Akut Anterior Miyokard İnfarktüsü Geçiren ve Primer Perkütan Koroner Girişim Uygulanan Hastalarda Sol Ventrikül Apikal Trombüs Oluşumunun Öngördürücüleri: SYNTAX Skorunun Önemi

Yıl 2021, Cilt: 16 Sayı: 3, 316 - 321, 01.11.2021

Mahmut Yılmaz Mehmet Ballı , Mustafa Gür

https://doi.org/10.17517/ksutfd.823196

Öz

Amaç: Sol Ventrikül (SV) apikal trombüs oluşumu Anterior Miyokard İnfarktüs (AMİ) geçiren hastalarda SV apikal anevrizma ve sistolik disfonksiyonun eşlik ettiği önemli bir istenmeyen olaydır. SYNTAX skoru koroner arter hastalarında kardiyovasküler mortalite ve morbiditenin önemli bir belirtecidir. Çalışmamızda AMİ geçiren hastalarda SV apikal trombus oluşumu ile SYNTAX skoru ve diğer risk faktörleri arasındaki ilişkiyi araştırdık. Yöntem: AMİ geçiren ve primer perkütan koroner girişim uygulanan ardışık 205 hasta çalışmamıza dahil edildi (Kadın:35/Erkek:170, ortalama yaş: 55.8 ± 9.6 yıl) . Koroner arter hastalığının ciddiyeti SYNTAX skoru ile değerlendirildi. Hastalar apikal trombüs varlığı (n=19) veya yokluğuna (n=186) göre iki gruba ayrıldı.
Sonuç: Apikal trombüs olan grupta sistolik ve diyastolik kan basıncı daha düşük olarak bulundu(p<0.001 her ikisi için). Apikal trombüs saptanan hastalarda SYNTAX skoru daha yüksek Sol Ventriküler Atım Oranı (SVAO)daha düşük olarak saptandı(p<0.001 her ikisi için). Çok değişkenli analizde SYNTAX skoru (p=0.003), düşük sistolik kan basıncı varlığı(p=0.006) ve düşük SVAO(p=0.001)’ın SV apikal trombüs oluşumunu bağımsız olarak öngördürdüğünü saptadık.
Tartışma: Çalışmamızda azalmış SVAO, düşük sistolik kan basıncı ve yüksek SYNTAX skorunun (>18.25) perkütan koroner girişim uygulanan AMİ hastalarında SV trombüs oluşumu açısından bu hasta grubunun yakın takip edilmesi akılcı bir yaklaşım olabilir.

Anahtar Kelimeler

Sol Ventrikül,, Trombüs,, SYNTAX skoru

Predictors Of Left Ventricular Apical Thrombus Formation in Patients With Acute Anterior Myocardial Infarction and Treated Primary Percutaneous Coronary Intervention: Importance of Syntax Score

Öz

Aim: Left ventricular (LV) apical thrombus development is one of the important advers event patients with anterior ST elevation myocardial infarction (STEMI) and accompanies with LV apical aneurysm and systolic dysfunction. SYNTAX score is an important determinant of cardiovascular morbidity and mortality in patients with coronary artery disease. We aimed that the relationship between LV apical thrombus and SYNTAX score and other clinical risk factors patients with anterior STEMI

Methods: A total of 205 consecutive anterior STEMI patients undergoing primary PCI (35 female/ 170 male mean age: 55.8 ± 9.6 years) were included in our study. We assessed the severity and complexity of coronary artery disease by using SYNTAX score. The patients were divided into two groups; patients with apical thrombus (n=19) and patients without apical thrombus(n=186).

Results: We found that systolic and diastolic blood pressure were lower patients with apical thrombus groups. (p<0.001 for both). Syntax score was higher and LV ejection fraction (LVEF) is lower in patients with apical thrombus (p<0.001 for both). We also showed that LV apical thrombus formation was independently associated with lower systolic blood pressure (p=0.006), SYNYAX score (p=0.003), and depressed LVEF (p=0.001).

Conclusion: In this study, impaired LVEF, lower systolic blood pressure and SYNTAX score have been found to be predictors of LV thrombus generation. Patients presenting with anterior myocardial infarction who have high SYNTAX scores (> 18.25) at PPCI should be followed up closely.

Anahtar Kelimeler

Left Ventricul, Thrombus, SYNTAX score

Kaynakça

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