ACİL SERVİSE BAŞVURAN HASTALARDA AKUT KORONER SENDROMUN DİURNAL VARYASYONUN KORONER ANJİYOGRAFİYE GÖRE DEĞERLENDİRİLMESİ Evaluation of Acute Coronary Syndrome with Coronary Angiography Due To Diurnal Variation in the Patients who Admitted to The Emergency Department

Year 2019, Volume: 9 Issue: 3, 146 - 150, 16.09.2019

İbrahim Çaltekin , Şiho Hidayet Levent Albayrak Emre Gökçen Atakan Savrun Mikail Kuşdoğan Yaşar Turan

Abstract

ÖZET

Amaç: Bu çalışmanın amacı, akut miyokard enfarktüslü hastaların diurnal varyasyon gösterip göstermediğini

ve etkilenen koroner arter ile bu diurnal varyasyon arasındaki ilişkiyi araştırmaktır.

Material ve Metodlar: Ocak-Aralık 2017 tarihleri arasında akut koroner sendrom semptomları ile Yozgat

Bozok Üniversitesi Acil Servisine başvuran hastalar retrospektif olarak incelendi. 24 saatlik zaman dilimi içinde

diurnal değişimler 6 grupta (00:01-04:00, 04:01-08:00, 08:01-12:00, 12:01-16:00, 16:01-20:00, 20:01-

00:00), mevsimsel değişimler 4 grupta (İlkbahar, Yaz, Sonbahar, Kış), haftalık değişimler ise 2 grupta (Hafta

içi, Hafta sonu) analiz edilmiştir.

Bulgular: Koroner arterlerin gün içindeki diurnal etkilenimleri incelendiğinde istatistiksel olarak anlamlı bir

sonuç bulunamadı. Diurnal etkilenimin hafta içi ile hafta sonu değişimleri incelendiğinde ise hafta içi olgularında

her üç koroner arter lezyonlarının hafta sonu görülen lezyonlara oranla istatistiksel olarak artmış

olduğu saptandı (p<0,05).

Sonuç: Çalışmamızın sonucu olarak günlük değişkenlik tespit edilmediyse de, koroner arter hastalığının artmasının,

hafta içi günlerde stres ve yoğun iş temposu gibi sosyal nedenlerden etkilendiği açıkça belirlenmiştir.

Anahtar kelimeler: Diurnal ritim; Myocard infartüsü; Acil servis

ABSTRACT

Backround: The aim of this study is to investigate whether patients with acute myocardial infarction exhibited

diurnal variation and the relationship between the affected coronary artery and this diurnal variation.

Material and Methods: The patients admitted to the emergency department of Yozgat Bozok University

with symptoms of acute coranary syndrome between January and December 2017 were retrospectively

analyzed. In 24 hour period diurnal changes were analyzed in 6 groups (00:01-04:00, 04:01-08:00, 08:01-

12:00, 12:01-16:00, 16:01-20:00, 20:01-00:00), seasonal changes were analyzed in 4 groups (Spring,

Summer, Autumn, Winter), and weekly changes were analyzed in 2 groups (Weekday, Weekend).

Results: When diurnal effects coronary arteries were examined, no statistically significant results were

found. When the changes of diurnal effect were observed at weekdays and weekends, it was found that

all three coronary artery lesions were statistically increased at weekdays compared to the lesions seen at

weekends (p<0,05).

Conclusion: Although daily diurnal variability was not detected as a result of our study, it was clearly

determined that the increase in coronary artery disease was affected by social reasons such as stress and

intensive work pace during the weekdays.

Keywords: Diurnal rhytm; Myocardial infarction; Emergency department

Keywords

ACİL SERVİSE BAŞVURAN HASTALARDA AKUT KORONER SENDROMUN DİURNAL VARYASYONUN KORONER ANJİYOGRAFİYE GÖRE DEĞERLENDİRİLMESİ Evaluation of Acute Coronary Syndrome with Coronary Angiography Due To Diurnal Variation in the Patients who Admitted to The Emergency Department

References

• 1. Dominguez-Rodriguez A, Abreu-Gonzalez P, Kaski JC. Inflammatory systemic biomarkers in setting acute coronary syndromes--effects of the diurnal variation. Current drug targets. 2009;10(10):1001-8. 2. Bae MH, Ryu HM, Lee JH, Lee JH, Kwon YS, Lee SH, et al. The impact of circadian variation on 12-month mortality in patients with acute myocardial infarction. Korean circulation journal. 2010;40(12):616-24. 3. Suarez-Barrientos A, Lopez-Romero P, Vivas D, Castro-Ferreira F, Nunez-Gil I, Franco E, et al. Circadian variations of infarct size in acute myocardial infarction. Heart (British Cardiac Society). 2011;97(12):970-6. 4. Sayer JW, Wilkinson P, Ranjadayalan K, Ray S, Marchant B, Timmis AD. Attenuation or absence of circadian and seasonal rhythms of acute myocardial infarction. Heart (British Cardiac Society). 1997;77(4):325-9. 5. Reiter R, Swingen C, Moore L, Henry TD, Traverse JH. Circadian dependence of infarct size and left ventricular function after ST elevation myocardial infarction. Circulation research. 2012;110(1):105-10. 6. Durgan DJ, Young ME. The cardiomyocyte circadian clock: emerging roles in health and disease. Circulation research. 2010;106(4):647-58. 7. Leiza JR, de Llano JM, Messa JB, Lopez CA, Fernandez JA. New insights into the circadian rhythm of acute myocardial infarction in subgroups. Chronobiology international. 2007;24(1):129-41. 8. Jones-Crawford JL, Parish DC, Smith BE, Dane FC. Resuscitation in the hospital: circadian variation of cardiopulmonary arrest. The American journal of medicine. 2007;120(2):158-64. 9. Gami AS, Howard DE, Olson EJ, Somers VK. Day-night pattern of sudden death in obstructive sleep apnea. The New England journal of medicine. 2005;352(12):1206-14. 10. Seneviratna A, Lim GH, Devi A, Carvalho LP, Chua T, Koh TH, et al. Circadian Dependence of Infarct Size and Acute Heart Failure in ST Elevation Myocardial Infarction. PloS one. 2015;10(6):e0128526.