Acil Servise Göğüs Ağrısı Şikayeti ile Başvuran Hastalarda Akut Koroner Sendromun Risk Faktörleri ile Sağlıklı Yaşam Biçimi Davranışları Arasındaki İlişki

Öz

Amaç: Göğüs ağrısı, akut koroner sendromun potansiyel semptomlarından biridir ve dünyada acil başvuruları arasında ikinci sıradadır. Akut koroner sendrom dünya genelinde 45 yaş altı hastalarda görülme eğilimi göstermektedir. Acil servisten kardiyoloji polikliniğine yönlendirilen yüksek riskli akut koroner sendrom hastalarının başvurularının ve morbidite/mortalite oranlarının azaltılması için, uzun vadede kaliteli ve engelsiz bir yaşam sürecine katkıda bulunulabilmesi, sağlıklı yaşam biçimi davranışları ile ilişkilidir. Gereç ve Yöntemler: A1 Dal Eğitim Araştırma Hastanesi Ocak-Mart 2022 tarihleri arasında göğüs ağrısı şikayeti ile acile başvuran 70 gönüllü hastada akut koroner sendrom risk faktörleri ile sağlıklı yaşam biçimi davranışları arasındaki ilişkiyi belirlemek amacıyla bu çalışma kesitsel ve ilişki arayıcı dizaynda yapılmıştır. Akut koroner sendrom risk faktörleri ile sağlıklı yaşam tarzı davranışları arasındaki ilişkiler Sağlıklı Yaşam Tarzı Davranışları Ölçeği-II kullanılarak incelenmiştir. Bulgular: Çalışma katılımcılarının yaş ortalaması 55.06±14.06 idi, %31.43’ü kadındı. Sağlıklı Yaşam Tarzı Davranışları Ölçeği-II’nde toplam puan 91 ile 171 arasında değişirken ortalama 130.23±19.14 idi. Akut koroner sendrom risk faktörlerinin ile HLBS-II arasındaki birlikte ilişkisi incelendi. Ağrı süresi, ağrı şiddeti, troponin ile sağlık sorumluluğu fiziksel aktivite ve diyet puanları arasında pozitif yönde orta düzeyde istatistiksel olarak anlamlı ilişki bulundu (p<0.05). Sonuç: Acil servise göğüs ağrısı şikayeti ile ayaktan başvuran olası akut koroner sendrom hastalarının Sağlıklı Yaşam Tarzı Davranışları Ölçeği-II ile ilişkisinin belirlenmesi, özellikle değiştirilebilir risk faktörlerinin ilk gelişiminin önlenmesi, farkındalığın artması ve yaşam kalitesinin artmasına yönelik etkili ve etkin davranışçı yaşam biçimlerinin geliştirilmesi ile ilişkilidir.

Anahtar Kelimeler

• Göğüs ağrısı
• akut koroner sendrom
• sağlıklı yaşam davranışı
• acil servis
• risk faktörleri

THE RELATIONSHIP BETWEEN RISK FACTORS OF ACUTE CORONARY SYNDROME AND HEALTHY LIFESTYLE BEHAVIORS IN PATIENTS WHO APPLIED TO THE EMERGENCY DEPARTMENT WITH CHEST PAIN

Öz

Objective: Chest pain is one of the potential symptoms of acute coronary syndrome and is the second most common emergency worldwide. Acute coronary syndrome tends to be seen in patients aged <45 years throughout the world. To be able to reduce the admission of patients with high-risk acute coronary syndrome referred to the cardiology polyclinic from the Emergency Department and decrease the morbidity/mortality rates, the association of acute coronary syndrome with healthy lifestyle behaviours should be examined, which will also contribute to a long-term high-quality and disability-free life. Material and Methods: This cross-sectional study included 70 patients who presented with complaints of chest pain at the emergency department of an A1 Branch Training and Research Hospital between January and March 2022. The relationships were examined between acute coronary syndrome risk factors and healthy lifestyle behaviours using the Healthy Lifestyle Behaviours Scale-II. Results: In the study population, mean age was 55.06±14.06 years. Of the study population, 31.43% were women. The mean total score in Healthy Lifestyle Behaviours Scale-II was 130.23±19.14, ranging from 91 to 171. The relationship between ACS risk factors and Healthy Lifestyle Behaviours Scale-II examined. A statistically significant medium level positive correlation was found between pain duration, pain severity, troponin with the health responsibility physical activity and diet points (p<0.05). Conclusion: Determining the relationship between possible acute coronary syndrome patients presenting at emergency department with chest pain complaints and the Healthy Lifestyle Behaviours Scale-II is associated with the prevention of initial development of modifiable risk factors, increased awareness and the development of effective and effective behavioural lifestyles to increase the quality of life.

