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Çok Damarlı ST Yükselmesiz Miyokard İnfarktüsü Hastalarında Tek Aşamalı ve Çok Aşamalı Koroner Revaskülarizasyonun Mortalite Sonuçları

Yıl 2021, Cilt 23, Sayı 2, 129 - 136, 30.08.2021
https://doi.org/10.18678/dtfd.868952

Öz

Amaç: Bu çalışmanın amacı, çok damar hastalığı olan ST segment yükselmesiz miyokard enfarktüsü (non-ST segment elevation myocardial infarction, NSTEMI) tanısı aşan hastalarda tek aşamalı perkütan koroner girişim (single-stage percutaneous coronary intervention, SS-PCI) ile çok aşamalı perkütan koroner girişim (multi-stage percutaneous coronary intervention, MS-PCI) stratejilerinin kısa dönem ve uzun dönem mortalite sonuçlarının karşılaştırılmasıdır. Gereç ve Yöntemler: Bu çalışmaya çok damar hastalığı olan NSTEMI tanısı alan (SS-PCI grubunda 71 (%23,8) hasta ve MS-PCI grubunda 227 (%76,2) hasta olmak üzere) ardışık toplam 298 hasta dahil edildi. Mortalite ile ilgili veriler, enstitümüzün sağlık bilgi sisteminden ve ulusal sağlık sicilinden alındı. Bulgular: Hastane içi mortalite oranları tek değişkenli analizde SS-PCI grubunda MS-PCI grubuna göre anlamlı olarak daha yüksek saptamasına rağmen (%14,1 (n=10)’e karşı %4,0 (n=9); p=0,005), çoklu modelde bağımsız olarak genel mortalite ile ilişkili saptanmadı. Mortalite ile ilişkili olarak belirlenen parametreler içerisinde, hemoglobin düşüklüğü (odds raito (OR)=0,485; %95 güven aralığı (GA)=0,332-0,708; p=0,002), No-reflow gelişimi (OR=6,194; %95 GA=1,310-29,300; p=0,021) ,post dilatasyon kullanılmaması (OR=0,287; %95 GA=0,085-0,970; p=0,045) genel mortalitenin bağımsız ön gördürücüleri olarak saptandı. Sonuç: SS-PCI ve MS-PCI stratejileri ile tam koroner revaskülarizasyon uygulanan çok damar hastalığı olan NSTEMI hastalarında total mortalite açısından iki grup arasında anlamlı bir fark saptanmamasına rağmen düşük hemoglobin, No-reflow gelişimi ve post-dilatasyon kullanılmaması mortalitenin bağımsız ön gördürücüleri olarak bulundu.

