The diagnostic role of end-tidal CO2 to distinguish unstable angina pectoris in patients with chest pain

Serhat Günlü; Ahmet Yeşil; Fethullah Kayan; Mehmet Zülkif Karahan

Article Details

The diagnostic role of end-tidal CO2 to distinguish unstable angina pectoris in patients with chest pain

Authors:

Serhat Günlü | Ahmet Yeşil | Fethullah Kayan | Mehmet Zülkif Karahan

Publisher:

Mus Alparslan University

Main Topics:

Klinik Tıp Bilimleri (Diğer)

Journal:

Muş Alparslan Üniversitesi Sağlık Bilimleri Dergisi Vol.3 Issue 2, pp.29-36

Document Type:

Article

Publication Date:

7/2023

Document Language:

English

Document ID (Org No.):

2001293497

pISSN:

2792-0925

Keywords:

Abstract:

 Objective: Unstable angina pectoris UAP, one of the acute coronary syndrome ACS types, is difficult to identify from non-cardiac chest pain non-CCP, hence various strategies are applied for accurate diagnosis. This study aims to examine whether non-invasively measured end-tidal CO2 ETCO2 can detect UAP in patients admitted to the emergency department ED with chest pain in the lack of a cardiovascular history. Methods: This research was conducted as a prospective observational study. The individuals were separated into two groups based on the inclusion and exclusion criteria: 75 patients with non-CCP and 75 UAP. Analyses of receiver operating characteristics ROC were utilized to define the diagnostic value cutoff. Using univariate regression analysis, the odds ratio of ETCO2 with 95CI was computed for UAP prediction. Results: The mean age of the research population was 61.211.3 years, with 34 females 22.7 and, 116 males 77.3. There were no substantial differences across the groups regarding clinical characteristics and laboratory parameters. ETCO2 levels were substantially lower in the UAP group compared with the non-CCP group p0.001. Analysis of the ROC curve revealed that a decreased ETCO2 35 predicted UAP with 78 sensitivity and 89 specificity AUC:0.81, p 0.001. In addition, the negative predictive value was 71.6, and the positive predictive value was 79.4. Patients with UAP were 8.84 times more likely to have ETCO2 35 than patients with non-CCP. Conclusion: UAP may be differentiated from non-CCP by ETCO2 measured as a non-invasive parameter in patients with chest pain.

 Objective: Unstable angina pectoris UAP, one of the acute coronary syndrome ACS types, is difficult to identify from non-cardiac chest pain non-CCP, hence various strategies are applied for accurate diagnosis. This study aims to examine whether non-invasively measured end-tidal CO2 ETCO2 can detect UAP in patients admitted to the emergency department ED with chest pain in the lack of a cardiovascular history. Methods: This research was conducted as a prospective observational study. The individuals were separated into two groups based on the inclusion and exclusion criteria: 75 patients with non-CCP and 75 UAP. Analyses of receiver operating characteristics ROC were utilized to define the diagnostic value cutoff. Using univariate regression analysis, the odds ratio of ETCO2 with 95CI was computed for UAP prediction. Results: The mean age of the research population was 61.211.3 years, with 34 females 22.7 and, 116 males 77.3. There were no substantial differences across the groups regarding clinical characteristics and laboratory parameters. ETCO2 levels were substantially lower in the UAP group compared with the non-CCP group p0.001. Analysis of the ROC curve revealed that a decreased ETCO2 35 predicted UAP with 78 sensitivity and 89 specificity AUC:0.81, p 0.001. In addition, the negative predictive value was 71.6, and the positive predictive value was 79.4. Patients with UAP were 8.84 times more likely to have ETCO2 35 than patients with non-CCP. Conclusion: UAP may be differentiated from non-CCP by ETCO2 measured as a non-invasive parameter in patients with chest pain.

 Objective: Unstable angina pectoris UAP, one of the acute coronary syndrome ACS types, is difficult to identify from non-cardiac chest pain non-CCP, hence various strategies are applied for accurate diagnosis. This study aims to examine whether non-invasively measured end-tidal CO2 ETCO2 can detect UAP in patients admitted to the emergency department ED with chest pain in the lack of a cardiovascular history. Methods: This research was conducted as a prospective observational study. The individuals were separated into two groups based on the inclusion and exclusion criteria: 75 patients with non-CCP and 75 UAP. Analyses of receiver operating characteristics ROC were utilized to define the diagnostic value cutoff. Using univariate regression analysis, the odds ratio of ETCO2 with 95CI was computed for UAP prediction. Results: The mean age of the research population was 61.211.3 years, with 34 females 22.7 and, 116 males 77.3. There were no substantial differences across the groups regarding clinical characteristics and laboratory parameters. ETCO2 levels were substantially lower in the UAP group compared with the non-CCP group p0.001. Analysis of the ROC curve revealed that a decreased ETCO2 35 predicted UAP with 78 sensitivity and 89 specificity AUC:0.81, p 0.001. In addition, the negative predictive value was 71.6, and the positive predictive value was 79.4. Patients with UAP were 8.84 times more likely to have ETCO2 35 than patients with non-CCP. Conclusion: UAP may be differentiated from non-CCP by ETCO2 measured as a non-invasive parameter in patients with chest pain.

