Primer Perkütan Koroner Girişim Yapılan Hastalarda Akut Stent Trombozunu Öngörmek İçin R2CHA2DS2-VASc Skoru ile CHA2DS2-VASc Skorlarının Karşılaştırılması

Yıl 2021, Cilt: 5 Sayı: 2, 150 - 156, 30.08.2021

Çağrı Zorlu , Özge Kurmuş

https://doi.org/10.30565/medalanya.864907

Öz

Amaç: Akut stent trombozu (AST), özellikle ST segment yükselmesi olan miyokard infarktüsü (STYMI) hastalarında stent yerleştirildikten sonra ani damar tıkanıklığı sonucu oluşan önemli bir komplikasyondur. Primer perkütan koroner girişim sonrası hastaların yaklaşık% 1'inde ortaya çıkar. CHA2DS2-VASc skoru günlük pratikte kolayca uygulanır ve bu skorun bileşenleri AST'nin risk faktörlerine benzer. Kronik böbrek hastalığında pıhtılaşmaya meyilli bir duruma yol açabilir ve bu durum STYMI' da artmış AST riski ile ilişkilidir. CHA2DS2-VASc skoru renal disfonksiyonlu hastalarda yetersiz olduğundan AST'li hastalarda modifiye skor olan R2CHA2DS2-VASc skorunun prognostik önemini araştırmayı amaçladık.

Yöntem: STYMI sonrası 56 AST' li hasta ve AST'siz 1493 hasta retrospektif olarak bu kesitsel çalışmaya dahil edildi. CHA2DS2-VASc skoru ve R2CHA2DS2-VASc skoru iki grup arasında karşılaştırıldı.

Bulgular: Medyan CHA2DS2-VASc skoru ve medyan R2CHA2DS2-VASc skoru AST grubunda anlamlı olarak daha yüksekti (P <0.001, P <0.001). R2CHA2DS2-VASc skoru ≥2 iken %65 duyarlılık ve % 89 özgüllük ile AST' nin bir prediktörü olarak kullanılabilir.

Sonuç: R2CHA2DS2-VASc skoru, AST' yi tahmin edebilen basit, ucuz ve kolay erişilebilir bir skorlamadır.

Anahtar Kelimeler

akut stent trombozu, CHA2DS2-VASc skoru, R2CHA2DS2-VASc skoru, ST segment yükselmeli miyokard enfarktüsü

Comparison between R2CHA2DS2-VASc Score and CHA2DS2-VASc Score to Predict Acute Stent Thrombosis in Patients with After Primary Percutaneous Coronary Intervention

Öz

Aim: Acute stent thrombosis (AST) is an important complication resulting from sudden vascular occlusion after stent implantation, especially in patients with ST-segment elevation myocardial infarction (STEMI). It occurs in about 1% of the patients after primary percutaneous coronary intervention. The CHA2DS2-VASc score is easily applied in daily practice and the components of this score are similar to common risk factors of the AST. Chronic renal disease has a hypercoagulable state and this condition is associated with an increased risk of AST in STEMI. Since the CHA2DS2-VASc score is insufficient to assess the risk of AST in patients with renal dysfunction, we aimed to investigate the prognostic significance of the modified score, R2CHA2DS2-VASc score in patients with AST.

Methods:This cross-sectional study retrospectively included 56 patients withAST and 1493 patients without AST after STEMI. The CHA2DS2-VASc and R2CHA2DS2-VASc scores were compared between the two groups.

Results:The median CHA2DS2-VASc and R2CHA2DS2-VASc scores were significantly higher in the AST group (P <0.001, P <0.001, respectively). The R2CHA2DS2-VASc score ≥2 was used as a predictor of the AST with a sensitivity of 65% and specificity of 89%.

Conclusions: The R2CHA2DS2-VASc score is a simple, cheap, and easily accessible score that can predict AST.

Anahtar Kelimeler

Acute stent thrombosis, CHA2DS2-VASc score, R2CHA2DS2-VASc score, ST segment elevation myocardial infarction

Kaynakça

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