The Relationship Between The Level of Serum Uric Acid and No-Reflow Phenomenon After Primary Percutaneous Coronary Intervention in Patients With St Segment Elevated Myocardial Infarction

Year 2010, Volume: 12 Issue: 3, 40 - 44, 01.12.2010

Emine Çakcak Erden Serhat Bahadır Sözen Osman Kayapınar Sabri Onur Çağlar Cengiz Başar İsmail Erden

Abstract

No-reflow phenomenon is the absence of myocardial perfusion despite adequate dilatation ofthe infarct related coronary artery during percutaneous coronary intervention. Uric acid (UA)release during ischemia and washout from the ischemic zone during reperfusion is adeninenucleotide breakdown product. Therefore uric acid may play reperfusion injury and no-reflow.İn this study, we aimed to compare serum uric acid value of ST segment elevated Mİ patientsgroups whith no-reflow phenomenon and normal miyocardial perfusion after primary coronaryintervention.47 patients was enrolled consecutively to this study. During hospital admission, patients bloodsamples were taken for serum uric acid value. Patients was grouped as no reflow and normalperfusion groups according to myocardial blush grades (MBG). Patient with myocardial blushgrades 0-1 were accepted as no-reflow group, patients with MBG 2-3 normal perfusion group.When the serum uric acid value of no-reflow and normal perfusion groups was compared, therewas statistificaly significant difference (respectively 6,680±1,11 mg/dl versus 5,066±0,68 mg/dl.p

Keywords

No-reflow, Uric acid, Acute myocardial infarction, primary coronary intervention

St Elevasyonlu Miyokard İnfarktüslü Hastalarda Primer Perkütan Girişim Sonrası No-Reflow Fenomeni Gelişimi ile Serum Ürik Asit Düzeyleri Arasındaki İlişki

Abstract

Perkütan koroner girişimlerde, sorumlu arterin açılmasına rağmen, miyokardial perfüzyonunsağlanamaması “no-reflow” fenomeni olarak tanımlanır. Adenin nükleotit metabolitlerinden biriolan ürik asidin hem iskemi sırasında, hem de reperfüzyon sırasında iskemik dokulardansalındığı gösterilmiş ve iskemik hasar ile reperfüzyon hasarında rol oynayabileceğidüşünülmüştür. Biz çalışmamızda ST elevasyonlu akut miyokard infarktüsü tanısı alıp, primerperkütan girişim uygulanan hastalarımızda, işlem sonrası anjiyografik olarak no-reflowfenomeni gelişen ve gelişmeyen gruplarda ürik asit değerlerini karşılaştırdık. Çalışmaya 47 hasta alındı. Olguların hastaneye gelişinde kan örnekleri alınarak ürik asit sayımıyapıldı. Hastalar primer perkütan girişim sonrası Miyokardial Blush Grade (MBG) derecelerinegöre iki gruba ayrıldı. Buna göre MBG 0 ve 1 olan olgular no-reflow fenomeni var, MBG 2 ve3 olan olgular no-reflow fenomeni yok, olarak kabul edildi.İki grup mutlak ürik asit değerleri açısından karşılaştırıldı ve no-reflow fenomeni gözlenenhastaların ürik asit değerleri ortalaması 6,680±1,11 mg/dl iken, no-reflow gözlenmeyen grupta5,066±0,68 mg/dl idi. İki değer arasındaki fark istatistiksel olarak anlamlı kabul edildi.(p

Keywords

No-reflow, Ürik asit, Akut miyokard infarktüsü, Primer koroner girişim

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