MİYOKARD ENFARKTÜSÜ NEDENLİ KORONER ANJİYOGRAFİYE YÖNLENDİRİLEN COVID-19 HASTALARINDA MORTALİTE PREDİKTÖRLERİ

Yıl 2023, Cilt: 4 Sayı: 2, 89 - 94, 28.07.2023

Cem Çöteli , Furkan Kulekci , Özge Çakmak Karaaslan , Murat Oguz Özilhan , Emre Aruğaslan , Havva Tuğba Gürsoy , Mehmet Akif Erdol , Serdal Baştuğ , Ahmet Kasapkara

https://doi.org/10.48176/esmj.2023.112

Öz

Amaç
Miyokard enfarktüsü tablosu ile başvuran COVID-19 hastalarında mortalite ve mortalite verileri hastaların uzun süreli takiplerinin olmaması nedeniyle kısıtlıdır. Bu çalışmada bu hasta grubunun mortalite prediktörlerinin araştırılması amaçlanmıştır.
Araçlar ve Yöntem
COVID-19 enfeksiyonu mevcut olan ve yüksek riskli miyokard enfarktüsü nedeniyle invaziv koroner anjiyografi yapılan 80 hasta çalışmaya dahil edilmiştir. Tüm hastalar ilk başvurudan sonra en az 1 yıl süre ile takip edilmiştir. Hastaların mortalite verileri ve medikal kayıtları hastanenin medikal kayıt programından retrospektif olarak alınmıştır.
Sonuç
Otuz dört hastanın (%42,5) ilk başvurudan sonraki bir yıllık takipte öldüğü izlendi. Bu hastaların 30’u (%88,2) ilk başvurudaki hastane yatışı sonlanmadan öldü. Medyan kapı balon süresi 107,5 dk (17-1278) olarak izlendi. 49 hastaya (%61,25) invaziv koroner anjiyografi sırasında perkütan koroner girişim uygulandı. Yüksek ferritin ve LDH seviyelerinin mortalite ile bağımsız olarak ilişkili olduğu izlendi (OR: 1,006, CI %95: 1,001-1,01, p: 0,011; OR:1,005, CI %95: 1,001-1,009, p:0,025; sırasıyla). Ferritin için kestirim değeri 211 mcg/L (AUC:0.762, sensitivite: 73.5%, spesifite 63%, p:<0.001) ve LDH için kestirim değeri 492 U/L (AUC:0.863, sensitivite: 79.4%, spesifite 80.4%, p:<0.001) olarak hesaplandı.
İnvaziv medikal tedaviye rağmen miyokard enfarktüsü gelişen COVID-19 hastalarında mortalite oranı yüksektir. Çalışmada yalnızca artmış LDH ve ferritin seviyelerinin mortalite prediktörü olduğu izlenmiştir.

Anahtar Kelimeler

Miyokard Enfarktüsü, COVID-19, Koroner Anjiyografi, Mortalite, Myocardial Infarction, Coronary Angiography, Mortality

THE PREDICTORS OF MORTALITY IN PATIENTS WHO WERE REFERRED TO CORONARY ANGIOGRAPHY DUE TO MYOCARDIAL INFARCTION AND HAD COVID-19

Öz

Background and Objective
The mortality and morbidity data are limited because the patients who presented with myocardial infarction and have COVID-19 were not followed for an extended period. This study aimed to investigate mortality predictors in this group.
Method
Eighty patients with COVID-19 infection who performed invasive coronary angiography due to high-risk myocardial infarction were enrolled. All patients were followed at least one year after the first admission. Mortality data and medical records were retrospectively collected using the hospital’s medical record software.
Results
Thirty-four patients (42.5%) died one year after the first admission. Thirty of them (88.2%) were in-hospital mortality. The median door-to-procedure time was 107.5 minutes (17-1278). PCI was performed in 49 patients (61.25%). Higher ferritin and LDH were independent factors related to mortality (OR: 1.006, CI 95%: 1.001-1.01, p: 0.011; OR:1.005, CI 95%: 1.001-1.009, p:0.025; respectively). The cut-off value was estimated at 211 mcg/L for ferritin (AUC:0.762, sensitivity: 73.5%, specificity 63%, p:<0.001), and 492 U/L for LDH (AUC:0.863, sensitivity: 79.4%, specificity 80.4%, p:<0.001).
Conclusion
Despite invasive management, the mortality rate in patients with myocardial infarction and COVID-19 is high. Only increased LDH and ferritin levels were independent predictors for mortality.

Anahtar Kelimeler

Miyokard Enfarktüsü, COVID-19, Koroner Anjiyografi, Mortalite, Myocardial Infarction, Coronary Angiography, Mortality

Kaynakça

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