Mustafa Aytek ŞİMŞEK, Nezihi BARIŞ, Özgür ASLAN, Sema GÜNERİ

İLAÇ SALINIMLI STENT İMPLANTE EDİLEN HASTALARDA STENT TİPİ İLE TAKİPTE GELİŞEN KARDİYAK ADVERS OLAYLARIN ARASINDAKİ İLİŞKİNİN İNCELENMESİ

Giriş: İlaç salınımlı stentler (İSS) güncel girişimsel kardiyoloji pratiğinde yoğun bir şekilde kullanılmaktadır. Bu stentlerin yeni kullanılmaya başlandığı döneme ait takip verileri önem arz etmektedir Gereç ve Yöntem: Kasım 2007 ve Aralık 2010 arasında Dokuz Eylül Üniversitesi Hastanesi Kardiyoloji bölümünde ilaç salınımlı stentimplante edilen 221 ardışık hasta çalışmaya dahil edildi. Demografik ve klinik veriler hastane kayıtlarından, takip verileri ise hastane kayıtları ve hastlarala yapılan telefon görüşmelerinden elde edildi. Takip süresince gelişen majör advers kardiyovasküler olay (MAKO) (kardiyovasküler ölüm, ölümcül olmayan miyokard infarktüsü, ölümcül olmayan inme ve kardiyovasküler nedenli hastaneye yatış) ve herhangi bir koroner revaskülarizasyon kaydedildi. Primer son nokta stent tipleri ile MAKO arasındaki ilişkinin saptanması olarak belirlendi. Bulgular: Ortalama yaş 62,3± 10,3 idi. Katılımcıların 165 tanesi (%74,7) erkekti. Oratalama takip süresi 24,6±11,0 idi. 153 (%69.2) hastada akut koroner sendrom tanısı ile işlem uygulandı. 113 (%51,1) hastaya zotarolimus salınımlı stent implante edildi. Takipte 53 (%23,9) hastada MAKO, 23 (%10,4) hastada ise herhangi bir koroner revaskülarizasyon saptandı. Stent tipleri ile MAKO veya herhangi bir koroner revaskülarizasyon arasında anlamlı ilişki saptanmadı. Cox regresyon analizi ile diyabet varlığı ve toplam stent uzunluğu MAKO gelişimi için bağımsız prediktörler olarak saptandı. (sırasıyla HR:2.9, 95% CI 1.63-5.19; HR: 1.19, 95% CI 1.038-1.363) Sonuç: İSS tipleri ile MAKO veya herhangi bir damar revaskülarizasyon arasında anlamlı ilişki saptanmamıştır.

RELATIONSHIP BETWEEN STENT TYPE AND FOLLOW UP CARDIOVASCULAR ADVERSE EVENTS IN DRUG ELUTING STENT IMPLANTED PATIENTS

Introduction: Drugeluting stents are widely used in contemporary interventional cardiology practice. Their use was relatively new 10 years ago and the followup data of those patients are important torevealearly experience with these stents Material and Method: 221 patients treated with drug eluting stents in Dokuz Eylul University Hospital Cardiology Department BetweenNovember 1st 2007 and December 31st 2010 were included. Data were acquired via hospital records and telephone interview. Demographic and clinical data, procedural features were recorded. Followup data included cardiovascular complications defined as major adverse cardiovascular events (MACE) and revascularization of any coronary artery .major cardiovascular events were the combination of cardiovascular death, nonfatal myocardial infarction, non fatal stroke and hospitalization due to cardiovascular causes. Primary end point was to determine the relation ship between stent types and MACE. Results: Meanagewas 62,3± 10,3, 165 patients (74.7%) weremale. Mean follow up was 24.6±11.0 months. Indication for treatment was acute coronary syndrome in 153 cases (69.2%),. MACE developed in 53 patients (23.9%) and 23 (10.4%) patients had revascularization for any coronary artery during followup. No significant relationship was found between stent types and MACE or any coronary revascularization Cox regression analysis revealed diabetes (HR:2.9, 95% CI 1.63-5.19) and total lesionlength in mm (HR: 1.19, 95% CI 1.038-1.363) as independent predictors of MACE. Conclusion: No significant relationship between DES typesand MACE or any coronary revacularization during 24 month followup.

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