Determination of the Risk Factors of Vascular Pathology of Coronary Angiography Patients at Appealing, Vital Signs, Comorbid Diseases, Drugs and ECG Findings

Year 2018, Volume: 1 Issue: 2, 6 - 12, 28.12.2018

Tanju Taşyürek Sinan Karacabey , Erkman Sanrı , Kerem Ali Kabaroğlu Haldun Akoğlu , Özge Onur , Arzu Denizbaşı

Abstract

Aim: Patients who applied to our emergency department and had percutaneous coronary intervention (PCI) at the coronary angiography laboratory of the same hospital with acute coronary syndrome (ACS) diagnose, detected coronary artery pathologies and retrospectivaly vital signs, ECG and physical examination findings and medical history (chronic illnesses, drugs and habits) at the time of appication were investigated whether to find a risk ratio.

Material and Methods: Records of adult patients over 18 years of age who were admitted to the emergency service between 01.01.2015 and 31.01.2016 and who underwent PCI in the coronary angiography laboratory were retrospectively screened. A case- control study was prepared, patient who have ACS structured as case and patients who did not have an ACS diagnosis structured as control group.The obtained data were collected and analyzed in five groups as demographic features, chronic diseases and smoking, drugs being used, vital findings and pain type, ECG findings and type of ACS (STEMI, NSTEMI, unstabil angina).

Results: The study group consisted of 108 male patients (77.7%) and 31 female patients (33.3%) (total 139). Five (3.6%) of the patients were arrest and the mean age of the study population was 61.4 years.The median vital findings at the time of admission showed a tendency to mild hypertension with normal range.The rate of patients with typical and atypical angina was 47.5% and 48.9%, respectively.The most common type of ACS was found to be NSTEMI (80%).This was followed by STEMI.In angio results of patients, the vessel with the least occlusion, in other words less than 20%, was detected as LMCA.LAD were detected 79% the vessel obstructed more than 70%. In RCA and Cx, obstruction were observed in values close to this (72 and 68%, respectively).

Conclusion: While advanced age and male sex were statistically significant, other parameters were not statistically significant in terms of prediction of angiographic absence of vessel occlusion and angiographically complete obstruction risk. In our series, no different findings were found in terms of the risk assessments used.

Keywords

Emergency department, acute coronary syndrome, coronary angiography, STEMI, NSTEMI

Koroner Anjiyografi Hastalarındaki Damar Patolojlerinin Başvuru Anındaki Vital Bulgularının, Hikayesinin, Ek Hastalıklarının, Kullandığı İlaçların ve EKG Bulgularının Oluşturduğu Risk Oranlarının Tespiti

Abstract

Amaç: Acil servisimize başvuran ve akut koroner sendrom (AKS) tanısıyla aynı hastanenin koroner anjiyografi laboratuvarında perkütan koroner girişim (PKG) uygulanan hastalarda tespit edilen koroner damar patolojilerini, geriye doğru bakarak hastaların acil servise başvurdukları zaman tespit edilen vital bulguları, fizik muayene sonuçları, EKG bulguları ve özgeçmiş özellikleri (kronik hastalıklar, kullandığı ilaçlar ve alışkanlıklar) ile karşılaştırılarak, bir risk oranı tespit edilip edilemeyeceği araştırılmıştır.

Gereçler ve Yöntem: Çalışmada 01.01.2015 ile 31.01.2016 tarihleri arasında acil servise başvurup, koroner anjiyo laboratuvarında PKG uygulanan, 18 yaş üstü, erişkin hastaların kayıtlar retrospektif olarak taranmıştır. AKS tanısı alan hastalar vaka, almayanlar ise kontrol grubu olarak yapılandırılarak, bir vaka-kontrol çalışması formatı hazırlanmıştır. Elde edilen veriler demografik özellikler, kronik hastalıklar ve sigara kullanımı, kullanılmakta olan ilaçlar, vital bulgular ve ağrı tipi, EKG bulguları ile AKS tipi (ST Elevasyonlu Miyokard İnfarktüsü (STEMI), Non ST Elevasyonlu Miyokard İnfarktüsü (NSTEMI), anstabil anjina) olarak beş grupta toplanmış ve analiz edilmiştir.

Bulgular: Çalışmamızın hasta grubunu 108’i erkek (%77,7), 31’i kadın (%33,3) olmak üzere toplam 139 hasta oluşturmuştur. Hastalardan 5 (%3,6) tanesi arrest haliyle başvurmuş olup, çalışma popülasyonunun ortalama yaşı 61,4 yıldır (p<0.01). Başvuru anındaki medyan vital bulgular normal sınırlarda olmakla beraber hafif hipertansiyona eğilim gözlenmekteydi. Başvuru belirtisi tipik ve atipik anjina ile uyumlu hasta oranı birbirine denkti (%47,5 ve %48,9). AKS tipi incelendiğinde en sık NSTEMI olduğu görüldü (%80). Bunu ikinci sıklıkta STEMI izledi. Hastaların anjiyo sonuçlarında, en az tıkalı olan, bir diğer ifadeyle %20’den az darlık olan damar sol ana koroner arter olarak tespit edildi. %70’den fazla obtrüksüyon tespit edilen damar %79 ile LAD oldu. RCA ve Cx’de buna yakın değerlerde (sırasıyla %72 ve 68) tıkanıklık saptandı.

Sonuç: İleri yaş, erkek cinsiyet varlığı istatistiksel anlamlılık gösterirken diğer parametrelerin anjiyografik olarak damar tıkanıklığı olmaması ile anjiyografide tam tıkanıklık tespit edilmesi riskini öngörmede istatistiksel bir anlamlılık görülmemiştir. Bizim serimizde mevcut kullanılan risk değerlendirmeleri açısından farklı bir bulguya rastlanılmamıştır.

Keywords

acil servis, akut koroner sendrom, koroner anjiyografi, STEMI, NSTEMI

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