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2018 Yılında Tek Merkezde Primer Perkutan Koroner Girişim Yapılan Hastaların Klinik Özellikleri, Anjiyografi İşleminin ve Hastane İçi Klinik Sonuçların Analizi

Year 2020, Volume: 10 Issue: 2, 197 - 204, 15.06.2020
https://doi.org/10.31832/smj.658235

Abstract

Amaç: Primer perkutan koroner
girişim (pPKG), ST elevasyonlu miyokard infarktüsünde (STEMI) ölüm başta olmak
üzere klinik sonuçları fibrinolitik tedaviye kıyasla daha iyi olması üzerine,
önerilen ve gittikçe daha yaygın kullanılan tedavi yöntemidir. Amacımız
hastanemizde bir yıl içinde yapmış olduğumuz pPKG işlemlerinin ve hastane içi klinik
sonuçlarının istatistiksel analizini yapmaktır.



Gereç ve yöntem: Ocak
2018 ile Aralık 2018 arasında pPKG ile tedavi edilmiş STEMI hastaları
retrospektif olarak hastane kayıtlarından belirlendi, anjiyografi görüntüleri
izlendi, hastane içi mortalite ve iskemik-kanama-prosedürel komplikasyon
oranları analiz edildi.



Bulgular: Acil
pPKG tedavisi amacıyla kateter laboratuvarına alınmış olan 982 hasta belirlendi.
İşlem başarısı oranı %96.9 idi. Ortalama (Ort.) yaş kadın hastalarda (69±11)
erkeklere (59±12) göre daha fazlaydı. Ortalama kapı-balon zamanı (KBZ) 60.0±18
dk. olup, hastaların %94.5’inde <90dk. KBZ hedefine ulaşıldı. Ponksiyon yeri
ile ilişkili komplikasyon oranına bakıldığında radyal ponksiyon femoral
ponksiyona göre daha güvenli bulundu (%1.4 v.s. % 3.5, p=0.037). Kardiyojenik
şokta olan hastaların mortalite oranı %76.0’dı. STEMI hastane içi mortalite
oranı %8.6 saptandı. Mortal seyreden grupta yaş ort.’sı daha yüksekti (69±14
v.s. 60±12, p<0.001) ve kadın cinsiyette ölüm oranı (%15.0 v.s. % 6.8,
p<0.001) erkeklerdeki ölüm oranına göre anlamlı olarak daha fazla saptandı.



Sonuç: Verilerimiz neticesinde,
STEMI hastalarında mortalite özellikle kardiyojenik şok tablosundaki hastalar
ile, ileri yaş ve kadınlarda daha yüksek saptanmıştır. STEMI hastalarında pPKG
kliniğimizde yüksek başarı oranı ile uygulanmaktadır.

