ST segment yükselmesiz miyokard enfarktüsü olan hastalarda CHA2DS2 -VASc skorunun koroner arter hastalığının ciddiyet ve karmaşıklığı ile ilişkisi

Öz

Amaç: Bu çalışmada ST segment yükselmesiz miyokard enfarktüsü (NSTEMI) olan hastalarda CHA2DS2 -VASc skorunun koroner arter hastalığının ciddiyet ve karmaşıklığını predikte eden SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) skoru ile korelasyonunun belirlenmesi amaçlandı. Yöntem: Bu retrospektif kesitsel çalışma bir üçüncü basamak sağlık merkezinde yürütüldü. Acil serviste NSTEMI tanısı alan ve perkütan koroner girişim uygulanan hastalar dahil edildi. Hastaların demografik, klinik ve anjiyografik özellikleri hastanenin elektronik veri sisteminden elde edildi. Ekokardiyografi ve anjiyografi görüntüleri hastaların klinik özelliklerine kör, deneyimli bir girişimsel kardiyolog tarafından değerlendirildi. CHA2DS2-VASc ve SYNTAX skorları hesaplandı. Çalışmanın primer sonlanımı CHA2DS2-VASc ve SYNTAX skorları arasındaki korelasyondu. Bulgular: Çalışmaya toplam 216 hasta dahil edildi. Ortalama CHA2DS2-VASc ve SYNTAX skorları sırasıyla 2,9±1,7 ve 16,6±7,9 olarak belirlendi. SYNTAX skoruna göre risk gruplarına ayrılan hastaların CHA2DS2-VASc skorları arasında düşük ve orta risk arasında (sırasıyla 2,8±1,7 ve 3,4±1,7, p<0,001), düşük ve yüksek risk arasında (sırasıyla, 2,8±1,7 ve 3,7±1,8, p<0.001) anlamlı fark izlendi. CHA2DS2-VASc ve SYNTAX skorları arasında yapılan korelasyon analizinde anlamlı pozitif korelasyon belirlendi (Spearman’s rho= 0,454, p=0,02). Sonuç: Bu çalışmada CHA2DS2-VASc ve SYNTAX skorları arasında kabul edilebilir bir pozitif korelasyon olduğu gösterilmiştir. Acil serviste NSTEMI tanısı alan hastalarda koroner arter hastalığının ciddiyeti ve karmaşıklığını ön görmede CHA2DS2-VASc skorunun kullanılması fayda sağlayabilir.

Anahtar Kelimeler

• ST segment yükselmesiz miyokard enfarktüsü
• koroner arter hastalığı
• CHA2DS2-VASc skoru
• SYNTAX skoru

Relation of CHA2DS2 -VASc score with severity and complexity of coronary artery disease in patients with non-ST segment elevation myocardial infarction

Öz

Objectives: This study aimed to determine the correlation between CHA2DS2 -VASc score and the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) scoring system for predicting severity and complexity of coronary artery disease in patients with non-ST segment elevation myocardial infarction (NSTEMI). Methods: This is a retrospective cross-sectional study conducted in a tertiary care center. The patients admitted to the emergency department (ED) with NSTEMI and who underwent the PCI were included. The patients’ demographic, clinical and angiographic characteristics were gathered from the hospital electronic medical records. Echocardiography and angiography images were evaluated by an experienced interventional cardiologist blinded to the patients' clinical information. The CHA2DS2-VASc and SYNTAX scores were calculated. The primary outcome of this study was the correlation between the CHA2DS2-VASc and SYNTAX scores. Results: A total of 216 patients were included. The mean CHA2DS2-VASc and SYNTAX scores were 2.9±1.7 and 16.6±7.9, respectively. There were significant differences in the mean CHA2DS2-VASc scores between the low and moderate (2.8±1.7 and 3.4±1.7, respectively, p<0.001), and low and high-risk groups (2.8±1.7 and 3.7±1.8, respectively, p<0.001) according to the SYNTAX score risk classification. The rank correlation analysis showed a significant positive correlation between the CHA2DS2-VASc and SYNTAX scores (Spearman’s rho= 0.454, p=0.02). Conclusion: This study showed a fair, positive correlation between the CHA2DS2-VASc and SYNTAX scores. The use CHA2DS2-VASc score might be practical to predict the severity and complexity of coronary artery disease in patients admitted to the ED with NSTEMI.

Anahtar Kelimeler

• non-ST elevation acute coronary syndrome
• coronary artery disease
• CHA2DS2-VASc score
• SYNTAX score

Kaynakça

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