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4 - The effect of thrombolytic therapy on serum TNF-alpha concentrations in patients diagnosed with acute myocardial infarction
Fatih Borlu, Çiğdem Yazıcı Ersoy, Hüseyin Yaşar, B. Tolga Konduk
Objective: In this study, the diagnostic value of TNF-alpha in myocardial infarction and the effect of thrombolytic therapy on TNF-alpha is assessed.
Study Design: Eight female and 22 male patients were enrolled in this study, who had attended to Sisli Etfal Hastanesi emergency service within the first eight hours of initiation of chest pain, in whom AMI was diagnosed with clinical evaluation and laboratory workup. The patients were, then, referred to coronary care unit. TNF-alpha concentrations, before thrombolytic therapy and in the 48th hour of thrombolytic therapy, were evaluated in the patients with ages ranging between 24 and 69, who had the indication of thrombolytic therapy.
Results: TNF-alpha concentration within the hours of 0 and 8, was high in all patents who had the diagnosis of AMI. No significant difference was found between the anterior and inferior AMI subgroups. TNF-alpha concentrations in the 48th hour of the thrombolytic therapy was apparently lower when compared with the concentrations in the first eight hours (p=O.OI6 in anterior AMI, p=0.03 in inferior AMI). There was a significant parallel correlation between the 48th hour of TNF-alpha and CRP concentrations of anterior AMI group (p=0,003), and the first eight hours of CRP concentrations in the inferior AMI group (p=0,028)
Conclusions: Plasma TNF-alpha concentrations can be accepted as both a valuable diagnostic indicator of myocardial necrosis and an indicator of reperfusion provided by thrombolytic therapy, as well.
Keywords: AMI, thrombolytic therapy, tumor necrosis factor- alfa (TNF-alpha)
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