Akut ST elevasyonlu miyokard enfarktüslü hastalarda aritmiler

Yıl 2019, Cilt: 44 Sayı: 2, 416 - 424, 30.06.2019

İhsan Dursun , Mustafa Beğenç Taşcanov

https://doi.org/10.17826/cumj.444433

Cited By: 2

Öz

Amaç: Aritmiler ve iletim bozuklukları akut miyokard enfarktüsünde (AMİ) yaygındır ve hastane öncesi dönemde önemli bir ölüm nedenidirler. Bu çalışmanın amacı, hastane içi dönemde ST yükselmeli AMI (STEMI) hastalarında tüm aritmiler için ortak öngördürücüleri araştırmaktı.

Gereç ve Yöntem: Akut STEMI olan 90 hasta (74 erkek, 55±11 yıl) çalışmaya dahil edildi. Hastaların klinik özellikler kaydedildi ve serum C-reaktif protein (CRP), kreatinin kinaz MB (CKMB) ve potasyum düzeyleri gibi laboratuvar parametreleri ölçüldü. Hastalar aritmilerin gelişip gelişmemesine göre hastalar iki gruba ayrıldı.

Bulgular: Grup 1 (n = 42) hastalar  yeni başlangıçlı aritmi  ve Grup 2 (n = 48) olan hastalar aritmisi olmayan hastalardı. Medyan bazal CRP düzeyleri, özellikle atriyal fibrilasyon ve ventriküler aritmiler olan hastalarda grup 1'de (36.6 (21.8-77) mg/dl'ye karşı 21.8 (24.2-30.7) mg/dl, P = 0.002) anlamlı olarak yüksek bulundu. Lojistik regresyon analizi, başlangıç yüksek CRP düzey (P = 0.018), tepe CKMB düzeyi ve inferior lokalizasyonlu AMI'nin  AMI sonrası aritmi gelişimi ile anlamlı olarak ilişkili olduğunu gösterdi.

Sonuç: CRP ve CKMB düzeyleri ile inferior  lokalizasyonlu infarktüsün, AMI sırasında tüm aritmik olaylar için öngördürücü değere sahip olduğunu bulduk. CRP düzeylerinin hem atriyal hem de ventriküler aritmiler ile ilişkili olduğu bulunmuştur. CRP düzeylerinin değerlendirilmesi, STEMI'den sonra aritmik olaylar için yüksek risk taşıyan hastaları tespit etmek için kullanılabilir.

Anahtar Kelimeler

Miyokard infarktüsü, kardiyak aritmiler

Arrhythmias in patients with acute ST elevation myocardial infarction

Öz

Purpose: Arrhythmias and conduction disturbances are common during acute myocardial infarction (AMI) and a major cause of death in the pre-hospital phase. The aim of this study was to investigate common predictors for all arrhythmias in patients with ST elevation AMI (STEMI) during in-hospital phase. 

Materials and Methods: Ninety patients (74 male, 55 ±11 years) with acute STEMI were included. Clinical charesteristics were recorded and laboratory parameters including serum C- reactive protein (CRP), creatinine kinase MB (CKMB) and potassium levels were measured. The patients were divided into two groups according to development of arrhythmias.

Results: Group 1 (n=42) patients had new onset arrhythmias and Group 2 (n=48) patients had without arrhythmias. Median baseline CRP levels were significantly higher in group 1 (36.6 (21.8-77) mg/dl vs. 21.8 (24.2-30.7) mg/dl), especially in patients with atrial fibrillation and ventricular arrhythmias. Logistic regression analysis showed that baseline higher CRP level, peak CKMB level and inferior localization of AMI were significantly associated with the development of arrhythmia following AMI. 

Conclusion: Levels of CRP and CKMB and inferior infarct localization have predictive values for all the arrhythmic events during AMI. CRP levels were found to be associated with both atrial and ventricular arrhythmias. The assessment of CRP levels can be used to detect patients at high risk for arrhythmic events after STEMI.

Anahtar Kelimeler

Myocardial infarction, cardiac arrhythmias, , inflammation

Kaynakça

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