The Effects of Previous Regular Use of Acetylsalicylic Acid on TIMI Flow Grade and Myocardial Damage in Patients Presenting with Acute Coronary Syndrome

Öz

Objective: Cardiovascular diseases are the leading cause of death worldwide. Antiaggregant therapies have an important place in the secondary prevention of cardiovascular diseases. In this study, the effects of regular use of acetylsalicylic acid on TIMI flow grade and myocardial damage will be investigated in patients presenting with acute coronary syndrome. Methods: The patients who admitted with the clinic of acute coronary syndrome and underwent coronary angiography were included in the study, retrospectively. The patients were divided into two groups as those who used acetylsalicylic acid regularly (group 1) and those who never used acetylsalicylic acid (group 2). Demographic data, laboratory data, TIMI flow grade and troponin-I values as a marker of myocardial damage were compared between the groups. Results: 440 patients were included in the study. There were 122 patients in group 1(mean age 64.9±1.0 years; 25(20.5%) women) and 318 patients in group 2(mean age 61.0±0.7 years; 83(26.1%) women). Advanced age, hypertension, diabetes mellitus, hyperlipidemia and history of coronary artery disease were observed at a higher rate in group 1. TIMI-0 flow was observed at a significantly lower rate in patients in group 1(30.3% vs. 47.8%; p=0.004). Additionally, the maximum measured troponin values of the patients in group 1 were found significantly lower (median 5486 pg/ml vs. 15740 pg/ml; p<0.001). Conclusion: TIMI flow grades were higher and the amount of enzymatic myocardial damage was found less in patients who admitted with the clinic of acute coronary syndrome and used previously regular acetylsalicylic acid. Thus, the importance of secondary protection was emphasized once again in this study.

Anahtar Kelimeler

• Acetylsalicylic acid
• acute coronary syndrome
• TIMI flow grade
• myocardial damage

Akut Koroner Sendrom ile Başvuran Hastalarda Daha Önceden Düzenli Asetilsalisilik Asit Kullanımının TIMI Akımı ve Miyokardiyal Hasar Üzerine Etkileri

Öz

Amaç: Kardiyovasküler hastalıklar, dünya çapında önde gelen en önemli ölüm nedenidir. Kardiyovasküler hastalıkların sekonder korumasında antiagregan tedaviler önemli bir yer tutmaktadır. Bu çalışma ile; akut koroner sendrom ile başvuran hastalarda, daha önceden düzenli asetilsalisilik asit kullanımının TIMI akımı ve miyokardiyal hasar üzerine olan etkileri araştırılacaktır. Yöntem: Çalışmaya retrospektif olarak akut koroner sendrom kliniği ile başvurmuş ve koroner anjiyografi yapılmış hastalar alındı. Hastalar daha önceden düzenli asetilsalisilik asit kullanan (grup 1) ve hiç asetilsalisilik asit kullanmayanlar olarak (grup 2) iki gruba ayrıldı. Gruplar arasında demografik veriler, laboratuvar verileri, TIMI akımları ve miyokardial hasar belirteci olarak troponin I değerleri karşılaştırıldı. Bulgular: Çalışmaya 440 hasta alındı. Grup 1’de 122 hasta (yaş ortalaması 64.9±1 yıl; 25 (%20.5) kadın) ve grup 2’de 318 hasta (yaş ortalaması 61±0.7 yıl; 83 (%26.1) kadın) yer aldı. Grup 1’de ileri yaş, hipertansiyon, diyabetes mellitus, hiperlipidemi ve koroner arter hastalığı öyküsü daha yüksek oranda gözlendi. Grup 1’deki hastalarda TIMI-0 akım grup 2’ye göre anlamlı olarak daha düşük oranda gözlendi (%30.3’e karşın, %47.8; p=0.004). Bunun yanı sıra; grup 1’deki hastaların maksimum ölçülen troponin I değerleri grup 2’deki hastalara göre anlamlı olarak daha düşük düzeyde bulundu (median 5486 pg/ml’ye karşın 15740 pg/ml; p <0.001). Sonuç: Akut koroner sendrom kliniği ile başvurmuş ve daha önceden düzenli asetilsalisilik asit kullanan hastalarda TIMI akım dereceleri daha yüksek ve enzimatik miyokardiyal hasar miktarı daha az bulunmuştur. Böylelikle sekonder korumanın önemi bu çalışmayla bir kez daha vurgulanmıştır.

Anahtar Kelimeler

• Asetilsalisilik asit
• akut koroner sendrom
• TIMI akım derecesi
• miyokardiyal hasar

Kaynakça

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