Etkin Düzeyde Oral Antikoagülan Kullanan Hastalarda Tekrarlayan İskemik Hastalıkların Epidemiyolojik İncelenmesi

Year 2020, , 102 - 107, 01.07.2020

Kadir Dibek , Seda Özkan , Sinan Yıldırım , Selim Genç , Sinem Burul Alp

https://doi.org/10.38175/phnx.740834

Abstract

Objective: Many complications can occur while treating the ischemic diseases, also while under treatment some patients have recurrent ischemic diseases. In our study we aimed that to investigate dermographic characteristics, risk factors, and causes for patients, who has ischemic disease while under treatment of oral anticoagulant therapy for any reason and INR levels between 2-3.

Method: The files of patients diagnosed with myocardial infarction, ischemic cerebro vascular disease and pulmonary embolism who applied to the emergency department between 01.01.2014 and 31.12.2015 were analyzed retrospectively. The data of patients with an INR value of 2-3 and using oral anticoagulants were found from the hospital automation system. The data obtained were evaluated with the SPSS 17 Statistical analysis program.

Results: The INR value was determined in 2-3 of 452 pulmonary embolus patients, 24 of 1442 ischemic cerebrovascular patients, and 55 of 1263 myocardial infarction patients. 6 people from 55 patients with myocardial infarction, 3 people from 24 patients with pulmonary embolism and 3 people from 24 patients with stroke had the same disease before. The patients who diagnosed with pulmonary embolism, were seen less frequently received high Wells scores and big vessels embolism in the group with INR levels in treatment range. The patients diagnosed with stroke whose INR levels in treatment range, had atrial fibrillation more frequently. Congestive heart failure, atrial fibrillation and pulmonary embolism were found to be high risk factors in myocardial infarction patients with an INR value of 2-3.

Conclusion: As a result, we believe that patients who is under oral anticoagulant therapy, always carrying a risk of ischemic diseases and in this patient group risk factors are different from well known risk factors, so there will be a need for more work on this issue.

Keywords: Oral anticoagulants; pulmonary embolism; ischemic stroke; myocardial infarction.

Keywords

pulmoner emboli, iskemi, inme, antikuagulanlar, miyokard enfarktüsü

Epidemiological Research for Who has Ischemic Diseases While Using Effective Oral Anticoagulant Drug

Abstract

Objective: Many complications can occur while treating the ischemic diseases, also while under treatment some patients have recurrent ischemic diseases. In our study we aimed that to investigate dermographic characteristics, risk factors, and causes for patients, who has ischemic disease while under treatment of oral anticoagulant therapy for any reason and INR levels between 2-3.
Method: The files of patients diagnosed with myocardial infarction, ischemic cerebro vascular disease and pulmonary embolism who applied to the emergency department between 01.01.2014 and 31.12.2015 were analyzed retrospectively. The data of patients with an INR value of 2-3 and using oral anticoagulants were found from the hospital automation system. The data obtained were evaluated with the SPSS 17 Statistical analysis program.
Results: The INR value was determined in 2-3 of 452 pulmonary embolus patients, 24 of 1442 ischemic cerebrovascular patients, and 55 of 1263 myocardial infarction patients. 6 people from 55 patients with myocardial infarction, 3 people from 24 patients with pulmonary embolism and 3 people from 24 patients with stroke had the same disease before. The patients who diagnosed with pulmonary embolism, were seen less frequently received high Wells scores and big vessels embolism in the group with INR levels in treatment range. The patients diagnosed with stroke whose INR levels in treatment range, had atrial fibrillation more frequently. Congestive heart failure, atrial fibrillation and pulmonary embolism were found to be high risk factors in myocardial infarction patients with an INR value of 2-3.
Conclusion: As a result, we believe that patients who is under oral anticoagulant therapy, always carrying a risk of ischemic diseases and in this patient group risk factors are different from well known risk factors, so there will be a need for more work on this issue.

Keywords

pulmonary embolism, myocardial infarction, anticoagulants, stroke, ischemia

References

• Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med 2002;162:1182-9.
• Riedel M. Venous Tromboembolic Disease, Acute Pulmonary Embolism: Pathophysiology, Clinical Presentation, And Diagnosis. Heart 2001;85:229-240.
• Kroegel C, Reissig A. Principle Mechanisms Underlying Venous Thromboembolism Epidemiology, Risk Factors. Respiration 2003;70:7-30.
• Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G. Pharmacology and Management of the Vitamin K Antagonists: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest 2008;133(6 Suppl):160S-198S.
• Leoo T, Lindgren A, Petersson J, Arbin Mv. Risk Factors and Treatment at Recurrent Stroke Onset: Results from the Recurrent Stroke Quality and Epidemiology (RESQUE) Study. Cerebrovasc Dis 2008;25:254-260.
• Tapson VF. Acute pulmonary embolism. N Engl J Med 2008;358:1037-52.
• British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003;58:470-84.
• Prandoni P, Noventa F, Ghirarduzzi A, Pengo V, Bernardi E, Pesavento R, et al. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients. Haematologica, 2007;92:199-205.
• Gex G, Gerstel E, Righini M, LE Gal G, Aujesky D, Roy PM, et al. Is atriyal fibrillation associated with pulmonary embolism? J Thromb Haemost 2012;10:347-51.
• Saito D, Shiraki T, Oka T, Kajiyama A, Takamura T. Risk Factors Indicating Recurrent Myocardial Infarction After Recovery From Acute Myocardial Infarction. Circ J 2002;66:877-80.
• Feigin VL, Carlene MML, Bennett DA, Anderson CS. Stroke epidemiology: a review of population-based studies of incidence, prevalence and case-fatality in the late 20th century. Lancet Neurol 2003;2:43-53.