Erkan BAYSAL, Barış YAYLAK, Bernas ALTINTAŞ

AKUT İNFERİOR MİYOKARD ENFARKTÜSLÜ HASTALARDA LEAD III >LEAD II ST-ELEVASYONUNUN SAĞ VENTRİKÜL ENFARKTÜSÜNÜ VE HASTANE İÇİ MORTALİTEYİ ÖNGÖRDÜRÜCÜ DEĞERİ

Amaç: Bu çalışmanın amacı akut inferior miyokard enfarktüsü ile başvuran primer perkütanöz koroner girişim yapılan hastalarda lead III 'deki ST- Elevasyonun lead II'deki ST-elevasyonundan fazla olmasının sağ ventrikül miyokard enfarktüsü ve hastaneiçi mortalite yi öngördürmedeki değerini araştırdık. Yöntem: Çalışmaya sağ koroner arterden kaynaklanan ve primer perkütanöz koroner girişime giden 180 akut inferior miyokard enfarktüsü hasta alındı. Sağ ventrikül miyokard enfarktüsü sağ taraflı çekilen EKG'de V4R'daki ST-elevasyonu olması ile tanımlandı. V4R'daki ST-elevasyonu olmayan hastalar sağ ventrikül miyokard enfarktüsü olmayan akut inferior miyokard enfarktüsü, V4R'da STelevasyonu olan hastalar sağ ventrikül miyokard enfarktüsü olan akut inferior miyokard enfarktüsü hastalar olarak iki gruba ayrıldı. lead III 'deki ST- elevasyonun lead II'deki ST-elevasyonundan yüksek olmasının sağ ventrikül enfarktüsü belirlemesi ve hastaneiçi mortaliteyi öngörmesine bakıldı. Bulgu: Lead III>II ST-elevasyonu sağ ventrikül miyokard enfarktüsü olan hastalarda oranı daha yüksek izlendi (pII ST-elevasyonunun sağ ventrikül miyokard enfarktüsü bağımsız öngördürücü olduğu izlendi ( odds ratio :2.8,95% CI 1.555.25; p=0.008). Ancak, hastaneiçi mortalite üzerindeki öngördürücülüğü izlenmedi.Sonuç: Sağ koroner arterden kaynaklanan akut inferior miyokard enfarktüslü primer perkütanöz koroner girişime giden hastalarda Lead III>II ST-elevasyonu sağ ventrikül miyokard enfarktüsünün bağımsız öngördürücüsüdür. Ancak hastaneiçi mortalite üzerine bir öngördücülüğü yoktur

Predictive Value of Lead III >Lead II ST Elevation for Ventricular Infarction and Hospital Mortality Rate in Patients with Acute Inferior Myocardial Infarction

Objectives: The aim of this study was to evaluate ST-elevation in lead III more than II (III>II) findings in predicting right ventricular infarction (RVI) and in-hospital mortality in patients with acute inferior myocardial infarction (AIMI) undergoing primary percutaneous coronary intervention (pPCI). Methods: A total of 180 AIMI patients undergoing pPCI and right coronary artery (RCA) as infarctrelated artery were included in the study. The presence of RVI was determined by ST-elevation in right side lead (V4R). Patients were divided into 2 groups: patients without ST-elevation in lead V4R (AIMI without RVI), and patients with ST-elevation in lead V4R (AIMI with RVI). We assessed the diagnostic accuracy of ST-elevation in lead III more than II to identify RVI and predicting inhospital mortality.Results: A large proportion of ST-elevation in lead III>II (p=0.001) were observed in patients with RVI. In a multivariate regression analysis, ST-elevation in lead III>II remained an independent predictor of RVI (odds ratio :2.8,95% CI 1.55-5.25; p=0.008). However , this predictive effect was not observed in-hospital mortality. Conclusion: ST-elevation in lead III>II was an independent predictor of RVI in patients with RCA related inferior myocardial infarction undergoing pPCI. However, ST-elevation in lead III>II was not predictor of in-hospital mortality

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