Kaynakça

  • McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011;124(1):40-7.
  • Terkelsen CJ, Lassen JF, Nørgaard BL, Gerdes JC, Jensen T, Gøtzsche LB, et al. Mortality rates in patients with ST-elevation vs. non-ST-elevation acute myocardial infarction: observations from an unselected cohort. Eur Heart J. 2005;26(1):18-26.
  • Montalescot G, Bolognese L, Dudek D, Goldstein P, Hamm C, Tanguay JF, et al. Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes. N Engl J Med. 2013;369(11):999-1010.
  • Stone GW, Ware JH, Bertrand ME, Lincoff AM, Moses JW, Ohman EM, et al. Antithrombotic strategies in patients with acute coronary syndromes undergoing early invasive management: one-year results from the ACUITY trial. JAMA. 2007;298(21):2497-506.
  • Thiele H, Rach J, Klein N, Pfeiffer D, Hartmann A, Hambrecht R, et al. Optimal timing of invasive angiography in stable non-ST-elevation myocardial infarction: the Leipzig Immediate versus early and late PercutaneouS coronary Intervention triAl in NSTEMI (LIPSIA-NSTEMI Trial). Eur Heart J. 2012;33(16):2035-43.
  • Kerensky RA, Wade M, Deedwania P, Boden WE, Pepine CJ, Veterans Affairs Non-Q-Wave Infarction Stategies in-Hospital (VANQWISH) Trial Investigators. Revisiting the culprit lesion in non-Q-wave myocardial infarction. Results from the VANQWISH trial angiographic core laboratory. J Am Coll Cardiol. 2002;39(9):1456-63.
  • Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O'Neill WW. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med. 2000;343(13):915-22.
  • Bainey KR, Alemayehu W, Armstrong PW, Westerhout CM, Kaul P, Welsh RC. Long-term outcomes of complete revascularization with percutaneous coronary intervention in acute coronary syndromes. JACC Cardiovasc Interv. 2020;13(13):1557-67.
  • Windecker S, Hernández-Antolín RA, Stefanini GG, Wijns W, Zamorano JL. Management of ST-elevation myocardial infarction according to European and American guidelines. EuroIntervention. 2014;10(Suppl T):T23-31.
  • Hannan EL, Samadashvili Z, Walford G, Holmes DR Jr, Jacobs AK, Stamato NJ, et al. Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease. JACC Cardiovasc Interv. 2010;3(1):22-31.
  • Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228.
  • Ijsselmuiden AJ, Ezechiels J, Westendorp IC, Tijssen JG, Kiemeneij F, Slagboom T, et al. Complete versus culprit vessel percutaneous coronary intervention in multivessel disease: a randomized comparison. Am Heart J. 2004;148(3):467-74.
  • Hannan EL, Samadashvili Z, Walford G, Jacobs AK, Stamato NJ, Venditti FJ, et al. Staged versus one-time complete revascularization with percutaneous coronary intervention for multivessel coronary artery disease patients without ST-elevation myocardial infarction. Circ Cardiovasc Interv. 2013;6(1):12-20.
  • Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999-3054.
  • Cuddy ML. Treatment of hypertension: guidelines from JNC 7 (the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 1). J Pract Nurs. 2005;55(4):17-21.
  • Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(Suppl 1):S5-20.
  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-421.
  • TIMI Study Group. The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. N Engl J Med. 1985;312(14):932-6.
  • Piana RN, Paik GY, Moscucci M, Cohen DJ, Gibson CM, Kugelmass AD, et.al. Incidence and treatment of 'No-reflow' after percutaneous coronary intervention. Circulation. 1994;89(6):2514-8.
  • Kim MC, Hyun JY, Ahn Y, Bae S, Hyun DY, Cho KH, et al. Optimal revascularization strategy in non-ST-segment-elevation myocardial infarction with multivessel coronary artery disease: culprit-only versus one-stage versus multistage revascularization. J Am Heart Assoc. 2020;9(15):e016575.
  • Lee JM, Rhee TM, Kim HK, Hwang D, Lee SH, Choi KH, et al. Comparison of long-term clinical outcome between multivessel percutaneous coronary intervention versus infarct-related artery-only revascularization for patients with ST-segment-elevation myocardial infarction with cardiogenic shock. J Am Heart Assoc. 2019;8(24):e013870.
  • Ahmed F, Khan MS, Ali Shah SD, Jalbani J, Ali Shah A, Shaikh GA. Frequency of three-vessel disease among patients with non-ST segment elevation myocardial infarction. Cureus. 2020;12(11):e11634.
  • Rathod KS, Koganti S, Jain AK, Astroulakis Z, Lim P, Rakhit R, et al. Complete versus culprit-only lesion intervention in patients with acute coronary syndromes. J Am Coll Cardiol. 2018;72(17):1989-99.
  • Sardella G, Lucisano L, Garbo R, Pennacchi M, Cavallo E, Stio RE, et al. Single-staged compared with Multi-staged PCI in multivessel NSTEMI patients: The SMILE trial. J Am Coll Cardiol. 2016;67(3):264-72.
  • Sabatine MS, Morrow DA, Giugliano RP, Burton PB, Murphy SA, McCabe CH, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation. 2005;111(16):2042-9.
  • Lorente V, Aboal J, Garcia C, Sans-Roselló J, Sambola A, Andrea R, et al. Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units. J Geriatr Cardiol. 2020;17(1):35-42.
  • Karjalainen PP, Niemelä M, Laine M, Airaksinen JK, Ylitalo A, Nammas W. Usefulness of post-coronary dilation to prevent recurrent myocardial infarction in patients treated with percutaneous coronary intervention for acute coronary syndrome (from the BASE ACS trial). Am J Cardiol. 2017;119(3):345-50.
  • Obeid S, Frangieh AH, Räber L, Yousif N, Gilhofer T, Yamaji K, et al. Prognostic value of SYNTAX score II in patients with acute coronary syndromes referred for invasive management: A subanalysis from the SPUM and COMFORTABLE AMI cohorts. Cardiol Res Pract. 2018;2018:9762176.
  • He C, Song Y, Wang CS, Yao Y, Tang XF, Zhao XY, et al. Prognostic value of the clinical SYNTAX score on 2-year outcomes in patients with acute coronary syndrome who underwent percutaneous coronary intervention. Am J Cardiol. 2017;119(10):1493-9.
  • Kim MC, Cho JY, Jeong HC, Lee KH, Park KH, Sim DS, et al. Long-term clinical outcomes of transient and persistent no reflow phenomena following percutaneous coronary intervention in patients with acute myocardial infarction. Korean Circ J. 2016;46(4):490-8.
  • Refaat H, Tantawy A, Gamal AS, Radwan H. Novel predictors and adverse long-term outcomes of No-reflow phenomenon in patients with acute ST elevation myocardial infarction undergoing primary percutaneous coronary intervention. Indian Heart J. 2021;73(1):35-43.
  • Baumann AAW, Mishra A, Worthley MI, Nelson AJ, Psaltis PJ. Management of multivessel coronary artery disease in patients with non-ST-elevation myocardial infarction: a complex path to precision medicine. Ther Adv Chronic Dis. 2020;11:2040622320938527.

Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients

Yıl 2021, Cilt 23, Sayı 2, 129 - 136, 30.08.2021
https://doi.org/10.18678/dtfd.868952

Öz

Aim: The aim of this study was to compare the short-term and long-term mortality results of single-stage percutaneous coronary intervention (SS-PCI) and multi-stage percutaneous coronary intervention (MS-PCI) strategies in patients diagnosed with non-ST segment elevation myocardial infarction (NSTEMI) with multivessel disease. Material and Methods: A total of 298 consecutive patients diagnosed with multivessel NSTEMI (71 (23.8%) patients in the SS-PCI group and 227 (76.2%) patients in the MS-PCI group) were included in this study. Data regarding mortality were obtained from the health information system of our institute and national health registry. Results: Although in-hospital mortality rates were found to be significantly higher in univariate analysis in the SS-PCI group compared to the MS-PCI group (14.1% (n=10) vs 4.0% (n=9); p=0.005), it was not independently associated with total mortality in multiple model. Among the parameters predicted mortality determinants, low hemoglobin (odds ratio (OR)=0.485, 95% confidence interval (CI)=0.332-0.708; p=0.002), No-reflow occurrence (OR=6.194, 95% CI=1.310-29.300, p=0.021), not using post dilatation (OR=0.287, 95% CI=0.085-0.970, p=0.045) were independently associated with total mortality. Conclusion: There was no statistical difference in overall mortality between the two study groups in multivessel NSTEMI patients who underwent complete coronary revascularization with the SS-PCI and MS-PCI strategy, while low hemoglobin, No-reflow phenomenon, and not using post-dilatation were found as independent predictors of mortality.

