Fatih AKSOY, İsmail Barkın IŞIK, Hasan Aydın BAŞ, Ali BAĞCI, Fatih KAHRAMAN, Yunus Emre OKUDAN, Mevlüt Serdar KUYUMCU, Ahmet ALTINBAŞ

CHADS2-VASc skorunun primer percutan koroner girişim yapılan ST elevasyonlu miyokart enfarktüslü hastalarda ST segment rezolusyonunu öngörmedeki yararlılığı

Amaç: Tıkalı koroner arterde hızlı koroner kan akımın sağlanması, ST yükselmeli miyokard infarktüsü (STEMI) tedavisinin temel amacıdır. Her ne kadar koroner kan akımı sağlanmış olsa da, çoğunlukla mikrovasküler düzeyde yetersiz miyokard reperfüzyonu çok sayıda hastada saptanmıştır. Elektrokardiyografik olarak işlem sonrası ST-segment rezolusyonunu (STR) ölçmek reperfüzyon başarısını değerlendirilmek için kolay ve iyi bir göstergedir. CHA2DS2-VASc risk skoru, valvüler olmayan AF hastalarında tromboembolizm riskini tahmin etmek için kullanılır. STEMI ile başvuran hastalarda STR yetersizliğinin gelişmesini öngörmedeki yararı bilinmemektedir. STEMI sonrası STR’ nun değerlendirilmesinde CHA2DS2-VASc skorunun prediktif değerinin araştırılması amaçlanmıştır.Yöntem: CHA2DS2-VASc ve CHA2DS2-VASc -HS puanlarının prediktif değerini test etmek için klinik ve laboratuvar parametrelerini içeren modeller yapıldı. Hastalar STR>% 70 olan ve olmayan olarak iki gruba ayrılmıştır. STR başarısızlığının öngördürücüleri, çok değişkenli regresyon analizi ile belirlendi.Bulgular: Çalışmada STR saptanmayan hastalarda CHA2DS2-VASc ve CHA2DS2-VASc-HS skorları anlamlı olarak yüksekti. Çoklu regresyon analizi, CHA2DS2-VASc-HS skoru, Anterior STEMI, pik CK-MB seviyesi ve perkütan koroner girişim zamanının STEMI ile başvuran hastalarda STR yetersizliği gelişimi ile ilişkili olduğunu gösterdi. ROC eğrisi analizi, CHA2DS2-VASc ve CHA2DS2-VASc –HS skorlarının STR başarısızlığı için öngördürücü olduğunu göstermiştir. Sonuç: CHA2DS2-VASc ve CHA2DS2-VASc -HS skorları, STEMI sunan hastalarda STR yetmezliğini öngörmektedir.

Anahtar Kelimeler:

CHA2DS2-VASc skoru, ST segment rezolusyonu, miyokart enfarktüsü

Usefulness of the CHA2DS2-VASc Score to Predict “St Segment Resolution Failure” In Patients Treated With Primary Percutaneous Coronary Intervention for St-Segment Elevation Myocardial Infarction

Background: Rapid supply of coronary blood flow in the occluded coronary artery is the principle aim of early ST-elevation myocardial infarction (STEMI) therapy. Although coronary blood flow has been supplied, insufficient myocardial reperfusion mainly at the level of micro vascular circulation has been assessed a large number of patients. Electrocardiographically by measuring ST-segment resolution (STR) after procedure is an easy and good indicator for the evaluation of reperfusion failure. The CHA2DS2-VASc risk score is used to predict the risk of thromboembolism in non-valvular AF patients. Its usefulness in predicting AF in the development of STR failure in patients presenting with STEMI is unknown. We evaluated the predictive value of the CHA2DS2-VASc score in patients with STR failure following STEMI.Methods: Models including clinical and laboratory parameters were constructed to test the predictive value of CHA2DS2-VASc and CHA2DS2-VASc -HS scores. Patients were divided into two groups: those with STR> 70 % and those without STR> 70. Predictors of STR failure were determined by multivariate regression analysis.Results: Multiple regression analysis showed that CHA2DS2-VASc-HS score, Anterior STEMI, peak CK-MB level and symptom to percutaneous coronary intervention time were associated with development of STR failure in patients presenting with STEMI. ROC curve analyses showed that CHA2DS2-VASc and CHA2DS2-VASc -HS scores were signiﬁcant predictors for STR failure. Conclusion: CHA2DS2-VASc and CHA2DS2-VASc -HS scores predict STR failure in patients presenting STEMI.

Keywords:

CHA2DS2-VASc scores, ST segment resolution, myocardial infarction,

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