 Amaç: Akut koroner sendrom AKS türlerinden biri olan kararsız angina pektoris UAP, kalp dışı göğüs ağrısından non-CCP ayırt edilmesi zordur, bu nedenle doğru tanı için çeşitli stratejiler uygulanır. Bu çalışma, kardiyovasküler öyküsü olmayan göğüs ağrısı ile acil servise AS başvuran hastalarda non-invaziv olarak ölçülen end-tidal CO2nin ETCO2 UAPyi saptayıp saptayamayacağını incelemeyi amaçlamaktadır. Yöntemler: Bu araştırma prospektif gözlemsel bir çalışma olarak yürütülmüştür. Bireyler, dahil etme ve hariç tutma kriterlerine göre iki gruba ayrıldı: CCP olmayan 75 hasta ve 75 UAP. Teşhis değeri kesimini tanımlamak için alıcı işletim özelliklerinin ROC analizlerinden yararlanılmıştır. Tek değişkenli regresyon analizi kullanılarak, UAP tahmini için ETCO2nin olasılık oranı 95 CI ile hesaplandı. Bulgular: Araştırma popülasyonunun yaş ortalaması 61.211.3 olup, 34ü kadın 22.7, 116sı erkektir 77,3. Klinik özellikler ve laboratuvar parametreleri açısından gruplar arasında önemli farklılıklar yoktu. ETCO2 seviyeleri UAP grubunda CCP olmayan grupla karşılaştırıldığında önemli ölçüde daha düşüktü p0.001. ROC eğrisinin analizi, 78 duyarlılık ve 89 özgüllükle EAA:0.81, p 0.001 azalmış bir ETCO2 35in UAPyi öngördüğünü ortaya koydu. Ayrıca negatif prediktif değer 71.6, pozitif prediktif değer ise 79.4 olarak bulundu. UAPli hastaların ETCO2 35e sahip olma olasılığı ÇKP olmayan hastalara göre 8.84 kat daha fazlaydı. Sonuç: UAP, göğüs ağrısı olan hastalarda non-invaziv bir parametre olarak ölçülen ETCO2 ile CCP olmayandan ayırt edilebilir.

Article Details

The diagnostic role of end-tidal CO2 to distinguish unstable angina pectoris in patients with chest pain

Authors:

Serhat Günlü | Ahmet Yeşil | Fethullah Kayan | Mehmet Zülkif Karahan

Publisher:

Mus Alparslan University

Main Topics:

Klinik Tıp Bilimleri (Diğer)

Journal:

Muş Alparslan Üniversitesi Sağlık Bilimleri Dergisi Vol.3 Issue 2, pp.29-36

Document Type:

Article

Publication Date:

7/2023

Document Language:

English

Document ID (Org No.):

2001293497

pISSN:

2792-0925

end-tidal carbon dioxide

non-cardiac chest pain

acute coronary syndrome

coronary care unit

unstable anginakararsız anjina

soluk sonu karbondioksit

kalp dışı göğüs ağrısı

akut koroner sendrom

koroner bakım ünitesi

Issues

Article Details

Authors: Serhat Günlü | Ahmet Yeşil | Fethullah Kayan | Mehmet Zülkif Karahan

Publisher: Mus Alparslan University

Main Topics: Klinik Tıp Bilimleri (Diğer)

Journal: Muş Alparslan Üniversitesi Sağlık Bilimleri Dergisi Vol.3 Issue 2, pp.29-36

Document Type: Article

Publication Date: 7/2023

Document Language: English

Document ID (Org No.): 2001293497

pISSN: 2792-0925

Issues

Authors:

Serhat Günlü | Ahmet Yeşil | Fethullah Kayan | Mehmet Zülkif Karahan

Publisher:

Mus Alparslan University

Main Topics:

Klinik Tıp Bilimleri (Diğer)

Journal:

Muş Alparslan Üniversitesi Sağlık Bilimleri Dergisi Vol.3 Issue 2, pp.29-36

Document Type:

Article

Publication Date:

7/2023

Document Language:

English

Document ID (Org No.):

2001293497

pISSN:

2792-0925