Koroner Bypas Cerrahisi Sonrasında Gelişen Safen Ven Greft Darlıklarına Perkütan Girişim Yapılan Hastalarda Majör Olumsuz Kardiyovasküler Olaylar ile Serum Fibrinojen Düzeyi Arasındaki İlişki

Yıl 2023, Cilt: 14 Sayı: 1, 105 - 110, 23.03.2023

İlker Duman , Ayşe Çolak , Halil Lütfi Kısacik

https://doi.org/10.18663/tjcl.1184730

Öz

Amaç: Koroner arter bypas greft (KABG) cerrahisi sonrasında gelişen safen ven greft (SVG) hastalığına perkütan girişim ile revaskülarizasyon sağlanan bireylerde uzun dönem kardiyovasküler sonuçlar ve mortaliteyi öngördürmede, aterosklerozun patogenezinde rol oynayan serum fibrinojen seviyesinin değerini aydınlatmak amaçlandı.

Gereç ve Yöntemler: Perkütan koroner girişim (PKG) yolu ile safen ven greft darlıklarına müdahale edilen hastalar retrospektif olarak tarandı. Toplamda 115 hasta çalışmaya dahil edildi. Majör olumsuz kardiyovasküler olay (MACE) varlığına göre 56 hasta (+), 59 hasta (-) olarak değerlendirildi. Her iki grubun PKG öncesi fibrinojen düzeyleri belirlenerek MACE ve fibrinojen değerleri arasındaki ilişki incelendi.

Bulgular: Ortalama takip süresi 42,5 ay olan çalışmada beyaz küre ve serum fibrinojen değerleri, MACE'nin olduğu grupta diğer gruba oranla istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,001). Fibrinojen yüksekliği ve hipertansiyonun bağımsız olarak MACE oluşumuna neden olduğu saptandı (sırasıyla p=0,001 CI: 1,880-6,142; p=0,005 CI: 0,076-0,632). Fibrinojen değerinin 2,75 gr/L’nin olması, %76,2 sensitivite ve %62,7 spesifite ile bağımsız olarak MACE oranlarının öngördürücüsü olarak bulundu (AUC 0,793 CI:0,710-0,875).

Sonuçlar: Serum fibrinojen düzeyinin, safen ven greft darlıklarına yapılacak girişimsel tedavi öncesi değerlendirildiğinde, ölüm ve istenmeyen kardiyak klinik son noktaları öngörmede faydalı olabileceği sonucuna varıldı.

Anahtar Kelimeler

Fibrinojen, Safen ven hastalığı, Ateroskleroz

Kaynakça

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