References

  • 1. Gümrükçüoğlu HA, Şahin M, Eryoncu B, et al. Kliniğimizde kardiyak kateterizasyon uygulanan hastalıkların üç yıllık sonuçlarının istatistiksel analizi. Van Tıp Dergisi 2006;13(3): 78-84.
  • 2. Dubey G, Verma SK, Bahl VK. Primary percutaneous coronary intervention for acute ST elevation myocardial infarction: Outcomes and determinants of outcomes: A tertiary care center study from North India. Indian Heart Journal 2017;69:294-98.
  • 3. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal (2018) 39:119–177. 4. Temiz A, Gazi E, Güngör Ö, et al. Platelet/lymphocyte ratio and risk of in-hospital mortality in patients with ST-elevated myocardial infarction. Med Sci Monit 2014 (22);20:660-5.
  • 5. Ugalde H, Yubini MC, Rozas S, et al. Prediction of hospital mortality of ST elevation myocardial infarction using TIMI score. Rev Med Chil 2017;145(5):572-578.
  • 6. Shaikh AH, Siddiqui MS, Hanif B, et al. Outcomes of primary percutaneous coronary intervention in a tertiary care cardiac centre. J Pak Med Assoc 2009;59:426-29.
  • 7. Yekefellah L, Pournorooz M, Noori H, et al. Evaluation of door-to-balloon time for performing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction patients transferred by pre-hospital emergency system in Tehran. Iran J Nurs Midwifery Res 2019;24(4):281-5.
  • 8. Nallamothu BK, Bradley EH, Krumholz HM. Time to treatment in primary percutaneous coronary intervention. N Eng J Med 2007;357:1631-8.
  • 9. McCabe JM, Armstrong EJ, Hoffmayer KS, et al. Impact of door-to-activation time on door-to-balloon time in primary percutaneous coronary intervention for ST-segment elevation myocardial infarctions. Cardiovasc Qual Outcomes 2012;5:672-9.
  • 10. Dreyer RP, Tavella R, Curtis JP, et al. Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a medicare population. Eur Heart J e-pub2019 Jun 21. pii: ehz393. doi: 10.1093/eurheartj/ehz403.
  • 11. Gue YX, Corballis N, Ryding A, et al. MINOCA presenting with STEMI: incidence, aetiology and outcome in a contemporaneous cohort. Journal of Thrombosis and Thrombolysis 2019 Nov;48(4):533-538.
  • 12. Maznyczka AM, Carrick D, Carberry J, et al. Sex-based associations with microvascular injury and outcomes after ST-segment elevation myocardial infarction. Open Heart 2019 Apr 29;6(1):e000979. doi: 10.1136/openhrt-2018-000979. eCollection 2019.
  • 13. Zachura M, Wilczek K, Janion M, et al. Long-term outcomes in men and women with ST-segment elevation myocardial infarciton and incomplete reperfusion after a primary percutaneous coronary intervention: a 2-year follow-up. Coronary Artery Disease 2019;30: 171-6.
  • 14. Kanic V, Suran D, Krajnc I, et al. ST-elevation myocardial infarction in a real population-An observational retrospective study with a sexperspective. Eur J InternMed. 2019;66:81-84.
  • 15. Schernthaner C, Hammerer M, Harb S, et al. Radial versus femoral access site for percutaneous coronary intervention in patients suffering acute myocardial infarction. Wien Klin Wochenschr 2018;130:182-9.
  • 16. Dubey L, Bhattacharya R, Guruprasad S, et al. Early clinical outcomes of primary percutaneous coronary intervention in Bharatpur, Nepal. A Journal of Clinical Medicine 2013;8(2):103-7.
  • 17. Kalra S, Bhatt H, Kirtane AJ. Stenting in primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. Methodist Debakey Cardiovasc J 2018; 14(1):14-22. 7.
Year 2020, Volume: 10 Issue: 2, 197 - 204, 15.06.2020
https://doi.org/10.31832/smj.658235

