Akut Koroner Sendromlu Hastalarda Kronik Total Oklüzyon Sıklığı ve Risk Faktörleriyle İlişkisi

Abstract

Amaç: Bu çalışma kliniğimizde akut koroner sendrom sebebiyle yatarak tedavi edilen hastalarda kronik total oklüzyon sıklığı ve bunun kardiyovasküler risk faktörleriyle ilişkisini belirlemek amacıyla yapılmıştır.

Gereç ve yöntem: Çalışmaya Nisan 2015 – Eylül 2018 tarihleri arasında akut koroner sendrom sebebiyle koroner anjiyografik değerlendirmeye alınan hastalar dahil edildi. Koroner anjiyografik incelemelerde lezyon bölgesinde TIMI 0 akım olan hastalar kronik total oklüzyon olarak kabul edildi. Risk faktörleri anamnez ve laboratuvar bulgularına göre tespit edildi.

Bulgular: Çalışmaya kriterlere uyan 904 hasta dahil edildi. İki yüz on dört hastada (%23) kronik total oklüzyon tespit edildi. Kronik total oklüzyon olan hastalarda ortalama yaş (67 ± 11, 60 ± 13, p < 0.001), hipertansiyon varlığı (%54.7, %43.0, p = 0.004) ve diyabetes mellitus  (%41.1, %31.6, p = 0.013) istatistiksel olarak daha yüksek saptandı, erkek cinsiyet (%64, %73, p = 0.008), prematüre koroner arter hastalığı öyküsü (%10.3, %19.9, p = 0.001) ve sigara kullanımı (%28.0, %48.8, p < 0.001) ise daha düşük saptandı.

Sonuç: Bu çalışmada akut koroner sendrom hastalarında kronik total oklüzyonu olan ve olmayan hasta grupları arasında risk faktörleri açısından anlamlı farklar olduğu tespit edildi. Bildiğimiz kadarıyla, bu çalışma literatürdeki kronik total oklüzyon ve kardiyovasküler risk faktörleri arasındaki ilişkiyi gösteren ilk çalışmadır

Keywords

• Akut koroner sendrom,kronik total oklüzyon,kardiyovasküler risk faktörleri

Frequency of Chronic Total Occlusion in Patients with Acute Coronary Syndrome and its Relationship with Risk Factors

Abstract

Objective: In the present study, we aimed to determine the frequency of chronic total occlusion  and its relationship with cardiovascular risk factors in inpatients with acute coronary syndrome treated in our clinic.

Materials and methods: Patients who underwent coronary angiographic evaluation for acute coronary syndrome between April 2015 and September 2018 were included in the study. Patients with TIMI 0 flow in the lesion region were accepted as chronic total occlusion in coronary angiographic examinations. Risk factors were determined according to the anamnesis and laboratory findings.

Results: 904 patients were included in the study. Two hundred and fourteen patients (23%) had chronic total occlusion. Mean age (67 ± 11, 60 ± 13, p <0.001), hypertension (54.7%, 43.0%, p = 0.004) and diabetes mellitus (41.1%, 31.6%, p = 0.013) were significantly higher in patients with chronic total occlusion and male gender (64%, 73%, p = 0.008), premature coronary artery disease (10.3%, 19.9%, p = 0.001) and cigarette smoking (28.0%, 48.8%, p <0.001) were lower.

Conclusion: In the present study, there were significant differences in risk factors among patients with and without chronic total occlusion   in acute coronary syndrome patients. To the best of our knowledge, this is the first study in the literature to demonstrate the relationship between chronic total occlusion and cardiovascular risk factors.

Keywords

• Acute coronary syndrome,chronic total occlusion,cardiovascular risk factors

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