Yıl: 2023 Cilt: 23 Sayı: 1 Sayfa Aralığı: 30 - 37 Metin Dili: İngilizce DOI: 10.4103/2452-2473.366483 İndeks Tarihi: 18-05-2023

Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication

Öz:
OBJECTIVES: This single center, retrospective study investigates the predictive value of cardiovascular (CV) risk-calculation systems in patients admitted to the emergency department with carbon monoxide (CO) intoxication for the identification of potential myocardial injury. METHODS: The total CV risk of 558 patients presenting to the emergency department with CO intoxication were calculated on admission using different CV risk scoring systems, including SCORE Turkey, European Heart SCORE, and FRAMINGHAM to predict potential myocardial injury secondary to poisoning, and the risk levels were categorized based on the calculated scores. The presence of myocardial injury was identified based on the level of elevation of a cardiac biomarker (Serum cardiac troponin-I >99th percentile upper reference limit). RESULTS: Myocardial injury due to CO intoxication was detected in 132 (23.7%) of the patients. A comparison of the risk scoring systems’ ability to detect the presence of myocardial injury revealed that all had significant, similar, but low predictive values (the “area under the curve” values of SCORE Turkey, European Heart SCORE and FRAMINGHAM were 0.653, 0.632, and 0.629, respectively; P < 0.001). Among the three risk scoring systems, SCORE Turkey was the most successful test in diagnosing myocardial injury with 87% specificity, while FRAMINGHAM scoring was the most successful test in excluding the presence of myocardial injury with 72.1% sensitivity. CONCLUSION: Among the tested CV risk calculation systems SCORE Turkey, was found to be the most effective in the prediction of myocardial injury secondary to CO poisoning, but all produced similar and significant results.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Piantadosi CA. Carbon monoxide poisoning. Undersea Hyperb Med 2004;31:167 77.
  • 2. Tritapepe L, Macchiarelli G, Rocco M, Scopinaro F, Schillaci O, Martuscelli E, et al. Functional and ultrastructural evidence of myocardial stunning after acute carbon monoxide poisoning. Crit Care Med 1998;26:797 801.
  • 3. Varol E, Ozaydin M, Aslan SM, Doğan A, Altinbaş A. A rare cause of myocardial infarction: Acute carbon monoxide poisoning. Anadolu Kardiyol Derg 2007;7:322 3.
  • 4. Satran D, Henry CR, Adkinson C, Nicholson CI, Bracha Y, Henry TD. Cardiovascular manifestations of moderate to severe carbon monoxide poisoning. J Am Coll Cardiol 2005;45:1513 6.
  • 5. Henry CR, Satran D, Lindgren B, Adkinson C, Nicholson CI, Henry TD. Myocardial injury and long term mortality following moderate to severe carbon monoxide poisoning. JAMA 2006;295:398 402.
  • 6. Penney DG. Chronic carbon monoxide poisoning: A case series. In: Penney DG, editors. Carbon Monoxide Poisoning. Boca Raton, FL: CRC Press; 2007. p. 551 67.
  • 7. Van Meter KW. Carbon monoxide poisoning. In: Tintinalli JE, Kelen GD, Stapczynski JS, editors. Emergency Medicine a Comprehensive Study Guide. New York: McGraw Hill; 2000. p. 1302 6.
  • 8. Kandis H, Katırcı Y, Çakır Z, et al. Acil servise karbonmonoksit entoksikasyonu ile başvuran olgularin geriye dönük analizi [Article in Turkish]. J Acad Emerg Med 2007;5:21 5.
  • 9. Allred EN, Bleecker ER, Chaitman BR, Dahms TE, Gottlieb SO, Hackney JD, et al. Effects of carbon monoxide on myocardial ischemia. Environ Health Perspect 1991;91:89 132.
  • 10. Allred EN, Bleecker ER, Chaitman BR, Dahms TE, Gottlieb SO, Hackney JD, et al. Short term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. N Engl J Med 1989;321:1426 32.
  • 11. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Eur Heart J 2020;41:111 88.
