Acil servise başvuran hastalarda akut koroner sendromun diürnal varyasyonun koroner anjiyografiye göre değerlendirilmesi

- , 01.09.2019

İbrahim Çaltekin , Şiho Hidayet , Levent Albayrak , Emre Gökçen , Atakan Savrun , Mikail Kuşdoğan Yaşar Turan

https://doi.org/10.16919/bozoktip.591272

Öz

Özet

Amaç:
Bu
çalışmanın amacı, akut miyokard enfarktüslü hastaların diurnal varyasyon
gösterip göstermediğini ve etkilenen koroner arter ile bu diurnal varyasyon
arasındaki ilişkiyi araştırmaktır.

Material
ve Metodlar: Ocak-Aralık 2017 tarihleri arasında akut
koroner sendrom semptomları ile Yozgat Bozok Üniversitesi Acil Servisine
başvuran hastalar retrospektif olarak incelendi. 24 saatlik zaman dilimi içinde diurnal değişimler 6 grupta
(00:01-04:00, 04:01-08:00, 08:01-12:00, 12:01-16:00, 16:01-20:00, 20:01-00:00),
mevsimsel değişimler 4 grupta (İlkbahar, Yaz, Sonbahar, Kış), haftalık
değişimler ise 2 grupta (Hafta içi, Hafta sonu) analiz edilmiştir.

Bulgular:
Koroner
arterlerin gün içindeki diurnal etkilenimleri incelendiğinde istatistiksel
olarak anlamlı bir sonuç bulunamadı. Diurnal etkilenimin hafta içi ile hafta
sonu değişimleri incelendiğinde ise hafta içi olgularında her üç koroner arter
lezyonlarının hafta sonu görülen lezyonlara oranla istatistiksel olarak artmış
olduğu saptandı (p<0,05).

Sonuç:
Çalışmamızın sonucu olarak günlük değişkenlik tespit edilmediyse de, koroner
arter hastalığının artmasının, hafta içi günlerde stres ve yoğun iş temposu
gibi sosyal nedenlerden etkilendiği açıkça belirlenmiştir.

Anahtar Kelimeler

Diurnal ritim, myocard infartüsü, acil servis

Destekleyen Kurum

yok.

Proje Numarası

yok.

Teşekkür

yok.

Evaluation of acute coronary syndrome with coronary angiography due to diurnal variation in the patients who admitted to the emergency department

Öz

Abstract

Backround: The
aim of this study is to investigate whether patients with acute myocardial
infarction exhibited diurnal variation and the relationship between the
affected coronary artery and this diurnal variation.

Material and Methods: The
patients admitted to the emergency department of Yozgat Bozok University with
symptoms of acute coranary syndrome between January and December 2017 were
retrospectively analyzed. In 24 hour
period diurnal changes were analyzed in 6 groups (00:01-04:00, 04:01-08:00,
08:01-12:00, 12:01-16:00, 16:01-20:00, 20:01-00:00), seasonal changes were
analyzed in 4 groups (Spring, Summer, Autumn, Winter), and weekly changes were
analyzed in 2 groups (Weekday, Weekend).

Results: When
diurnal effects coronary arteries were examined, no statistically significant
results were found. When the changes of diurnal effect were observed at
weekdays and weekends, it was found that all three coronary artery lesions were
statistically increased at weekdays compared to the lesions seen at weekends
(p<0,05).

Conclusion:
Although daily diurnal variability was not detected as a result of our study,
it was clearly determined that the increase in coronary artery disease was
affected by social reasons such as stress and intensive work pace during the
weekdays.

Anahtar Kelimeler

Diurnal rhytm, emergency department, myocardial infarction

Proje Numarası

yok.

Kaynakça

• Reference 1. Dominguez-Rodriguez A, Abreu-Gonzalez P, Kaski JC. Inflammatory systemic biomarkers in setting acute coronary syndromes--effects of the diurnal variation. Current drug targets. 2009;10(10):1001-8.
• Reference 2. Bae MH, Ryu HM, Lee JH, Lee JH, Kwon YS, Lee SH, et al. The impact of circadian variation on 12-month mortality in patients with acute myocardial infarction. Korean circulation journal. 2010;40(12):616-24.
• Reference 3. Suarez-Barrientos A, Lopez-Romero P, Vivas D, Castro-Ferreira F, Nunez-Gil I, Franco E, et al. Circadian variations of infarct size in acute myocardial infarction. Heart (British Cardiac Society). 2011;97(12):970-6.
• Reference 4. Sayer JW, Wilkinson P, Ranjadayalan K, Ray S, Marchant B, Timmis AD. Attenuation or absence of circadian and seasonal rhythms of acute myocardial infarction. Heart (British Cardiac Society). 1997;77(4):325-9.
• Reference 5. Reiter R, Swingen C, Moore L, Henry TD, Traverse JH. Circadian dependence of infarct size and left ventricular function after ST elevation myocardial infarction. Circulation research. 2012;110(1):105-10.
• Reference 6. Durgan DJ, Young ME. The cardiomyocyte circadian clock: emerging roles in health and disease. Circulation research. 2010;106(4):647-58.
• Reference 7. Leiza JR, de Llano JM, Messa JB, Lopez CA, Fernandez JA. New insights into the circadian rhythm of acute myocardial infarction in subgroups. Chronobiology international. 2007;24(1):129-41.
• Reference 8. Jones-Crawford JL, Parish DC, Smith BE, Dane FC. Resuscitation in the hospital: circadian variation of cardiopulmonary arrest. The American journal of medicine. 2007;120(2):158-64.
• Reference 9. Gami AS, Howard DE, Olson EJ, Somers VK. Day-night pattern of sudden death in obstructive sleep apnea. The New England journal of medicine. 2005;352(12):1206-14.
• Reference 10. Seneviratna A, Lim GH, Devi A, Carvalho LP, Chua T, Koh TH, et al. Circadian Dependence of Infarct Size and Acute Heart Failure in ST Elevation Myocardial Infarction. PloS one. 2015;10(6):e0128526.
• Reference 11. Celik M, Celik T, Iyisoy A, Yuksel UC, Bugan B, Demirkol S, et al. Circadian variation of acute st segment elevation myocardial infarction by anatomic location in a Turkish cohort. Medical science monitor : international medical journal of experimental and clinical research. 2011;17(4):Cr210-5.
• Reference 12. D'Negri CE, Nicola-Siri L, Vigo DE, Girotti LA, Cardinali DP. Circadian analysis of myocardial infarction incidence in an Argentine and Uruguayan population. BMC cardiovascular disorders. 2006;6:1.
• Reference 13. Li J, Hua Q, Pi L, Tan J, Li B. Circadian variation on the onset of acute ST segment elevation myocardial infarction in diabetic subjects. Journal of cardiovascular disease research. 2010;1(1):23-6.
• Reference 14. Kanth R, Ittaman S, Rezkalla S. Circadian patterns of ST elevation myocardial infarction in the new millennium. Clinical medicine & research. 2013;11(2):66-72.
• Reference 15. Virag JA, Lust RM. Circadian influences on myocardial infarction. Frontiers in physiology. 2014;5:422.