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Akut miyokard infarktüsünde yeni gelişen atriyal fibrilasyon ile SYNTAX skoru arasındaki ilişki

Year 2018, Volume: 9 Issue: 3, 7 - 14, 06.12.2018
https://doi.org/10.22312/sdusbed.467690

Abstract

Amaç: Atriyal fibrilasyon (AF) akut miyokard infarktüsü (AMİ)
sonrası en sık görülen ritim bozukluğu olup kısa ve uzun dönem prognozu olumsuz
yönde etkilemektedir. Koroner arter hastalığı (KAH) AF gelişimi için bağımsız
bir risk faktörüdür. SYNTAX (SYNergy between PCI with TAXUS and Cardiac Surgery) skorlama
sistemi, revaskülarizasyon öncesi, kantitatif ve tekrarlanabilir temel bir ölçüm
olması nedeniyle koroner anatomik ciddiyet ve karmaşıklığı gösterebilir.
Bilgimize göre SYNTAX skoru ile AF arasındaki ilişki araştırılmamıştır. Bu
nedenle AMİ ‘li hastalarda yeni gelişen AF ile SYNTAX skoru arasındaki ilişkiyi
araştırmayı amaçladık.



Metod: AMİ tanısıyla Ocak 2015-Haziran 2016 tarihleri arasında
kliniğimize yatırılan 350 hasta retrospektif olarak çalışmaya alındı.
Hastaların 273’ü (%78) erkekti. Hastaların 23 ‘ü dışlandı. Hastaların
demografik ve klinik özellikleri kaydedildi ve hastalar düşük SYNTAX skorlu ve
orta-yüksek SYNTAX skorlu olmak üzere iki gruba ayrıldı. SYNTAX skoru ile AF
gelişimi arasındaki ilişki değerlendirildi. AF gelişen hastaların bağımsız
belirteçleri çoklu regresyon analizine ile belirlendi.



Bulgular: Çalışmaya dahil edilen 327 hastanın 255’i (%77,8) düşük
SYNTAX skorlu iken 72’si (%22,2) orta-yüksek SYNTAX skorlu idi. Hastaların
37’inde (%10,6) takipte AF gelişti. Düşük ve orta-yüksek SYNTAX skorlu grupta
AF gelişme sıklığı benzer bulundu (%9,4’a karşılık %12,5, p=0,442). Çoklu
regresyon analizi sonucunda hastanede ADEİ başlanması (Olasılık oranı=0,362,
%95 güven aralığı 0,157-0,835, p=0,017), hastaların yaşı (Olasılık oranı=1,041,
%95 güven aralığı 1,008-1,075 p=0,014) ve KYBÜ’sinde yatış süresinin (Olasılık
oranı=2,911, %95 güven aralığı 1,595-5,315, p=0,001) AF gelişim riskiyle
bağımsız ilişkili olduğu saptandı.



Sonuç: AMİ hastalarında AF gelişimi ile SYNTAX skoru arasında
ilişki saptanmadı. Bu çalışmada yaş, yatış sonrası ADEİ başlanması ve KYBÜ
yatış süresi AF gelişimi ile bağımsız ilişkili olduğu gösterildi. 

