Şebnem ALBEYOĞLU, Ufuk ÇİLOĞLU, Bahar TEMUR, Cemal KOCAASLAN, Mustafa ALDAĞ, Tolga CAN, Ergin Emin EREN

Akut Koroner Sendrom Tipine Göre Acil İzole Koroner Baypas Cerrahisinin Sonuçları

Giriş: Bu çalışmada, akut koroner sendrom (AKS) tiplerine göre izole acil koroner baypas (KABG) sonuçlarının tek merkezde beş yıllık tecrübeyle değerlendirilmesi amaçlanmıştır. Hastalar ve Yöntem: Eylül 2009 ile Temmuz 2014 tarihleri arasında KABG yapılan toplam 138 hasta bu çalışmaya retrospektif yöntemle dahil edilmiştir. Kohort AKS tipine göre dört gruba ayrılmıştır; 1: Unstabil anjina (n= 14, %10.1); 2: non-ST segment yükselmeli miyokart infarktüsü (NSTEMİ) (n= 43, %31.2); 3: ST segment yükselmeli miyokart infarktüsü (STEMİ) (n= 65, %47.1); 4: Kardiyojenik şok (n= 16, %11.6). Çalışmanın üç esas amacı vardır; hastane içi ve 30 günlük erken mortalite sonuçlarının tespiti, alt gruplara göre mortalite oran analizi, acil izole KABG uygulanan AKS hastalarında EuroScore II’nin performansının değerlendirilmesi. Bulgular: Gruplar arasında demografik ve preoperatif risk faktörleri açısından anlamlı fark bulunmadı. Gözlenen 30 günlük toplam mortalite oranı %15.9 (n= 22) idi. Alt gruplarda mortalite oranları sırasıyla; stabil olmayan anjina (USAP)’da %7 (n= 1), NSTEMİ’de %4.65 (n= 2), STEMİ’de %15.38 (n= 10) ve şok alt grubunda %68.75 (n= 11) idi. Gruplar arasında mortalitede anlamlı fark vardı (p< 0.05). EuroScore II’nin ROC değeri 0.890 (%95 GA, 0.826-0.937) olarak tespit edilmiştir. Sonuç: Bu çalışma, acil izole KABG gerektiren STEMİ ve Şok hastalarında gözlenen ölüm oranının yüksek olduğunu göstermektedir. Ayrıca, Euroscore II NSTEMI hastalarında iyi bir risk öngörüsüne sahipken, diğer gruplarda mortaliteyi önemli ölçüde küçümsemektedir.

Results of Isolated Emergency Coronary Bypass Surgery According to Acute Coronary Syndrome

Introduction: The aim of the present study was to evaluate the results of isolated emergency coronary arterybypass grafting (CABG) according to acute coronary syndrome (ACS) types in a single center with 5-yearexperience.Patients and Methods: A total of 138 patients who underwent emergency isolated CABG surgery fromSeptember 2009 to July 2014 in our hospital were enrolled in this retrospective descriptive study. The cohortwas divided into four groups according to the type of ACS: (1) unstable angina (USAP) (n= 14, 10.1%), (2) nonST segment elevated myocardial infarction (NSTEMI) (n= 43, 31.2%), (3) ST segment elevated myocardialinfarction (STEMI) (n= 65, 47.1%), and (4) cardiogenic shock (SHOCK) (n= 16, 11.6%). There were three coprimary outcomes in the study: (1) in-hospital and 30-day mortality rate results, (2) mortality analysis accordingto subgroups, and (3) to assess the performance of European System for Cardiac Operative Risk Evaluation(EuroScore) II in patients with ACS who underwent emergency isolated CABG.Results: No significant differences were observed between the groups with regard to demographic andpreoperative risk factors. The observed 30-day total mortality rate was 15.9% (n= 22). Mortality rates in thesubgroups were 7% (n= 1) in USAP, 4.65% (n= 2) in NSTEMI, 15.38% (n= 10) in STEMI, and 68.75% (n=11) in SHOCK, respectively. There was a significant difference in mortality between the groups (p< 0.05). Thereceiver operating characteristic curve value of EuroScore II was 0.890 (95% Confidence Interval, 0.826-0.937).Conclusion: The current study demonstrates that the observed mortality rate for STEMI and SHOCK patientsrequiring emergency CABG remains high. Moreover, EuroScore II has a good risk prediction in NSTEMIpatients while significantly underestimates the mortality in the other groups.

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi