Taner SARAK, Lütfü BEKAR, Adem İlkay DİKEN

Tirofibanın ST Elevasyonsuz Miyokard İnfarktüslü Hastalarda QT Dispersiyonu ve Aritmi Üzerine Etkisi

Amaç: Çalışmanın amacı NSTEMİ li hastalarda standart tedaviye ek olarak verilen tirofibanın QT dispersiyonu vearitmi sıklığı üzerindeki etkisini ortaya koymaktır. Giriş: QT dispersiyonu ventrikül repolarizasyon heterojenitesini yansıtan noninvaziv bir göstergedir. NSTEMİndetirofibanın mortaliteyi azaltmadaki etkisinin aritmi ile ilgisi açıklığa kavuşmuş değildir. Bu etkinin trombüsün eri- mesine mi bağlı olduğu, yoksa aritmiye bağlı komplikasyonların engellenerek mi oluştuğunu açıklayabilmek üzereiki ayrı grup karşılaştırılmıştır. Yöntem ve Gereçler: Altmış altı NSTEMİ tanılı hasta, tirofiban ve standart tedavi verilen 32 hasta Grup 1, sadecestandart tedaviyi alan 34 hasta Grup 2 olmak üzere ikiye ayrılmıştır. Tüm hastalardan hastaneye kabul edildikleri1.gün ve 7. günde 50 mm/sn hız ve 20 mm/mV amplitüdünde EKG kaydı alındı. Yoğun bakım takibi süresince tele- metri ile aritmi takibi uygulandı. Sonuçlar: Her iki grupta da major yada minor kanamaya rastlanmadı. Grup 1 ile grup 2 arasında 1. gün (tedaviöncesi) QT, QTc, QTd ve QTcd değerleri arasında anlamlı fark saptanmadı. 1. ve 7. gündeki QT, QTc, QTd değerle- rindeki değişim miktarlarında anlamlı fark saptanmazken ortalama QTcd değerindeki azalma Grup 1de istatistikselolarak anlamlı idi (p=0,001) Grup 1 ve grup 2deki parametreler birbirileriyle karşılaştırıldığında QT, QTc değerleriarasında anlamlı fark saptanmazken, QTd ve QTcd değerleri Grup 1de anlamlı olarak daha düşük bulundu (sırasıy- la p

The Effect of Tirofiban on QT Dispersion and Arrhythmia in Patients With Non-ST Elevation Myocardial Infarction

Background: The aim of the study is to reveal the efficacy of additional tirofiban therapy over QT dispersion andarrhythmia frequency on patients with NSTEMI.Introduction: QT dispersion is a noninvasive predictor of ventricular repolarisation heterogeneity. The effect oftirofiban on mortality rate of patients with NSTEMI could not be clarified. It is unknown whether this effect is bythe clearance of the thrombus or reduction of the arrhythmia related complications. Material And Methods: 66 patients with NSTEMI were divided into two groups 32 patients were labeled as Group1 who received tirofiban while other 34 patients (Group 2) received standard therapy only. ECG records (50mm/sn rate, 20mm/mV amplitude) were obtained during the first day of submission and at the 7th day. Arrhythmia analysiswere performed during intensive care unit follow up via telemetric monitoring system. Results: Any major or minor bleeding no observed . Pre-treatment QT, QTc, QTd ve QTcd values were similar be- tween two groups. The difference on QT, QTc, QTd was insignificant between first and 7th day in both groups whiledifference on QTcd value was significant in Group 1 (p=0,001). When inter-group values were compared; QT andQTc difference were not significant, however; QTd and QTcd difference were significant only in Group 1 (p

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