Kaynakça

  • McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med. 2011;124(1):40-7.
  • Terkelsen CJ, Lassen JF, Nørgaard BL, Gerdes JC, Jensen T, Gøtzsche LB, et al. Mortality rates in patients with ST-elevation vs. non-ST-elevation acute myocardial infarction: observations from an unselected cohort. Eur Heart J. 2005;26(1):18-26.
  • Montalescot G, Bolognese L, Dudek D, Goldstein P, Hamm C, Tanguay JF, et al. Pretreatment with prasugrel in non-ST-segment elevation acute coronary syndromes. N Engl J Med. 2013;369(11):999-1010.
  • Stone GW, Ware JH, Bertrand ME, Lincoff AM, Moses JW, Ohman EM, et al. Antithrombotic strategies in patients with acute coronary syndromes undergoing early invasive management: one-year results from the ACUITY trial. JAMA. 2007;298(21):2497-506.
  • Thiele H, Rach J, Klein N, Pfeiffer D, Hartmann A, Hambrecht R, et al. Optimal timing of invasive angiography in stable non-ST-elevation myocardial infarction: the Leipzig Immediate versus early and late PercutaneouS coronary Intervention triAl in NSTEMI (LIPSIA-NSTEMI Trial). Eur Heart J. 2012;33(16):2035-43.
  • Kerensky RA, Wade M, Deedwania P, Boden WE, Pepine CJ, Veterans Affairs Non-Q-Wave Infarction Stategies in-Hospital (VANQWISH) Trial Investigators. Revisiting the culprit lesion in non-Q-wave myocardial infarction. Results from the VANQWISH trial angiographic core laboratory. J Am Coll Cardiol. 2002;39(9):1456-63.
  • Goldstein JA, Demetriou D, Grines CL, Pica M, Shoukfeh M, O'Neill WW. Multiple complex coronary plaques in patients with acute myocardial infarction. N Engl J Med. 2000;343(13):915-22.
  • Bainey KR, Alemayehu W, Armstrong PW, Westerhout CM, Kaul P, Welsh RC. Long-term outcomes of complete revascularization with percutaneous coronary intervention in acute coronary syndromes. JACC Cardiovasc Interv. 2020;13(13):1557-67.
  • Windecker S, Hernández-Antolín RA, Stefanini GG, Wijns W, Zamorano JL. Management of ST-elevation myocardial infarction according to European and American guidelines. EuroIntervention. 2014;10(Suppl T):T23-31.
  • Hannan EL, Samadashvili Z, Walford G, Holmes DR Jr, Jacobs AK, Stamato NJ, et al. Culprit vessel percutaneous coronary intervention versus multivessel and staged percutaneous coronary intervention for ST-segment elevation myocardial infarction patients with multivessel disease. JACC Cardiovasc Interv. 2010;3(1):22-31.
  • Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228.
  • Ijsselmuiden AJ, Ezechiels J, Westendorp IC, Tijssen JG, Kiemeneij F, Slagboom T, et al. Complete versus culprit vessel percutaneous coronary intervention in multivessel disease: a randomized comparison. Am Heart J. 2004;148(3):467-74.
  • Hannan EL, Samadashvili Z, Walford G, Jacobs AK, Stamato NJ, Venditti FJ, et al. Staged versus one-time complete revascularization with percutaneous coronary intervention for multivessel coronary artery disease patients without ST-elevation myocardial infarction. Circ Cardiovasc Interv. 2013;6(1):12-20.
  • Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32(23):2999-3054.
  • Cuddy ML. Treatment of hypertension: guidelines from JNC 7 (the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 1). J Pract Nurs. 2005;55(4):17-21.
  • Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(Suppl 1):S5-20.
  • National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-421.
  • TIMI Study Group. The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. N Engl J Med. 1985;312(14):932-6.
