Journals / MN Kardiyoloji / 2001 / Cilt: 8 - Sayı: 2
The effect of thrombolytic therapy on mean platelet volume and QT dispersion in patients with acute myocardial infarction
- Journal
- MN Kardiyoloji
- Pages
- 93–96
- DOI
- —
Abstract
AIM: Increased mean platelet volume (MPV) is associated with increased complication risk like recurrent angina, reinfarction, heart failure and death in acute myocardial infarction (AMI). In addition, increased QT dispersion is associated with increased arrhythmia risk in patients with AMI. lit this present study, we aimed to investigate the effect of thrombolytic therapy on MPV and QTD in patients with AMI. MATERIALS AND METHODS: MPV, QTD and rate corrected QTD (QTcD) were measured in 211 patients with AMI on admission, 2 and 7 days. Patients were divided into two groups; group I: patients treated with thrombolytic therapy (n-113; 92 male, 21 female; mean age 56.83±11.22 year), group II: patients treated without thrombolytic therapy (n-98; 81 male, 17 female; mean age 57.43±11.67 year). Group 1 was subdivided into group la: patients with successful thrombolytic therapy (n-59; 48 male, 11 female; mean age 56.03±10.65 year) and group Ib: patients with unsuccessful thrombolytic therapy (n=54; 44 ntale, 10female; mean age 57.70±l 1.85year). RESULTS: There was no significant difference in MPV, QTD, QTcD between group I and group lion admission. Although there was no significant difference in MPV between group I and group II, QTD, QTcD measured in group I were significantly lower than those of in group II on second day (p<0.005). MPV and QTD measured in roup I were significantly lower than those of in group II on 7. day (p<0.05). Although there was no significant difference between MPV measured on admission and second day, there was a significant decrease on 7. day both in group la and in group Ib (respectively p<0.001, p<0.05). QTD measured on 2.and 7.days were significantly lower than that on admission in group la (respectively P<0.005,p<0.01), but only on 7.day in group Ib (p<0.05). QTcD measured on 2.and 7.days were significantly lower than that on admission in group la (respectively P<0.001,p<0.05), but only on 7.day in group Ib (p<0.05). QTD measured on admission 2.and 7.days were similar in group II (p<0.05). QTcD measured on admission 2.and 7.days were similar in group II,too (p<0.05). CONCLUSION: Thrombolytic therapy causes a significant decrease on MPV and QTD in patients with AMI.This decrease is very definite in patients with successful thrombolytic therapy.We think that these effects may have some contribution to good outcomes obtained with thrombolytic therapy, and the reduction in MPV and QTD may be a predictor of a better outcome in patients with AMI underwent thrombolytıc therapy.
Özet
AMAÇ: Akut miyokard infarktüsünde artmış ortalama trombosit volümlerinin tekrarlayan anjina, reinfarktüs, kalp yetmezliği ve ölüm gibi komplikasyonlarla ilişkisi olduğu ve yine artmış QT dispersiyonunun da artmış aritmi riski ile birlikte olduğu bilinmektedir. Bu çalışma akut miyokard infarktüsünde trombolitik tedavinin ortalama trombosit volümü (OTV) ve QT dispersiyonu (QTD) üzerine olan etkilerini araştırmak amacı ile yapıldı. GEREÇ VE YÖNTEM: Akut miyokard infarktüslü trombolitik tedavi uygulanan 113 hasta (grup I; 92 erkek, 21 kadın; ortalama yaş 56.83±11.22 yıl) ve trombolitik tedavi uygulanmayan 98 (grup II; 81 erkek, 17 kadın; ortalama yaş 57.43±11.67 yıl) hastada hastaneye başvurma anında, 2. günde ve 7. günde OTV ve QTD, kalp hızı ile düzeltilmiş QTD (QTcD) ölçüldü. Grup I'deki hastalar trombolitik tedavinin başarılı olduğu (grup Ia,n=59; 48 erkek,11 kadın; ortalama yaş 56.03±10.65 yıl) v e trombolitik tedavinin başarısız olduğu (grup Ib,n=54; 44 erkek, 10 kadın;ortalama yaş 57.70±11.85 yıl) olgular olarak iki alt gruba ayrıldı. BULGULAR: Grup Ia'da başvuru anındaki OTV ile 2. günde saptanan OTV arasında anlamlı farklılık bulunmaz iken 7. günde saptanan OTV hem başlangıç hem de 2. günde saptanan değerlere göre anlamlı derecede daha düşüktü (p 0.05). QTcD grup Ia'da 2. günde ve 7. günde başlangıç değere göre anlamlı derecede düşük iken (sırası ile p 0.05). SONUÇ: Akut miyokard infarktüsünde trombolitik tedavi OTV ve QTD'nda anlamlı derecede azalma yapmaktadır. Bu azalma trombolitik tedavinin başarılı olduğu olgularda daha belirgindir. Başarılı trombolitik tedavi ile elde edilen olumlu sonuçlara bu etkilerin de katkısı olduğunu düşünmekteyiz.