1. COHgb levels predict the long-term development of acute myocardial infarction in CO poisoning
- Author
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M. Birhan Yilmaz, Osman Beton, Hakan Güneş, Ali Zorlu, Hasan Yucel, Hakki Kaya, Abuzer Coskun, Recep Kurt, [Kaya, Hakki -- Beton, Osman -- Zorlu, Ali -- Yucel, Hasan -- Yilmaz, M. Birhan] Cumhuriyet Univ, Dept Cardiol, Sch Med, Sivas, Turkey -- [Coskun, Abuzer] Sivas State Hosp, Dept Emergency, Sivas, Turkey -- [Kurt, Recep -- Gunes, Hakan] Sivas State Hosp, Dept Cardiol, Sivas, Turkey, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, and YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Cross-sectional study ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Risk Assessment ,Carbon Monoxide Poisoning ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Humans ,Medical history ,Myocardial infarction ,Intensive care medicine ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Carbon monoxide poisoning ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Emergency department ,Middle Aged ,Prognosis ,medicine.disease ,Cross-Sectional Studies ,Carboxyhemoglobin ,ROC Curve ,chemistry ,Emergency medicine ,Emergency Medicine ,Female ,Myocardial infarction diagnosis ,Emergency Service, Hospital ,business ,Biomarkers ,Follow-Up Studies ,Cohort study - Abstract
WOS: 000375063100015, PubMed ID: 26947364, Background: There are several studies evaluating the cardiac effects of carbon monoxide (CO) poisoning during the acute period; however, the number of studies evaluating the long-term cardiac effects is limited. Objective: The present study aimed to evaluate the effects of blood carboxyhemoglobin (COHb) levels, elevated due to CO poisoning on the long-term development of acute myocardial infarction (AMI). Methods: This cross-sectional cohort study included a total of 1013 consecutive patients who presented to the emergency department (ED) due to CO poisoning, between January 2005 and December 2007. The diagnosis of CO poisoning was made according to the medical history and a COHb level of greater than 5%. In terms of AMI development, the patients were followed up for an average of 56 months. Results: At the end of follow-up, 100 (10%) of 1013 patients experienced AMI. Carboxyhemoglobin levels at the time of poisoning were higher among those who were diagnosed with AMI compared to those who were not (55% +/- 6% vs 30% +/- 7%; P < .001). Using a multivariate Cox proportional hazards model with forward stepwise method, age, COHb level, CO exposure time, and smoking remained associated with an increased risk of AMI after adjustment for the variables found to be statistically significant in a univariate analysis. According to a receiver operating characteristic curve analysis, the optimal cutoff value of COHb used to predict the development of AMI was found to be greater than 45%, with 98% sensitivity and 94.1% specificity. Conclusion: In patients presenting to the ED with CO poisoning, COHb levels can be helpful for risk stratification in the long-term development of AMI. (C) 2016 Elsevier Inc. All rights reserved.
- Published
- 2016