  • Piana RN, Paik GY, Moscucci M, Cohen DJ, Gibson CM, Kugelmass AD, et.al. Incidence and treatment of 'No-reflow' after percutaneous coronary intervention. Circulation. 1994;89(6):2514-8.
  • Kim MC, Hyun JY, Ahn Y, Bae S, Hyun DY, Cho KH, et al. Optimal revascularization strategy in non-ST-segment-elevation myocardial infarction with multivessel coronary artery disease: culprit-only versus one-stage versus multistage revascularization. J Am Heart Assoc. 2020;9(15):e016575.
  • Lee JM, Rhee TM, Kim HK, Hwang D, Lee SH, Choi KH, et al. Comparison of long-term clinical outcome between multivessel percutaneous coronary intervention versus infarct-related artery-only revascularization for patients with ST-segment-elevation myocardial infarction with cardiogenic shock. J Am Heart Assoc. 2019;8(24):e013870.
  • Ahmed F, Khan MS, Ali Shah SD, Jalbani J, Ali Shah A, Shaikh GA. Frequency of three-vessel disease among patients with non-ST segment elevation myocardial infarction. Cureus. 2020;12(11):e11634.
  • Rathod KS, Koganti S, Jain AK, Astroulakis Z, Lim P, Rakhit R, et al. Complete versus culprit-only lesion intervention in patients with acute coronary syndromes. J Am Coll Cardiol. 2018;72(17):1989-99.
  • Sardella G, Lucisano L, Garbo R, Pennacchi M, Cavallo E, Stio RE, et al. Single-staged compared with Multi-staged PCI in multivessel NSTEMI patients: The SMILE trial. J Am Coll Cardiol. 2016;67(3):264-72.
  • Sabatine MS, Morrow DA, Giugliano RP, Burton PB, Murphy SA, McCabe CH, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation. 2005;111(16):2042-9.
  • Lorente V, Aboal J, Garcia C, Sans-Roselló J, Sambola A, Andrea R, et al. Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units. J Geriatr Cardiol. 2020;17(1):35-42.
  • Karjalainen PP, Niemelä M, Laine M, Airaksinen JK, Ylitalo A, Nammas W. Usefulness of post-coronary dilation to prevent recurrent myocardial infarction in patients treated with percutaneous coronary intervention for acute coronary syndrome (from the BASE ACS trial). Am J Cardiol. 2017;119(3):345-50.
  • Obeid S, Frangieh AH, Räber L, Yousif N, Gilhofer T, Yamaji K, et al. Prognostic value of SYNTAX score II in patients with acute coronary syndromes referred for invasive management: A subanalysis from the SPUM and COMFORTABLE AMI cohorts. Cardiol Res Pract. 2018;2018:9762176.
  • He C, Song Y, Wang CS, Yao Y, Tang XF, Zhao XY, et al. Prognostic value of the clinical SYNTAX score on 2-year outcomes in patients with acute coronary syndrome who underwent percutaneous coronary intervention. Am J Cardiol. 2017;119(10):1493-9.
  • Kim MC, Cho JY, Jeong HC, Lee KH, Park KH, Sim DS, et al. Long-term clinical outcomes of transient and persistent no reflow phenomena following percutaneous coronary intervention in patients with acute myocardial infarction. Korean Circ J. 2016;46(4):490-8.
  • Refaat H, Tantawy A, Gamal AS, Radwan H. Novel predictors and adverse long-term outcomes of No-reflow phenomenon in patients with acute ST elevation myocardial infarction undergoing primary percutaneous coronary intervention. Indian Heart J. 2021;73(1):35-43.
  • Baumann AAW, Mishra A, Worthley MI, Nelson AJ, Psaltis PJ. Management of multivessel coronary artery disease in patients with non-ST-elevation myocardial infarction: a complex path to precision medicine. Ther Adv Chronic Dis. 2020;11:2040622320938527.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp
Bölüm Araştırma Makalesi
Yazarlar

