Akut koroner sendromda kontrast nefropati gelişimi ile Syntax Skoru arasındaki ilişki

Amaç: Bu çalışmada akut koroner sendrom tanılı hasta grubunda Syntax (SYNergy between PCI with TAXUS and Cardiac Surgery) (SS) skorlama sistemi ile kontrast nefropatisi (KN) gelişimi arasındaki ilişkiyi tespit etmeyi amaçladık.Gereç ve yöntem: Çalışmaya Şubat 2016 ile Eylül 2017 tarihleri arasında akut koroner sendrom (AKS) tanısı konmuş koroner yoğun bakım ünitesinde takip edilen hastalar retrospektif olarak alındı. Koroner angiografi (KAG) yapılmayan veya kabul etmeyen hastalar, daha önceden KABG (koroner arter baypas greft) olan hastalar, orta-ciddi kalp kapak hastalığı olan hastalar ve diyalize giren hastalar çalışmaya alınmadı. Bu şartları sağlayan toplam 360 hasta çalışmaya alındı. Hastalar kontrast nefropati gelişen ve gelişmeyen olmak üzere iki gruba ayrıldı. Kontrast nefropati gelişiminin bağımsız belirteçleri çoklu regresyon analizine ile belirlendi.Bulgular: Hastaların 273 (%78)'ı erkek idi. Hastaların 79 ‘unda (%22) KN geliştiği tesbit edildi. Syntax Skoru KN gelişenlerde 16,2±8,5, gelişmeyenlerde 13,5±8,2 olarak tespit edildi. Çoklu regresyon analizi sonucuna göre yaş (Olasılık Oranı=1,04; %95 Güvenlik Aralığı= 1,00-1,08), opak miktarı (Olasılık Oranı= 1,05; %95 Güvenlik Aralığı= 1,03-1,06), Syntax skoru (Olasılık Oranı= 1,86; %95 Güvenlik Aralığı=1,81- 1,91), KN gelişmesi için bağımsız belirteçler olarak bulundu.Sonuç: Akut koroner sendrom tanısıyla koroner anjiyografi ve perkutan koroner işlem yapılan hastalarda SS ile KN arasında ilişki tespit edildi. Bu çalışmada yaş, SS ve kullanılan opak miktarının KN gelişimi ile bağımsız ilişkili olduğu gösterildi.

Anahtar Kelimeler:

akut koroner sendrom, Syntax Skoru, kontrast nefropatisi

Relationship between development of contrast nephropathy and Syntax Score in acute coronary syndrome

Purpose: The aim of this study was to determine the relationship between Syntax(SYNergy between PCI with TAXUS and Cardiac Surgery) scoring (SS) system and contrast induced nephropathy (CIN) development in patients with acute coronary syndrome.Materials and Methods: A total of 360 patients who were followed-up in the coronary intensive care unit between February 2016 and September 2017; were included in the study retrospectively. Exclusion criterias were previous coronary artery bypass graft; moderate-severe heart valve disease. Patients on dialysis and who had no coronary angiographic information were also not included. Patients were divided into two groups with and without contrast nephropathy. The independent predictors of contrast nephropathy were determined by multiple regression analysis.Results: Of the patients, 273 (78%) were male. 79 patients (22%) developed CIN. The SS was found to be 16.2 ± 8.5 in patients with CIN and 13.5 ± 8.2 in those without CIN. According to the results of multiple regression analysis; age (Odds Ratio = 1.04; 95% confidence interval = 1.00 to 1.08), the amount of contrast agent (Odds Ratio = 1.05; 95% confidence interval = 1.03 to 1, 06), SS (odds ratio = 1.86; 95% confidence interval = 1.81 to 1.91) were independent predictors for the development CIN. Conclusion: Coronary angiography and percutaneous coronary intervention in patients with acute coronary syndrome were found to be correlated with CIN. In this study; age, SS and the amount of contrast agent were independently correlated with the development of CIN.

Keywords:

Acute coronary syndrome, Syntax Score, contrast induced nephropathy,

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