  • 12. European Association of Preventive Cardiology [HeartScore Turkey Website]. Available from: http://www.heartscore.org/ tr_TR/accessheartscore. [Last accessed on 2021 Sep 27].
  • 13. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten year risk of fatal cardiovascular disease in Europe: The SCORE project. Eur Heart J 2003;24:987 1003.
  • 14. D’Agostino RB Sr., Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, et al. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation 2008;117:743 53.
  • 15. Touger M, Gallagher EJ, Tyrell J. Relationship between venous and arterial carboxyhemoglobin levels in patients with suspected carbon monoxide poisoning. Ann Emerg Med 1995;25:481 3.
  • 16. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol 2018;72:2231 64.
APA ÖZKOÇ M, AKSAKAL E, DERMAN O, SARAÇ İ, KOZA Y (2023). Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. , 30 - 37. 10.4103/2452-2473.366483
Chicago ÖZKOÇ MUSTAFA,AKSAKAL Emrah,DERMAN OMER,SARAÇ İBRAHİM,KOZA YAVUZER Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. (2023): 30 - 37. 10.4103/2452-2473.366483
MLA ÖZKOÇ MUSTAFA,AKSAKAL Emrah,DERMAN OMER,SARAÇ İBRAHİM,KOZA YAVUZER Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. , 2023, ss.30 - 37. 10.4103/2452-2473.366483
AMA ÖZKOÇ M,AKSAKAL E,DERMAN O,SARAÇ İ,KOZA Y Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. . 2023; 30 - 37. 10.4103/2452-2473.366483
Vancouver ÖZKOÇ M,AKSAKAL E,DERMAN O,SARAÇ İ,KOZA Y Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. . 2023; 30 - 37. 10.4103/2452-2473.366483
IEEE ÖZKOÇ M,AKSAKAL E,DERMAN O,SARAÇ İ,KOZA Y "Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication." , ss.30 - 37, 2023. 10.4103/2452-2473.366483
ISNAD ÖZKOÇ, MUSTAFA vd. "Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication". (2023), 30-37. https://doi.org/10.4103/2452-2473.366483
APA ÖZKOÇ M, AKSAKAL E, DERMAN O, SARAÇ İ, KOZA Y (2023). Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. Turkish journal of emergency medicine (Online), 23(1), 30 - 37. 10.4103/2452-2473.366483
Chicago ÖZKOÇ MUSTAFA,AKSAKAL Emrah,DERMAN OMER,SARAÇ İBRAHİM,KOZA YAVUZER Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. Turkish journal of emergency medicine (Online) 23, no.1 (2023): 30 - 37. 10.4103/2452-2473.366483
MLA ÖZKOÇ MUSTAFA,AKSAKAL Emrah,DERMAN OMER,SARAÇ İBRAHİM,KOZA YAVUZER Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. Turkish journal of emergency medicine (Online), vol.23, no.1, 2023, ss.30 - 37. 10.4103/2452-2473.366483
AMA ÖZKOÇ M,AKSAKAL E,DERMAN O,SARAÇ İ,KOZA Y Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. Turkish journal of emergency medicine (Online). 2023; 23(1): 30 - 37. 10.4103/2452-2473.366483
Vancouver ÖZKOÇ M,AKSAKAL E,DERMAN O,SARAÇ İ,KOZA Y Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication. Turkish journal of emergency medicine (Online). 2023; 23(1): 30 - 37. 10.4103/2452-2473.366483
IEEE ÖZKOÇ M,AKSAKAL E,DERMAN O,SARAÇ İ,KOZA Y "Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication." Turkish journal of emergency medicine (Online), 23, ss.30 - 37, 2023. 10.4103/2452-2473.366483
ISNAD ÖZKOÇ, MUSTAFA vd. "Predictive value of cardiovascular risk scoring systems for the detection of myocardial injury following carbon monoxide intoxication". Turkish journal of emergency medicine (Online) 23/1 (2023), 30-37. https://doi.org/10.4103/2452-2473.366483