Gökhan ALICI (Sorumlu Yazar)
ADANA ŞEHİR HASTANESİ
0000-0002-4589-7566
Türkiye


Alaa QUİSİ
Özel Medline Adana Hastanesi
0000-0002-5862-5789
Türkiye


Omer GENC
AĞRI DEVLET HASTANESİ
0000-0002-9097-5391
Türkiye


Hazar HARBALIOĞLU
DÜZCE ATATÜRK DEVLET HASTANESİ
0000-0002-6694-814X
Türkiye


Samir ALLAHVERDİYEV
Istanbul Aydin University Medical Park Florya Hospital
0000-0003-3175-0835
Türkiye


Abdullah YILDIRIM
ADANA ŞEHİR HASTANESİ
0000-0002-7071-8099
Türkiye


Örsan Deniz URGUN
ADANA KOZAN DEVLET HASTANESİ
0000-0001-9125-4732
Türkiye


Mustafa GÜR
ADANA ŞEHİR HASTANESİ
0000-0002-4761-0215
Türkiye

Yayımlanma Tarihi 30 Ağustos 2021
Yayınlandığı Sayı Yıl 2021, Cilt 23, Sayı 2

Kaynak Göster

Bibtex @araştırma makalesi { dtfd868952, journal = {Duzce Medical Journal}, issn = {}, eissn = {1307-671X}, address = {}, publisher = {Düzce Üniversitesi}, year = {2021}, volume = {23}, pages = {129 - 136}, doi = {10.18678/dtfd.868952}, title = {Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients}, key = {cite}, author = {Alıcı, Gökhan and Quisi, Alaa and Genc, Omer and Harbalıoğlu, Hazar and Allahverdiyev, Samir and Yıldırım, Abdullah and Urgun, Örsan Deniz and Gür, Mustafa} }
APA Alıcı, G. , Quisi, A. , Genc, O. , Harbalıoğlu, H. , Allahverdiyev, S. , Yıldırım, A. , Urgun, Ö. D. & Gür, M. (2021). Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients . Duzce Medical Journal , 23 (2) , 129-136 . DOI: 10.18678/dtfd.868952
MLA Alıcı, G. , Quisi, A. , Genc, O. , Harbalıoğlu, H. , Allahverdiyev, S. , Yıldırım, A. , Urgun, Ö. D. , Gür, M. "Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients" . Duzce Medical Journal 23 (2021 ): 129-136 <https://dergipark.org.tr/tr/pub/dtfd/issue/62396/868952>
Chicago Alıcı, G. , Quisi, A. , Genc, O. , Harbalıoğlu, H. , Allahverdiyev, S. , Yıldırım, A. , Urgun, Ö. D. , Gür, M. "Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients". Duzce Medical Journal 23 (2021 ): 129-136
RIS TY - JOUR T1 - Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients AU - Gökhan Alıcı , Alaa Quisi , Omer Genc , Hazar Harbalıoğlu , Samir Allahverdiyev , Abdullah Yıldırım , Örsan Deniz Urgun , Mustafa Gür Y1 - 2021 PY - 2021 N1 - doi: 10.18678/dtfd.868952 DO - 10.18678/dtfd.868952 T2 - Duzce Medical Journal JF - Journal JO - JOR SP - 129 EP - 136 VL - 23 IS - 2 SN - -1307-671X M3 - doi: 10.18678/dtfd.868952 UR - https://doi.org/10.18678/dtfd.868952 Y2 - 2021 ER -
EndNote %0 Düzce Tıp Fakültesi Dergisi Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients %A Gökhan Alıcı , Alaa Quisi , Omer Genc , Hazar Harbalıoğlu , Samir Allahverdiyev , Abdullah Yıldırım , Örsan Deniz Urgun , Mustafa Gür %T Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients %D 2021 %J Duzce Medical Journal %P -1307-671X %V 23 %N 2 %R doi: 10.18678/dtfd.868952 %U 10.18678/dtfd.868952
ISNAD Alıcı, Gökhan , Quisi, Alaa , Genc, Omer , Harbalıoğlu, Hazar , Allahverdiyev, Samir , Yıldırım, Abdullah , Urgun, Örsan Deniz , Gür, Mustafa . "Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients". Duzce Medical Journal 23 / 2 (Ağustos 2021): 129-136 . https://doi.org/10.18678/dtfd.868952
AMA Alıcı G. , Quisi A. , Genc O. , Harbalıoğlu H. , Allahverdiyev S. , Yıldırım A. , Urgun Ö. D. , Gür M. Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients. Duzce Medical Journal. 2021; 23(2): 129-136.
Vancouver Alıcı G. , Quisi A. , Genc O. , Harbalıoğlu H. , Allahverdiyev S. , Yıldırım A. , Urgun Ö. D. , Gür M. Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients. Duzce Medical Journal. 2021; 23(2): 129-136.
IEEE G. Alıcı , A. Quisi , O. Genc , H. Harbalıoğlu , S. Allahverdiyev , A. Yıldırım , Ö. D. Urgun ve M. Gür , "Mortality Outcomes of Single-staged versus Multi-staged Complete Coronary Revascularization in Multivessel Non-ST Elevation Myocardial Infarction Patients", Duzce Medical Journal, c. 23, sayı. 2, ss. 129-136, Ağu. 2021, doi:10.18678/dtfd.868952
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