Anahtar Kelimeler

• Chest Pain
• acute coronary syndrome
• emergency service
• healthy lifestyle behaviour
• risk factors

Kaynakça

1. Andruchow JE, Kavsak PA, McRae AD, Mark DG, Huang J, Chettipally U et al. Performance of coronary risk scores among patients with chest pain in the emergency department. Journal Of The American College Of Cardıology. 2018;71(6):606-16. 
2. Ferencik M, Mayrhofer T, Bittner DO, Emami H, Puchner SB, Lu MT et al. atherosclerotic plaque detection for risk stratification of patients with stable chest pain. JAMA Cardiol. 2018;3(2):144-52. 
3. Mahler SA, Lenoir KM, Wells BJ, Burke GL, Dun-can PW, Case LD et al. Safely identifying emer-gency department patients with acute chest pain for early discharge. Circulation 2018;138(22):2456-68. 
4. Laureano-Phillips J, Robinson R, Aryal S, Blair S, Wilson D, Boyd K et al. HEART score risk stratifi-cation of low-risk chest pain patients in the emer-gency department: a systematic review and meta-analysis. Annals of Emergency Medicine. 2019;74(2):187-203. 
5. Global Burden of Cardiovascular Diseases Colla-boration, Roth GA, Johnson CO, Abate KH, Abd-Allah F, Ahmed M, Alam K et al. The burden of cardiovascular diseases among US States, 1990-2016. JAMA Cardiology. 2018;3(5):375-89.
6. Yılmaz S, Coşansu K. Prognostic factors and outcomes in young patients with presented of dif-ferent types acute coronary syndrome. Angiology. 2020;71(10):894-902. 
7. Yüksel H. Contribution of TEKHARF study to medical science in recent years. Turk Kardiyol Dern Ars. 2018;46(7):519-524. 
8. Walker SN, Sechrist KR, Pender NJ. The health promoting lifestyle profile development and psychometric characteristics. Nursing Research 1987;36(2):76-81.

9. Bahar Z, Beşer A, Gördes N, Ersin F, Kıssal A. Healthy life style behavior scale II: A reliability and validity study. C.Ü.Hemşirelik Yüksekokulu Dergisi. 2008;12(1):1-12.
10. Baresko J, Rienks J, Nöthlings U. Lifestyle indices and cardiovascular disease risk: A meta-analysis. American Journal of Preventive Medicine. 2018;55(4):555-64. 
11. Wu S, An S, Li W, Lichtenstein AH, Gao J, Kris-Etherton PM et al. Association of trajectory of cardiovascular health score and incident cardio-vascular disease. JAMA Network Open. 2019;2(5):194758. 
12. Gutierrez JD, Canela MR, Gea A, Montero AF, Gonzalez AM. Association between a healthy li-festyle score and the risk of cardiovascular disea-se in the sun. Cohort. 2018;71(12):1001-9. 
13. Nowbar AN, Gitto M, Howard JP, Francis DP, Al-Lamee R. Mortality From Ischemic Heart Disea-se. Analysis of Data From the World Health Or-ganization and Coronary Artery Disease Risk Factors From NCD Risk Factor Collaboration. Circulation: Cardiovascular Quality and Outco-mes. 2019;12(6):e005375. 
14. Tokaldany M, Shahmansouri N, Karimi A, Sa-deghian S, Saadat S, Abbasi SH et al. Association between illness perception and health-related qua-lity of life in patients with preexisting premature coronary artery disease. Journal of Psychosoma-tic Research. 2019;120:118-23. 
15. Salas-Salvado J, Dıaz-Lopez A, Ruiz-Canela M, Basora J, Fito M, Corella D et al. Effect of a li-festyle ıntervention program with energy-restricted mediterranean diet and exercise on we-ight loss and cardiovascular risk factors: one-year results of the PREDIMED-Plus trial. Diabetes Ca-re. 2019;42(5):777–88 
16. Nyberg ST, Singh-Manoux A, Pentti J, Mandse EH, Sabia S, Alfredsson L et al. Association of healthy lifestyle with years lived without major chronic diseases. JAMA Intern Med. 2020;180(5):760-8. 
17. Petiot EV,  Ford R, Greenlaw N, Ferrari R, Fox K, Tardif C et al. Cardiovascular event rates and mortality according to achieved systolic and dias-tolic blood pressure in patients with stable coro-nary artery disease: an international cohort study .The Lancet. 2016; 388(10056):2142-52. 
18. Islam FMA, Lambert EA, Islam ŞMŞ, Islam MA, Biswas D, Mcdonald R et al. Lowering blood pres-sure by changing lifestyle through a motivational education program: a cluster randomized control-led trial study protocol. Trials. 2021;22(438):3-11. 
19. Rozanski A, Bavishi C, Kubzansky LD, Cohen R. et al. Association of optimism with cardiovascular events and all-cause mortality. JAMA Netw Open. 2019;2(9):e1912200. 
20. Stepinska J, Lettino M, Ahrens I, Bueno H, Gar-cia-Castrillo L, Khoury A et al. Diagnosis and risk stratification of chest pain patients in the emer-gency department: Focus on acute coronary syndromes. A position paper of the Acute Cardi-ovascular Care Association. European Heart Jo-urnal. Acute Cardiovascular Care. 2020;9(1):76-89. 
21. Januzzi JL, McCarthy CP. Evaluating Chest pain in the emergency department. Journal Of The American College Of Cardiology. 2018;71(6):20. 
22. Montassier E, Batard E, Gueffet JP, Trewick D, Le Conte P. Outcome of chest pain patients dischar-ged from a French emergency department: A 60-day prospective study. J Emerg Med. 2012;42(3):341-4. 
23. Gulati M, Levy PD,  Mukherjee VCD, Amsterdam E, Bhatt DL, Birtcher KK et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain. Journal Of The American College Of Cardiology. 2021;144(22):e368-e454.