Treatment of concurrent cardio-cerebral infarction: meta-analysis

Abstract

Amaç: Akut iskemik inme ve akut miyokard enfarktüsünün eş zamanlı ortaya çıkması son derece nadir görülen ve ölümcül olabilen bir durumdur. Bu vakalarda nedenler ve optimal tedavi hala belirsizdir. Yöntemler: Literatür taraması yaparak klinik tabloları, nedenlerini, miyokard enfarktüsünün tipini, inme bölgesini, taburculukta değiştirilmiş sıralama ölçeğini ve tedavi seçeneklerini analiz ettik. Kombinasyon müdahale tedavisi (koroner arterler için perkütan koroner girişim ve serebral damar için mekanik trombektomi) ve tıbbi tedavi uygulanan hastalar arasında hastaneden taburcu olurken ve taburcu olduktan 90 gün sonra ölüm oranlarını karşılaştırıyoruz. Bulgular : Vaka raporlarından ve vaka serilerinden 94 eşzamanlı kardiyo-serebral enfarktüs vakasını belirledik. Ortalama yaş 62,5±12,6 yıldı. 58 hasta (%61,7) erkek. Kombinasyon müdahaleli tedavi grubundaki hastalarda: hastane mortalite oranı %13,3 ve 90 günlük mortalite oranı: tıbbi tedavideki mortalite oranıyla karşılaştırıldığında %23,5 (hastanede %23,5 ve 90 günde %59,5 (sırasıyla P değeri 0,038 ve 0,012) Sonuç: Eşzamanlı kardiyo-serebral enfarktüs prognozu çok kötü olup, müdahale edilmezse hastaların yaklaşık %25'i taburcu olmadan kaybedilmiştir. Hastaların %60'ı inmeden 90 gün sonra ölmüştür. Hastaların yalnızca dörtte birinin kombinasyon müdahale tedavisi ile tedavi edilmesine rağmen, bu tedavi yöntemi, tıbbi tedaviye kıyasla mortalite oranını önemli ölçüde azaltmaktadır.

Keywords

• AMI
• AIS
• PCI
• MTE

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