Akut Koroner Sendromlu Hastalarda Kronik Total Oklüzyon Sıklığı ve Risk Faktörleriyle İlişkisi

Year 2019, Volume: 6 Issue: 3, 194 - 198, 30.09.2019

Taner Sarak , Muhammed Karadeniz

https://doi.org/10.34087/cbusbed.522987

Cited By: 2

Abstract

Amaç: Bu
çalışma kliniğimizde akut koroner sendrom sebebiyle yatarak tedavi edilen
hastalarda kronik total oklüzyon sıklığı ve bunun kardiyovasküler risk
faktörleriyle ilişkisini belirlemek amacıyla yapılmıştır.

Gereç ve yöntem: Çalışmaya Nisan 2015 – Eylül 2018 tarihleri arasında akut koroner
sendrom sebebiyle koroner anjiyografik değerlendirmeye alınan hastalar dahil
edildi. Koroner anjiyografik incelemelerde lezyon
bölgesinde TIMI 0 akım olan hastalar kronik
total oklüzyon olarak kabul edildi. Risk faktörleri
anamnez ve laboratuvar bulgularına göre tespit edildi.

Bulgular: Çalışmaya kriterlere uyan 904 hasta dahil edildi. İki yüz on dört hastada (%23) kronik total oklüzyon tespit edildi. Kronik
total oklüzyon olan hastalarda ortalama yaş (67 ± 11, 60 ± 13, p < 0.001),
hipertansiyon varlığı (%54.7, %43.0, p = 0.004) ve diyabetes mellitus  (%41.1, %31.6, p = 0.013) istatistiksel
olarak daha yüksek saptandı, erkek cinsiyet (%64, %73, p = 0.008), prematüre koroner arter hastalığı öyküsü (%10.3,
%19.9, p = 0.001) ve sigara kullanımı (%28.0, %48.8, p < 0.001) ise daha
düşük saptandı.

Sonuç: Bu çalışmada akut koroner sendrom hastalarında kronik total oklüzyonu
olan ve olmayan hasta grupları arasında risk faktörleri açısından anlamlı
farklar olduğu tespit edildi. Bildiğimiz kadarıyla, bu çalışma literatürdeki
kronik total oklüzyon ve kardiyovasküler risk faktörleri arasındaki ilişkiyi
gösteren ilk çalışmadır

Keywords

Akut koroner sendrom, kronik total oklüzyon, kardiyovasküler risk faktörleri

Frequency of Chronic Total Occlusion in Patients with Acute Coronary Syndrome and its Relationship with Risk Factors

Abstract

Objective: In the present study, we aimed to
determine the frequency of chronic total occlusion  and its relationship with cardiovascular risk
factors in inpatients with acute coronary syndrome treated in our clinic.

Materials and methods: Patients who
underwent coronary angiographic evaluation for acute coronary syndrome between
April 2015 and September 2018 were included in the study. Patients with TIMI
0 flow in the lesion region were accepted as chronic total occlusion in
coronary angiographic examinations. Risk factors were determined according to
the anamnesis and laboratory findings.

Results: 904 patients were included in the study.
Two hundred
and fourteen patients (23%) had chronic total occlusion. Mean age (67 ± 11,
60 ± 13, p <0.001), hypertension (54.7%, 43.0%, p = 0.004) and diabetes
mellitus (41.1%, 31.6%, p = 0.013) were significantly higher in patients with chronic
total occlusion and male gender (64%, 73%, p = 0.008), premature coronary
artery disease (10.3%, 19.9%, p = 0.001) and cigarette smoking (28.0%, 48.8%, p
<0.001) were lower.

Conclusion: In the present study, there were
significant differences in risk factors among patients with and without chronic
total occlusion   in acute coronary syndrome patients. To the best of our
knowledge, this is the first study in the literature to demonstrate the
relationship between chronic total occlusion and cardiovascular risk factors.

Keywords

Acute coronary syndrome, chronic total occlusion, cardiovascular risk factors

References

• 1. Kahn JK, Angiographic suitability for catheter revascularization of total coronary occlusions in patients from a community hospital setting. American heart journal 1993, 126:561-564.
• 2. Tajstra M, Gasior M ve ark. Comparison of five-year outcomes of patients with and without chronic total occlusion of noninfarct coronary artery after primary coronary intervention for ST-segment elevation acute myocardial infarction. The American journal of cardiology 2012, 109:208-213.
• 3. Gierlotka M, Tajstra M ve ark. Impact of chronic total occlusion artery on 12-month mortality in patients with non-ST-segment elevation myocardial infarction treated by percutaneous coronary intervention (from the PL-ACS Registry). International journal of cardiology 2013, 168:250-254.
• 4. Delp MD, Behnke BJ ve ark. Ageing diminishes endothelium‐dependent vasodilatation and tetrahydrobiopterin content in rat skeletal muscle arterioles. The Journal of physiology 2008, 586:1161-1168.
• 5. MacMahon S, Peto R ve ark. Blood pressure, stroke, and coronary heart disease: part 1, prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. The Lancet 1990, 335:765-774.
• 6. Grundy SM, Becker D ve ark. Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation 2002, 106:3143-3421.
• 7. Stabley JN, Towler DA. Arterial calcification in diabetes mellitus: preclinical models and translational implications. Arteriosclerosis, thrombosis, and vascular biology. 2017;37(2):205-17.
• 8. Celermajer DS, Sorensen KE ve ark. Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. Journal of the American College of Cardiology 1994, 24:471-476.
• 9. Messner B, Bernhard D: Smoking and Cardiovascular DiseaseSignificance: Mechanisms of Endothelial Dysfunction and Early Atherogenesis. Arteriosclerosis, thrombosis, and vascular biology 2014, 34:509-515.
• 10. Yusuf S, Hawken S ve ark. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The lancet 2004, 364:937-952.
• 11. Srivatsa SS, Edwards WD ve ark. Histologic correlates of angiographic chronic total coronary artery occlusions: influence of occlusion duration on neovascular channel patterns and intimal plaque composition. Journal of the American College of Cardiology 1997, 29:955-963.
• 12. Suzuki T, Hosokawa H ve ark. Time-dependent morphologic characteristics in angiographic chronic total coronary occlusions. American Journal of Cardiology 2001, 88:167-169.