Ozan KANDEMİR MD, Ozan KANDEMİR, Hakki KAYA

MİYOKARD PERFÜZYON SİNTİGRAFİSİNDE İSKEMİ SAPTANAN HASTALARDA KORONER ANJİOGRAFİDE MÜDAHALE GEREKTİREN LEZYON SAPTANMASININ ÖNGÖRDÜRÜCÜLERİ

Amaç: Bu çalışmada Miyokard perfüzyon sintigrafisinde (MPS) iskemi saptanması sonucu Koroner anjiografi (KAG) yapılan hastalarda; KAG sonucuna göre invaziv müdahale gerektiren lezyon saptanan hastalarla invaziv müdahale gerektiren lezyon saptanmayan hastaların özelliklerinin karşılaştırılması ve MPS de anlamlı iskemisi olan hastalarda; KAG sonucuna gore müdahale gerektiren lezyon saptanmasını öngördüren (predikte eden) faktörlerin belirlenmesi amaçlandı. Gereç ve Yöntemler: Çalışmaya Ocak 2013-Ocak 2015 tarihleri arasında MPS çekilen ve MPS de iskemi saptanıp KAG yapılan 616 hasta dahil edildi. Hastalar KAG sonuçlarına invaziv müdahale gerektiren koroner arter lezyonu saptananlar (Grup I) ve saptanmayanlar (Grup II) olarak iki gruba ayrıldı. Bulgular: Hastaların ortalama yaşı 66±10 olup %33 ü kadın , % 67 si erkekti. Tüm parametreler; KAG'da müdahale gerektiren lezyon saptanması ile ilişkili olan parametrelerin belirlenmesi amaçlı tek değişkenli regresyon analizine dahil edildi. Tek değişkenli analizde; erkek cinsiyet, yaş, EF, orta-ciddi mitral regurjitasyon bulunması, Hemoglobin, keratin değerleri ve platelet sayısı KAG da müdahale gerektiren lezyon saptanması ile ilişkili bulunurken çok değişkenli analizde ise sadece erkek cinsiyet, yaş, EF ve hemoglobin ilişkili kaldı. Sonuç: Çalışmamızda MPS de iskemisi olan hastalarda ; erkek cinsiyet, daha genç yaş, daha yüksek EF ve hemoglobinin diğer faktörlerden bağımsız olarak KAG da müdahale gerektiren lezyon saptanması ile ilişkili olduğu gösterildi.

Predictors for Detecting Lesions Requiring Intervention with Coronary Angiography in Patients with Ischemia Detected by Myocardial Perfusion Scintigraphy

Aim: This study aimed to compare the characteristics of patients with lesions requiring invasive intervention and patients with lesions that did not require invasive intervention according to the results of coronary angiography (CAG), which was conducted on these patients due to detected ischemia in the myocardial perfusion scintigraphy (MPS),and todetermine the predictive factors to detect lesions that require intervention according to the CAG results in patients who had significant ischemia in MPS. Materials and methods: This study included 616 patients who received CAG after detecting ischemia in MPS between January 2013 and January 2015. The patients were divided into two groups according to CAG results as patients with coronary artery lesions that require invasive intervention (Group I) and patients with coronary artery lesions that did not require invasive intervention (Group II). Results: The average age of patients was 66±10 and 33% of patients were female and 67% were male. All parameters were included into univariate regression analysis in order to determine the parameters related to detecting lesions requiring intervention in CAG. In the univariate analysis, male gender, age, EF, moderateto-severe MR, hemoglobin, creatinine levels, and platelet counts were related to detecting lesions requiring intervention in CAG. On the other hand, in the multivariate analysis, only male gender, age, EF,and hemoglobin level were found to be related. Conclusion: This study showed that male gender, younger age, higher EF, and hemoglobin values are related with detecting lesions requiring intervention in CAG independent from other factors in patients with ischemia in MPS.

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