Hazar HARBALIOĞLU, Caner TÜRKOĞLU, Taner ŞEKER, Alaa QUISI, Ömer GENÇ, Gökhan ALICI, Samir ALLAHVERDİYEV, Ahmet Oytun BAYKAN, Mustafa GUR

Incidence of bifurcation coronary lesion as a culprit lesion in patients with acute myocardial infarction: impact of treatment strategy on short and long term outcomes

Purpose: Although, there are several studies comparing single and two-stent techniques in patients with bifurcation lesions, evidence in patients presenting with myocardial infarction (MI) is still insufficient. We aimed to assess the short and long term outcomes of provisional and two-stent techniques of bifurcation lesions in patients with ACS. Materials and methods: 2992 patients with MI who underwent percutaneous coronary intervention (PCI) were enrolled in the present study. Of 2992 patients, 385 patients with MI had bifurcation lesions. The Synergy between PCI with TAXUS™ and Cardiac Surgery (SYNTAX) score, pre-PCI Thrombolysis in Myocardial Infarction (TIMI) flow, post-PCI TIMI flow, duration of procedure, angiographic features, post-PCI side branch loss, 1- and 12-month mortality rates were noted. Results: 169 (43.9%) patients had ST segment elevation MI, whereas 216 (56.1%) patients had non-ST segment elevation MI. 355 (92.2%) patients underwent provisional stenting and 30 (7.8%) patients underwent two-stent technique. Side branch loss was observed in 40 patients (11.2%) in the provisional group and 1 patient (3.3%) in the two-stent group (p=0.2). Compared to provisional group, durations of angiography and revascularization in two-stent group were significantly longer (p

Akut miyokart enfarktüsü olan hastalarda sorumlu lezyonun bifurkasyon lezyon olma sıklığı: seçilen tedavi stratejisinin erken ve geç dönem sonuçlara etkisi

Amaç: Bifurkasyon lezyonu olan hastalarda provizyonel teknik ile çift stent tekniğini karşılaştıran çalışmalar mevcuttur. Ancak, miyokart enfarktüsü (ME) tanısı alan ve bifurkasyon lezyonu saptanan hastalarda revaskülarizasyon tekniği ile ilgili çalışmalar yeterli değildir. Çalışmamızda ME tanısı alan ve bifurkasyon lezyonu saptanan hastalarda provizyonel yöntem ve çift stent tekniğinin erken ve geç dönem sonuçları üzerine olan etkisini araştırmayı amaçladık. Gereç ve yöntem: Miyokart enfarktüsü tanısı alan 2992 hastadan bifurkasyon lezyonu olan 385 hasta çalışmaya dahil edildi. Hastaların Synergy between PCI with TAXUS™ and Cardiac Surgery (SYNTAX) skoru, işlem öncesi Thrombolysis in Myocardial Infarction (TIMI) skoru, işlem süresi, anjiyografik özellikleri, işlem sonrası TIMI skoru, işlem sonrası yan dal kaybı, 30 günlük ve 1 yıllık mortalite bilgileri değerlendirildi. Bulgular: 169 (%43,9) hasta ST segment yükselmeli miyokart enfarktüsü (STYME), 216 (%56,1) hasta ST segment yükselmesi olmayan miyokart enfarktüsü (NSTYME) olarak değerlendirildi. 355 (%92,2) hastaya provizyonel teknik, 30 (%7,8) hastaya çift stent tekniği uygulandı. Provizyonel stentleme uygulanan hastaların 40’ında (%11,2) yan dal kaybı gelişti. Çift stent tekniği uygulanan hastaların 1’inde (%3,3) yan dal kaybı meydana geldi (p=0,2). Çift stent tekniği uygulanan hastalarda anjiyografi süresi ve işlem süresi anlamlı olarak daha uzundu (p

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