Importance of EuroSCORE-II in the Development of Acute Ischemic Heart Failure After Acute Anterior ST Elevation Myocardial Infarction

Yıl 2016, Cilt: 19 Sayı: 2, 65 - 71, 01.08.2016

İlker Gül Mustafa Zungur Ahmet Çağrı Aykan Aysel İslamlı Bekir Serhat Yıldız Murat Bilgin

Öz

Introduction:
We aimed to evaluate the importance of the
EuroSCORE-II (ES-II) risk-scoring system in predicting the development of acute
ischemic heart failure (AIHF) after acute anterior ST segment elevation
myocardial infarction (A-STEMI).

Patients
and Methods: A total of 261 patients (206 male; mean age,
63.5 ± 14.2 years) admitted to our centre with A-STEMI between April 2012 and
January 2013 were included in the study. The patients were divided into two
groups according to their clinical findings and were prospectively followed
during the hospitalisation period for the development of cardiac morbidity and
mortality. These groups were the AIHF group (n= 69) and non-AIHF group (n=
192). For the diagnosis of AIHF, we considered the recommendations of the
European Society of Cardiology Guidelines on Heart Failure and the Framingham
criteria.

Results: According
to our results, the morbidity and mortality rates were higher in the AIHF
group. Symptom-to-balloon time, ejection fraction (EF), glomerular filtration
rate (gfr), no-reflow phenomenon, left main coronary artery disease and ES-II,
which are the predictors of the development of AIHF, were determined via
logistic regression analysis. ROC analysis revealed that symptom-to-balloon
time > 209.5 min, EF < 36.5%, gfr < 68.5 mg/dL/1.73 m² and
ES-II > 4.9% were the cut-off values in the development of AIHF.

Conclusion: Patients with A-STEMI complicated
by AIHF have significantly high mortality rates. With the pre-estimation of the
development of AIHF, complication rates can be reduced. For this purpose, ES-II
score > 4.9% can be used as a predictor of AIHF after A-STEMI.

Anahtar Kelimeler

Coronary artery disease, ST elevation myocardial infarction, EuroSCORE-II, acute ischemic heart failure

Akut Anterior Miyokart İnfarktüsü Sonrası Akut İskemik Kalp Yetersizliği Gelişimini Öngörmede EuroSCORE-II’nin Önemi

Öz

Giriş:
Akut anterior ST yükselmeli miyokart infarktüsü
(A-STEMİ) sonrası akut iskemik kalp yetersizliği (AİKY) gelişimini öngörmede
EuroSCORE-II skorlama sisteminin önemini değerlendirmeyi amaçladık.

Hastalar
ve Yöntem: Çalışmaya Nisan 2012-Ocak
2013 tarihleri arasında merkezimize A-STEMİ nedeniyle kabul edilen 261 hasta
(206 erkek, ortalama yaş 63.5 ± 14.2) dahil edildi. Hastalar klinik bulgularına
göre iki farklı gruba ayrıldı ve hastanede yatış periyodu süresince kardiyak
morbidite ve mortalite gelişimi bakımından prospektif olarak takip edildi. Bu gruplar
AİKY grubu ((n= 69) ve non-AİKY grupları (n= 192) idi. AİKY tanısı koyabilmek
için Avrupa Kardiyoloji Cemiyeti kalp yetersizliği klavuzu ve Framingham
kriterleri göz önünde bulunduruldu.

Bulgular:
Çalışmamız sonuçlarına göre AİKY grubunda morbidite
ve mortalite daha yüksekti. Regresyon analizleri sonuçlarına göre semptom-balon
zamanı, ejeksiyon fraksiyonu, no-reflow fenomeni, sol ana koroner hastalığı, üç
damar koroner arter hastalığı, SYNTAX skoru ve ES-II’nin AİKY gelişiminin
prediktörleri oldukları belirlendi. ROC analizlerinin sonuçlarına gore
semptom-kapı zamanının > 229.5 dakika, EF < %36.5, SYNTAX skoru >
27.75 ve EsII > %4.9 değerlerinin AİKY gelişimini öngördürebilecek sınır
değerler oldukları belirlendi.

Sonuç: AİKY gelişen A-STEMİ’li hastalarda mortalite
oranları artmaktadır. AİKY gelişiminin önceden öngörülmesi kardiyak
komplikasyonları azaltabilir. Bu amaçla Es-II’nin > %4.9 olması A-STEMİ
sonrası AİKY gelişimim öngördürücüsü olarak kullanılabilir.

Anahtar Kelimeler

Koroner arter hastalığı, acut anterior ST yükselmeli miyokart infarktüsü, EuroSCORE-II, akut iskemik kalp yetersizliği

Kaynakça

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