Abstract

References

  • 1. Gümrükçüoğlu HA, Şahin M, Eryoncu B, et al. Kliniğimizde kardiyak kateterizasyon uygulanan hastalıkların üç yıllık sonuçlarının istatistiksel analizi. Van Tıp Dergisi 2006;13(3): 78-84.
  • 2. Dubey G, Verma SK, Bahl VK. Primary percutaneous coronary intervention for acute ST elevation myocardial infarction: Outcomes and determinants of outcomes: A tertiary care center study from North India. Indian Heart Journal 2017;69:294-98.
  • 3. Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal (2018) 39:119–177. 4. Temiz A, Gazi E, Güngör Ö, et al. Platelet/lymphocyte ratio and risk of in-hospital mortality in patients with ST-elevated myocardial infarction. Med Sci Monit 2014 (22);20:660-5.
  • 5. Ugalde H, Yubini MC, Rozas S, et al. Prediction of hospital mortality of ST elevation myocardial infarction using TIMI score. Rev Med Chil 2017;145(5):572-578.
  • 6. Shaikh AH, Siddiqui MS, Hanif B, et al. Outcomes of primary percutaneous coronary intervention in a tertiary care cardiac centre. J Pak Med Assoc 2009;59:426-29.
  • 7. Yekefellah L, Pournorooz M, Noori H, et al. Evaluation of door-to-balloon time for performing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction patients transferred by pre-hospital emergency system in Tehran. Iran J Nurs Midwifery Res 2019;24(4):281-5.
  • 8. Nallamothu BK, Bradley EH, Krumholz HM. Time to treatment in primary percutaneous coronary intervention. N Eng J Med 2007;357:1631-8.
  • 9. McCabe JM, Armstrong EJ, Hoffmayer KS, et al. Impact of door-to-activation time on door-to-balloon time in primary percutaneous coronary intervention for ST-segment elevation myocardial infarctions. Cardiovasc Qual Outcomes 2012;5:672-9.
  • 10. Dreyer RP, Tavella R, Curtis JP, et al. Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a medicare population. Eur Heart J e-pub2019 Jun 21. pii: ehz393. doi: 10.1093/eurheartj/ehz403.
  • 11. Gue YX, Corballis N, Ryding A, et al. MINOCA presenting with STEMI: incidence, aetiology and outcome in a contemporaneous cohort. Journal of Thrombosis and Thrombolysis 2019 Nov;48(4):533-538.
  • 12. Maznyczka AM, Carrick D, Carberry J, et al. Sex-based associations with microvascular injury and outcomes after ST-segment elevation myocardial infarction. Open Heart 2019 Apr 29;6(1):e000979. doi: 10.1136/openhrt-2018-000979. eCollection 2019.
  • 13. Zachura M, Wilczek K, Janion M, et al. Long-term outcomes in men and women with ST-segment elevation myocardial infarciton and incomplete reperfusion after a primary percutaneous coronary intervention: a 2-year follow-up. Coronary Artery Disease 2019;30: 171-6.
  • 14. Kanic V, Suran D, Krajnc I, et al. ST-elevation myocardial infarction in a real population-An observational retrospective study with a sexperspective. Eur J InternMed. 2019;66:81-84.
  • 15. Schernthaner C, Hammerer M, Harb S, et al. Radial versus femoral access site for percutaneous coronary intervention in patients suffering acute myocardial infarction. Wien Klin Wochenschr 2018;130:182-9.
  • 16. Dubey L, Bhattacharya R, Guruprasad S, et al. Early clinical outcomes of primary percutaneous coronary intervention in Bharatpur, Nepal. A Journal of Clinical Medicine 2013;8(2):103-7.
  • 17. Kalra S, Bhatt H, Kirtane AJ. Stenting in primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. Methodist Debakey Cardiovasc J 2018; 14(1):14-22. 7.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Salih Şahinkuş

Muhammed Aksoy 0000-0002-7722-0330

Ercan Aydın 0000-0001-8743-3762

Emre Eynel 0000-0002-8459-3418

Çağla Akçay 0000-0003-0924-352X

İbrahim Kocayiğit 0000-0001-8295-9837

Yusuf Can 0000-0002-4535-7367

Harun Kılıç 0000-0002-1358-5015

Ramazan Akdemir 0000-0002-2262-3087

Publication Date June 15, 2020
Submission Date December 12, 2019
Published in Issue Year 2020 Volume: 10 Issue: 2

Cite

AMA Şahinkuş S, Aksoy M, Aydın E, Eynel E, Akçay Ç, Kocayiğit İ, Can Y, Kılıç H, Akdemir R. 2018 Yılında Tek Merkezde Primer Perkutan Koroner Girişim Yapılan Hastaların Klinik Özellikleri, Anjiyografi İşleminin ve Hastane İçi Klinik Sonuçların Analizi. Sakarya Tıp Dergisi. June 2020;10(2):197-204. doi:10.31832/smj.658235

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