Usefulness of the CHA2DS2-VASc Score to Predict “St Segment Resolution Failure” In Patients Treated With Primary Percutaneous Coronary Intervention for St-Segment Elevation Myocardial Infarction

Year 2019, Volume: 46 Issue: 4, 847 - 855, 15.12.2019

Fatih Aksoy , İsmail Barkın Işık , Hasan Aydın Baş , Ali Bağcı , Fatih Kahraman , Yunus Emre Okudan Mevlüt Serdar Kuyumcu , Ahmet Altınbaş

https://doi.org/10.5798/dicletip.570650

Cited By: 2

Abstract

Background: Rapid
supply of coronary blood flow in the occluded
coronary artery is the principle aim of early ST-elevation myocardial
infarction (STEMI) therapy. Although coronary blood flow has been supplied,
insufficient myocardial reperfusion mainly at the level of micro vascular
circulation has been assessed a large number of patients. Electrocardiographically
by measuring ST-segment resolution (STR) after procedure is an easy and good
indicator for the evaluation of reperfusion failure. The CHA₂DS₂-VASc
risk score is used to predict the risk of thromboembolism in non-valvular AF
patients. Its usefulness in predicting AF in the development of STR failure in
patients presenting with STEMI is unknown. We evaluated the predictive value of
the CHA2DS2-VASc score in patients with STR failure following STEMI.

Methods: Models including clinical and laboratory parameters
were constructed to test the predictive value of CHA2DS2-VASc and CHA2DS2-VASc -HS
scores. Patients were divided into two groups: those with STR> 70 % and
those without STR> 70. Predictors of STR failure were determined by
multivariate regression analysis.

Results: Multiple regression analysis showed that CHA2DS2-VASc-HS
score, Anterior STEMI, peak CK-MB level and symptom to percutaneous coronary
intervention time were associated with development of STR failure in patients presenting with
STEMI. ROC curve analyses showed that CHA₂DS₂-VASc and CHA2DS2-VASc -HS scores were significant predictors for STR
failure.

Conclusion: CHA₂DS₂-VASc and CHA2DS2-VASc -HS scores predict STR failure in patients
presenting STEMI.  

Keywords

CHA2DS2-VASc scores, ST segment resolution, myocardial infarction

CHADS2-VASc skorunun primer percutan koroner girişim yapılan ST elevasyonlu miyokart enfarktüslü hastalarda ST segment rezolusyonunu öngörmedeki yararlılığı

Abstract

Amaç: Tıkalı koroner arterde hızlı koroner kan akımın sağlanması, ST
yükselmeli miyokard infarktüsü (STEMI) tedavisinin temel amacıdır. Her ne kadar
koroner kan akımı sağlanmış olsa da, çoğunlukla mikrovasküler düzeyde yetersiz
miyokard reperfüzyonu çok sayıda hastada saptanmıştır. Elektrokardiyografik
olarak işlem sonrası ST-segment rezolusyonunu (STR) ölçmek reperfüzyon başarısını
değerlendirilmek için kolay ve iyi bir göstergedir. CHA2DS2-VASc risk skoru,
valvüler olmayan AF hastalarında tromboembolizm riskini tahmin etmek için
kullanılır. STEMI ile başvuran hastalarda STR yetersizliğinin gelişmesini
öngörmedeki yararı bilinmemektedir. STEMI sonrası STR’ nun değerlendirilmesinde
CHA2DS2-VASc skorunun prediktif değerinin araştırılması amaçlanmıştır.

Yöntem:
CHA2DS2-VASc ve CHA2DS2-VASc -HS puanlarının prediktif değerini test etmek için
klinik ve laboratuvar parametrelerini içeren modeller yapıldı. Hastalar STR>%
70 olan ve olmayan olarak iki gruba ayrılmıştır. STR başarısızlığının öngördürücüleri,
çok değişkenli regresyon analizi ile belirlendi.

Bulgular: Çalışmada
STR saptanmayan hastalarda CHA2DS2-VASc ve CHA2DS2-VASc-HS skorları anlamlı
olarak yüksekti. Çoklu regresyon analizi, CHA2DS2-VASc-HS skoru, Anterior
STEMI, pik CK-MB seviyesi ve perkütan koroner girişim zamanının STEMI ile
başvuran hastalarda STR yetersizliği gelişimi ile ilişkili olduğunu gösterdi.
ROC eğrisi analizi, CHA2DS2-VASc ve CHA2DS2-VASc –HS skorlarının STR
başarısızlığı için öngördürücü olduğunu göstermiştir.

Sonuç:
CHA2DS2-VASc ve CHA2DS2-VASc -HS skorları, STEMI sunan hastalarda STR
yetmezliğini öngörmektedir. 

Keywords

CHA2DS2-VASc skoru, ST segment rezolusyonu, miyokart enfarktüsü

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