Predictive Value of Previous Coronary Angiography in Acute Coronary Syndrome

Öz

Objective: We aimed to evaluate patients presenting to the emergency department with chest pain in terms of acute coronary syndrome (ACS) risk based on previous coronary angiography (CAG) findings and recent cardiology evaluations. Material and Method: Patients presenting with chest pain were prospectively evaluated and categorized according to the development of major adverse cardiac events (MACE). Prior angiographic findings and recent cardiology evaluations were analyzed for their association with short-term outcomes. Results: A total of 159 patients were included. When patients with and without MACE were compared in terms of significant CAG findings within the last year, no statistically significant difference was observed between the groups (p = 0.576). However, coronary artery disease risk identified during recent cardiology evaluations was significantly higher in patients who developed MACE compared with those who did not (p = 0.022). Conclusion: Prior angiographic stenosis alone does not appear to predict acute adverse cardiac events in emergency presentations. However, recent cardiology evaluations identifying coronary risk may provide more meaningful insight into short-term clinical outcomes.

Anahtar Kelimeler

• chest pain;
• acute coronary syndrome;
• coronary angiography;
• major adverse cardiac events;

Önceki Koroner Anjiyografinin Akut Koroner Sendromu Öngörmedeki Değeri

Öz

Amaç: Acil servise göğüs ağrısı ile başvuran hastaları, önceki koroner anjiyografi (KAG) bulguları ve yakın dönem kardiyoloji değerlendirmeleri temelinde akut koroner sendrom (AKS) riski açısından değerlendirmeyi amaçladık. Gereç ve Yöntem: Göğüs ağrısı ile başvuran hastalar prospektif olarak değerlendirildi ve majör advers kardiyak olay (MACE) gelişimine göre sınıflandırıldı. Önceki anjiyografik bulgular ile yakın dönem kardiyoloji değerlendirmelerinin kısa dönem sonuçlarla ilişkisi analiz edildi. Bulgular: Toplam 159 hasta çalışmaya dahil edildi. Son bir yıl içinde anlamlı KAG bulguları açısından MACE gelişen ve gelişmeyen hastalar karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı fark saptanmadı (p = 0.576). Ancak yakın dönem kardiyoloji değerlendirmelerinde koroner arter hastalığı riski belirlenen hastalarda MACE gelişimi, belirlenmeyenlere kıyasla anlamlı derecede daha yüksekti (p = 0.022). Sonuç: Önceki anjiyografik stenoz varlığı tek başına acil başvurularda gelişen akut kardiyak olayları öngörmede yeterli görünmemektedir. Buna karşın, yakın dönem kardiyoloji değerlendirmelerinde belirlenen koroner risk, kısa dönem klinik sonuçlar hakkında daha anlamlı bilgi sağlayabilir.

Anahtar Kelimeler

• göğüs ağrısı;
• akut koroner sendrom;
• koroner anjiyografi;
• majör advers kardiyak olaylar;

Kaynakça

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