STABİL İSKEMİK KALP HASTALIĞINDA KORONER YAVAŞ AKIM VE CHA2 DS2 -VASC-HSF SKORU

Abstract

Amaç: Koroner yavaş akım fenomeni (KYA) ve nedenleri hala tam olarak açıklanamamıştır. Bu çalışmada stabil iskemik kalp hastalığında KYA tanısında CHA2DS2-VASc-HSF skorunun işlevselliğini ve kullanışlılığı araştırıldı. Gereç ve Yöntemler: Çalışmaya obstrüktif koroner arter hastalığı (KAH) olmayan ve koroner anjiyografi sonucunda KYA saptanan hastalar dahil edildi. KYA’lı hastalar olmayanlarla karşılaştırıldı. Koroner kan akış hızı, koroner anjiyografi görüntülerinden TIMI kare sayısı (TFC) hesaplanarak değerlendirildi. Hastaların geleneksel CHADS skorlarına ek olarak CHA2DS2-VASc-HSF skoru da hesaplandı. Bulgular: KYA’lı hastalar olmayan hastalara kıyasla daha yüksek CHA2DS2- VASc-HSF skoruna sahipti (3,75±1,27’ye karşı 2,85±1,11; p<0,001). İki grubun CHADS2 ve CHA2DS2-VASc skorları arasında fark yoktu. Lojistik regresyon modellerinde, CHA2DS2-VASc-HSF skoru ve Hs-troponin-T, KYA’nın bağımsız belirleyicileriydi. CHA2DS2-VASc-HSF skoru ve TFC, KYA grubunda pozitif korelasyon gösterdi (r=0,848, p<0,001). CHA2DS2-VAScHSF’nin KYA’nın varlığını tespit etmede duyarlılığı %56, özgüllüğü %74, kesme değeri ise 3,5 olarak belirlendi. Sonuç: Bu çalışma CHA2DS2-VASc-HSF skorunun KYA ile ilişkisini göstererek KYA ve ciddiyetini tahmin etmek için kullanılabileceğini düşündürmektedir.

Keywords

• CHA2DS2-VASc-HSF skoru
• koroner yavaş akım
• obstrüktif olmayan koroner arter

CORONARY SLOW FLOW AND CHA2 DS2 -VASC-HSF SCORE IN STABLE ISCHEMIC HEART DISEASE

Abstract

Objective: The coronary slow flow phenomenon (CSFP) and its causes are still not fully explained. We investigated the functionality and usefulness of the CHA2DS2-VASc-HSF score in the diagnosis of CSFP in stable ischemic heart disease. Material and Methods: Patients with no obstructive coronary artery disease (CAD) and CSFP detected as a result of coronary angiography were included in the study. Patients with CSFP were compared with those without. Coronary blood flow velocity was evaluated by calculating the TIMI frame count (TFC) from coronary angiography images. In addition to the traditional CHADS scores of the patients, the CHA2DS2-VASc-HSF score was also calculated. Results: According to our study results, the CHA2DS2-VASc-HSF score was higher in patients with CSFP than in those without (3.75±1.27 vs. 2.85±1.11; p<0.001). There was no difference between the CHADS2 and CHA2DS2-VASc scores of the two groups. In logistic regression models, Hs-troponin-T and CHA2DS2-VASc-HSF scores were determined as independent predictors of CSFP. CHA2DS2-VASc-HSF score and TFC were positively correlated in the CSFP group (r=0.848, p<0.001). The sensitivity of CHA2DS2-VASc-HSF was determined as 56%, the specificity was 74%, and the cut-off value was 3.5 in detecting the presence of CSFP. Conclusion: This study shows the association of CHA2DS2-VASc-HSF score with CSFP, suggesting that it can be used to predict CSFP and its severity

Keywords

• CHA2DS2-VASc-HSF score
• coronary slow flow
• non-obstructive coronary artery

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