Akut miyokard infarktüsünde yeni gelişen atriyal fibrilasyon ile SYNTAX skoru arasındaki ilişki

Year 2018, Volume: 9 Issue: 3, 7 - 14, 06.12.2018

Ali Bağcı , Fatih Aksoy , Tülay Oskay İsmail Barkın Işık , Yasin Türker , Yunus Emre Okudan Ahmet Altınbaş , Ercan Varol , Mustafa Karabacak

https://doi.org/10.22312/sdusbed.467690

Cited By: 1

Abstract

Amaç: Atriyal fibrilasyon (AF) akut miyokard infarktüsü (AMİ)
sonrası en sık görülen ritim bozukluğu olup kısa ve uzun dönem prognozu olumsuz
yönde etkilemektedir. Koroner arter hastalığı (KAH) AF gelişimi için bağımsız
bir risk faktörüdür. SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) skorlama
sistemi, revaskülarizasyon öncesi, kantitatif ve tekrarlanabilir temel bir ölçüm
olması nedeniyle koroner anatomik ciddiyet ve karmaşıklığı gösterebilir.
Bilgimize göre SYNTAX skoru ile AF arasındaki ilişki araştırılmamıştır. Bu
nedenle AMİ ‘li hastalarda yeni gelişen AF ile SYNTAX skoru arasındaki ilişkiyi
araştırmayı amaçladık.

Metod: AMİ tanısıyla Ocak 2015-Haziran 2016 tarihleri arasında
kliniğimize yatırılan 350 hasta retrospektif olarak çalışmaya alındı.
Hastaların 273’ü (%78) erkekti. Hastaların 23 ‘ü dışlandı. Hastaların
demografik ve klinik özellikleri kaydedildi ve hastalar düşük SYNTAX skorlu ve
orta-yüksek SYNTAX skorlu olmak üzere iki gruba ayrıldı. SYNTAX skoru ile AF
gelişimi arasındaki ilişki değerlendirildi. AF gelişen hastaların bağımsız
belirteçleri çoklu regresyon analizine ile belirlendi.

Bulgular: Çalışmaya dahil edilen 327 hastanın 255’i (%77,8) düşük
SYNTAX skorlu iken 72’si (%22,2) orta-yüksek SYNTAX skorlu idi. Hastaların
37’inde (%10,6) takipte AF gelişti. Düşük ve orta-yüksek SYNTAX skorlu grupta
AF gelişme sıklığı benzer bulundu (%9,4’a karşılık %12,5, p=0,442). Çoklu
regresyon analizi sonucunda hastanede ADEİ başlanması (Olasılık oranı=0,362,
%95 güven aralığı 0,157-0,835, p=0,017), hastaların yaşı (Olasılık oranı=1,041,
%95 güven aralığı 1,008-1,075 p=0,014) ve KYBÜ’sinde yatış süresinin (Olasılık
oranı=2,911, %95 güven aralığı 1,595-5,315, p=0,001) AF gelişim riskiyle
bağımsız ilişkili olduğu saptandı.

Sonuç: AMİ hastalarında AF gelişimi ile SYNTAX skoru arasında
ilişki saptanmadı. Bu çalışmada yaş, yatış sonrası ADEİ başlanması ve KYBÜ
yatış süresi AF gelişimi ile bağımsız ilişkili olduğu gösterildi. 

Keywords

atriyal fibrilasyon, SYNTAX skoru, miyokard infarktüsü

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