Akut Koroner Sendromu Olan Bireylerde CHA2DS2-VASc ve ATRIA Skorlarının Değerlendirilmesi

Amaç: CHA2DS2-VASc ve ATRIA skorları atriyal fibrilasyona bağlı tromboembolik komplikasyonların risk sınıflandırmasında kullanılan geçerli, pratik bir yöntemdir. Bu çalışmada CHA2DS2-VASC ve ATRIA skorlarının koroner arter hastalığına sahip yüksek riskli hastaları ön görmedeki kullanımının değerlendirilmesi amaçlanmıştır. Hastalar ve yöntem: Çalışmaya 2015 Mayıs ayı ile 2016 Ocak ayları arasında bir üniversite tıp fakültesi kardiyoloji ST elevasyonlu miyokart enfarktüsü tanısı ile takip edilen 432 hasta dahil edilmiştir. Tüm hastaların bazal demografik özellikleri değerlendirilmiş ATRIA, CHA2DS2-VASC ve SYNTAX skorları hesaplanmıştır. Hastalar düşük ve orta-yüksek SYNTAX skoruna göre iki gruba ayrılmıştır. Bulgular: Hastaların %20’si orta-yüksek SYNTAX skoruna sahipti ve %25,9’u kadındı. Hastaların yaş ortalaması ise 63,9±13,7 (28-91)’di. Orta-yüksek SYNTAX skoruna sahip olan hastaların ortalama CHA2DS2-VASC(2,0±1,4 ve 2,4±1,5; p=0,014) ve ATRIA skorları (3,2±2,8 ve 4,2±2,8; p=0,009) düşük SYNTAX grubuna sahip hastalara göre anlamlı olarak yüksekti. Yapılan korelasyon analizinde ise SYNTAX skoru ile CHA2DS2-VASC ve ATRIA skorları arasında pozitif korelasyon mevcuttu. Ayrıca yapılan tekli regresyon analizinde CHA2DS2-VASC ve ATRIA skorları orta-yüksek SYNTAX skoruna sahip hastaları öngörmekteydi. Sonuç: ATRIA ve CHA2DS2-VASc skorları koroner arter yaygınlığında kullanılabilen yatak başında hızlıca değerlendirilen skorlama sistemleridir. STEMI hastalarında yüksek riskli hastaların değerlendirilmesinde kullanımı önerilebilir.

Anahtar Kelimeler:

SYNTAX skoru, CHA2DS2-VASc skoru, ATRIA skoru, koroner arter hastalığı

Evaluation of CHA2DS2-VASc and ATRIA scores in patients with ST-elevation myocardial infarction

Objective: CHA2DS2-VASc and ATRIA scores are a valid, practical method for the risk classification of thromboembolic complications due to atrial fibrillation. The aim of this study was to evaluate the use of CHA2DS2-VASC and ATRIA scores in predicting high-risk patients with coronary artery disease.Patients and methods: Between May 2015 and Jan 2016, 432 patients who were followed up with a diagnosis of myocardial infarction with ST elevation were included in the study. Baseline demographic characteristics, ATRIA, CHA2DS2-VASC and SYNTAX scores were calculated. The patients were divided into two groups according to the low and medium-high SYNTAX score.Results: 20% of the patients had moderate to high SYNTAX score and 25.9% were female. The mean age of the patients was 63.9 ± 13.7 (28-91) years. CHA2DS2-VASC score and ATRIA score were significantly higher in patients with moderate-to-high SYNTAX score than in patients with low SYNTAX score (2.0 ± 1.4 versus 2.4 ± 1.5; p = 0.014 and 3.2 ± 2.8 versus 4.2 ± 2; p = 0.009, respectively). In the correlation analysis, there was a positive correlation between the SYNTAX score and the CHA2DS2-VASC and ATRIA scores. In addition, in the single regression analysis, the CHA2DS2-VASC and ATRIA scores predicted patients with moderate to high SYNTAX scores. Conclusion: ATRIA and CHA2DS2-VASc scores are the scoring systems that can be used in coronary artery prevalence. The use of STEMI patients in the evaluation of high-risk patients may be recommended.

Keywords:

SNTAX score, CHA2DS2-VASc score, ATRIA score, coronary artery disease,

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