during acute MI, based on the findings that urinary AERs were higher in those who died during the early phase of acute MI than in those who survived.
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Abstract (Original Language): 
Amaç: Akut miyokard infarktüsünün (MI) seyri s›ras›nda üriner albümin at›l›m (ÜAA) miktar› artmaktad›r. Çal›flmam› z›n amac› akut MI geçiren hastalarda ÜAA’n›n kalp yetersizli¤i ve erken dönem mortaliteyi belirlemede etkili olup olmad›¤›n› araflt›rmakt›r. Gereç ve yöntem: Çal›flmaya akut MI geçiren 116 hasta (Erkek / Kad›n: 96/20, yafl 59,8 ± 11,3 y›l) ile iskemik kalp hastal›¤› olan akut MI geçirmeyen 21 hasta (Erkek / Kad›n :17/4, yafl 60,2 ± 11,9 y›l) al›nd›. ÜAA yo¤un bak› ma al›nd›ktan itibaren ilk gün ve üçüncü gün olmak üzere 24 saatlik idrar toplanarak ölçüldü. Ekokardiyografi yap›labilen hastalar sol ventrikül ejeksiyon fraksiyonuna (LVEF) göre LVEF < %50 (n=61) ve LVEF > %50 (n=32) olmak üzere 2 gruba ayr›ld›. Bulgular: 1. ve 3. gün ÜAA akut MI geçiren hastalarda kontrol grubuna göre anlaml› olarak daha yüksek bulundu (1. gün 75,30 ve 13,00 mg/gün p<0.0001; 3. gün 21,50 ve 6,80 mg/gün, p<0,0001). Akut MI geçiren 11 hasta ilk bir hafta içerisinde kaybedildi. Bu hastalar›n 1. ve 3. günde ÜAA oranlar› MI geçiren ve sa¤ kalan hastalara göre anlaml› olarak daha yüksek bulundu (1.gün 124,00 ve 69,30 mg/gün, p<0.001; 3. gün 89,40 ve 18,90 mg/gün, p<0,001). Akut MI geçiren hastalardan LVEF si <%50 olanlarda 1. ve 3. gün ÜAA oran›, LVEF si >%50 olanlara göre anlaml› olarak daha yüksek bulundu (1. gün 81,90 ve 26,45 mg/gün, p=0,003; 3.gün 22,70 ve 8,45 mg/gün, p=0,001). Sonuç: Akut MI erken döneminde ÜAA oran› artmaktad›r. Bu art›fl sol ventrikül sistolik fonksiyonlar› bozuk olan hastalarda daha fazla olmaktad›r. Erken dönemde kaybedilen hastalar›n ÜAA oranlar›n›n daha yüksek bulunmas› akut MI seyrinde ÜAA oran›n›n erken mortaliteyi belirlemede önemli olabilece¤ini düflündürmektedir.
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  • Turkish

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