Akut Koroner Sendrom Hastalarında Klinik Özelliklerin ve Transport Zamanının Akut Koroner Sendrom Sınıflamasına Göre Karşılaştırılması

Amaç: Akut koroner sendrom hastalarında akut koroner sendrom sınıflarına göre klinik özelliklerinaraştırılması amaçlanmıştır.Metot ve Materyal: Çalışma kesitsel tip bir çalışma olup bir universite hastanesi koroner yoğunbakım ünitesinde akut koroner sendrom (AKS) nedeni ile yatırılan hastalarda yapılandırılmış çalışmaanketi uygulanarak yapılmıştır. Ankette hastaların klinik ve sosyodemografik özellikleri ile transportzamanaları sorgulanmıştır.Bulgular: 34-88 yaş arası ve yaş ortalaması 60,74±12,43 olan 152 olgu alınmıştır. Olguların 39’ukadın geriye kalan 112’si erkek hastalardan oluşmaktadır. Hastaların çoğunluğu (n=114,%74,5) STsegment Elevasyonlu miyokart Enfarktüsü (STEMI) olgularından oluşurken, %24,5’i ST-segmentElevasyonsuz Miyokart Enfarktüsü (NSTEMI) hastalarından (n=37,%24,5) oluşmuştur. Çalışmadakiolguların çoğunluğunun eğitim düzeyi ilkokul veya altındaydı. Sigara içenlerin sayısı da (n=84,%55,6) yüksek oranda saptandı. Olguların %84,8’inde (n=128) tipik anginal semptomlargözlemlenmiştir. Hastaların akut koroner sendrom başlangıcı esnasında %36,4’ünün (n=55 ) istirahathalinde olduğu saptanmıştır. Hastalarımızın %60,9 u (n=92) pre-enfarkt angina tariflemiştir.Çalışmadaki hastaların şikayetleri genellikle akşam ve sabah saatlerinde (n= 46, %30,5; n=45, %29,8sırayla) ortaya çıkmıştır. STEMI olguları NSTEMI olgularına göre yaş ortalaması daha düşük (59,2±12,0; 65,5±13,3); kadın/erkek oranı ise NSTEMI grubunda daha yüksek bulunmuştur (13/24 vs88/26). NSTEMI grubunda bulunan hastalar anlamlı olarak daha çok atipik göğüs ağrısı ile başvurdu(p=0.03) ve yine NSTEMI grubunda, öncesinde Mİ hikayesi olan hasta sayısının da daha fazla olduğusaptanmıştır (p=0.019). Eşlik eden diyabet, hipertansiyon ve koroner arter hastalığı NSTEMIhastalarında STEMI’ e göre sayıca daha fazla bulunmuştur (p=0.02).Sonuç: Çalışmamızda STEMI ve NSTEMI vakaları klinik özellikler açısından aralarında bazıfarklılıkların olduğu gösterilmiştir

Anahtar Kelimeler:

Akut Koroner Sendrom, ST-segment Elevasyonlu miyokart enfarktüsü, STsegment Elevasyonlu olmayan miyokart enfarktüsü

Comparison of Clinical Fatures and Transport Times in Patients with Acute Coronary Syndrome according to Classification of Acute Coronary Syndrome

Aim: Aimed to investigate clinical features in patients with acute coronary syndrome according toacute coronary syndrome classes.Materials and Methods: This cross-sectional study was conducted in coronary unit of a universityhospital, applying structured study survey to patients who were hospitalized for acute coronarysyndrome (ACS). With study survey, clinical and socio-demographic features along withtransportation data of patients were interrogated.Findings: The study included 152 subjects with average age of 60.74±12.43 years between 34-88 yrs(Male=112, female=39). Whereas majority of patients were ST-segment elevation myocardialinfarction (n=114, 74.5%), remaining 37 had non-ST-segment elevation myocardial infarction(24.5%). Education level of majority in the study were primary school or under. Rate of smoking wasdetected as high (n=84, 55.6%). 84.5% of subjects (n=128) defined typical anginal chest pain. 36.6%of patients (n=55) expressed that they were at rest at onset of ACS. Pre-infarct angina was detectedin 92 patients (60.9%). Onset of acute coronary syndrome was usually seen in morning and eveningtime (n=45, 29.8%; n= 46, 30.5 % respectively).Mean of age in patients with STEMI was lower than in NSTEMI (59.2 ±12.0; 65.5±13.3), and femaleto-male ratio in patients with NSTEMI was greater than in STEMI (13/24 versus 88/26). Atypicalchest pain was significantly higher in patients with NSTEMI (p=0.03). Previous MI in patients withNSTEMI was more in number, compared with STEMI (p=0.019). Co-morbid diseases such asdiabetes, hypertension, coronary artery disease were seen more in NSTEMI than in STEMI (p=0.02).Conclusion: some differences in respect of clinical features in STEMI and NSTEMI were shown inour study.Kew words: Acute coronary syndrome, ST-segment elevation myocardial infarction, non-ST-segmentelevation myocardial infarction

Keywords:

Acute coronary syndrome, ST-segment elevation myocardial infarction, non-ST-segmentelevation myocardial infarction,

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