References

  • 1. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart. 2001; 86(5): 516- 21.
  • 2. European Heart Rhythm A, European Association for Cardio-Thoracic S, Camm AJ, Kirchhof P, Lip GY, Schotten U, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2010; 12(10): 1360- 420.
  • 3. Adalet K. Klinik Kardiyoloji Tanı Ve Tedavi Kısım XI. Kalp ritim ve ileti bozuklukları, atriyal fibrilasyon. İstanbul Tıp Kitabevi; 2013. p. 819- 44.
  • 4. Knecht S, Oelschlager C, Duning T, Lohmann H, Albers J, Stehling C, et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. European heart journal. 2008; 29(17): 2125- 32.
  • 5. Schmitt J, Duray G, Gersh BJ, Hohnloser SH. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. European heart journal. 2009; 30(9): 1038- 45.
  • 6. Mehta RH, Dabbous OH, Granger CB, Kuznetsova P, Kline-Rogers EM, Anderson FA, Jr., et al. Comparison of outcomes of patients with acute coronary syndromes with and without atrial fibrillation. The American journal of cardiology. 2003; 92(9): 1031- 6.
  • 7. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2005; 1(2): 219- 27.
  • 8. Palmerini T, Genereux P, Caixeta A, Cristea E, Lansky A, Mehran R, et al. Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial. Journal of the American College of Cardiology. 2011; 57(24): 2389- 97.
  • 9. Magro M, Nauta S, Simsek C, Onuma Y, Garg S, van der Heide E, et al. Value of the SYNTAX score in patients treated by primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: The MI SYNTAXscore study. American heart journal. 2011; 161(4): 771- 81.
  • 10. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Global heart. 2012; 7(4): 275- 95.
  • 11. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European heart journal. 2007; 28(12): 1462- 536.
  • 12. Ryden L, Standl E, Bartnik M, Van den Berghe G, Betteridge J, de Boer MJ, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). European heart journal. 2007; 28(1): 88- 136.
  • 13. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European heart journal. 2011; 32(14): 1769- 818.
  • 14. Authors/Task Force m, Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European heart journal. 2014; 35(37): 2541- 619.
  • 15. Malkin CJ, George V, Ghobrial MS, Krishnan A, Siotia A, Raina T, et al. Residual SYNTAX score after PCI for triple vessel coronary artery disease: quantifying the adverse effect of incomplete revascularisation. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2013; 8(11): 1286- 95.
  • 16. Uyarel H, Onat A, Yuksel H, Can G, Ordu S, Dursunoglu D. [Incidence, prevalence, and mortality estimates for chronic atrial fibrillation in Turkish adults]. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2008; 36(4): 214- 22.
  • 17. Pedersen OD, Bagger H, Kober L, Torp-Pedersen C. The occurrence and prognostic significance of atrial fibrillation/-flutter following acute myocardial infarction. TRACE Study group. TRAndolapril Cardiac Evalution. European heart journal. 1999; 20(10): 748- 54.
  • 18. Baykan M, Çelik Ş, Erdöl C, Durmuş İ, Örem C, Küçükosmanoğlu M, et al. Effects of P‐wave Dispersion on Atrial Fibrillation in Patients with Acute Anterior Wall Myocardial Infarction. Annals of Noninvasive Electrocardiology. 2003; 8(2): 101- 6.
  • 19. Asanin M, Perunicic J, Mrdovic I, Matic M, Vujisic‐Tesic B, Arandjelovic A, et al. Prognostic significance of new atrial fibrillation and its relation to heart failure following acute myocardial infarction. European journal of heart failure. 2005; 7(4): 671- 6.
  • 20. Ozaydin M, Turker Y, Erdogan D, Karabacak M, Dogan A, Varol E, et al. The association between previous statin use and development of atrial fibrillation in patients presenting with acute coronary syndrome. International journal of cardiology. 2010; 141(2): 147- 50.
  • 21. Ramani G, Zahid M, Good CB, Macioce A, Sonel AF. Comparison of frequency of new-onset atrial fibrillation or flutter in patients on statins versus not on statins presenting with suspected acute coronary syndrome. The American journal of cardiology. 2007; 100(3): 404- 5.
  • 22. Pizzetti F, Turazza FM, Franzosi MG, Barlera S, Ledda A, Maggioni AP, et al. Incidence and prognostic significance of atrial fibrillation in acute myocardial infarction: the GISSI-3 data. Heart. 2001; 86(5): 527- 32.
  • 23. Avezum A, Makdisse M, Spencer F, Gore JM, Fox KA, Montalescot G, et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). American heart journal. 2005; 149(1): 67- 73.
  • 24. Wong C-K, White HD, Wilcox RG, Criger DA, Califf RM, Topol EJ, et al. New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. American heart journal. 2000; 140(6): 878- 85.
  • 25. Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, et al. Acute myocardial infarction complicated by atrial fibrillation in the elderly. Circulation. 2000; 101(9): 969- 74.
  • 26. Al-Khatib SM, Pieper KS, Lee KL, Mahaffey KW, Hochman JS, Pepine CJ, et al. Atrial fibrillation and mortality among patients with acute coronary syndromes without ST-segment elevation: results from the PURSUIT trial. The American journal of cardiology. 2001; 88(1): 76- 9.
  • 27. Crenshaw BS, Ward SR, Granger CB, Stebbins AL, Topol EJ, Califf RM. Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. Journal of the American College of Cardiology. 1997; 30(2): 406- 13.
  • 28. Danchin N, Fauchier L, Marijon E, Barnay C, Furber A, Mabo P, et al. Impact of early statin therapy on development of atrial fibrillation at the acute stage of myocardial infarction: data from the FAST-MI register. Heart. 2010; 96(22): 1809- 14.
  • 29. Dziewierz A, Siudak Z, Rakowski T, Jakala J, Dubiel JS, Dudek D. Prognostic significance of new onset atrial fibrillation in acute coronary syndrome patients treated conservatively. Cardiol J. 2010; 17(1): 57- 64.
  • 30. Gorenek B, Kudaiberdieva G. Atrial fibrillation in acute ST-elevation myocardial infarction: clinical and prognostic features. Current cardiology reviews. 2012; 8(4): 281- 9.
Year 2018, Volume: 9 Issue: 3, 7 - 14, 06.12.2018
https://doi.org/10.22312/sdusbed.467690

Abstract

References

  • 1. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart. 2001; 86(5): 516- 21.
  • 2. European Heart Rhythm A, European Association for Cardio-Thoracic S, Camm AJ, Kirchhof P, Lip GY, Schotten U, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2010; 12(10): 1360- 420.
  • 3. Adalet K. Klinik Kardiyoloji Tanı Ve Tedavi Kısım XI. Kalp ritim ve ileti bozuklukları, atriyal fibrilasyon. İstanbul Tıp Kitabevi; 2013. p. 819- 44.
  • 4. Knecht S, Oelschlager C, Duning T, Lohmann H, Albers J, Stehling C, et al. Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. European heart journal. 2008; 29(17): 2125- 32.
  • 5. Schmitt J, Duray G, Gersh BJ, Hohnloser SH. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. European heart journal. 2009; 30(9): 1038- 45.
  • 6. Mehta RH, Dabbous OH, Granger CB, Kuznetsova P, Kline-Rogers EM, Anderson FA, Jr., et al. Comparison of outcomes of patients with acute coronary syndromes with and without atrial fibrillation. The American journal of cardiology. 2003; 92(9): 1031- 6.
  • 7. Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2005; 1(2): 219- 27.
  • 8. Palmerini T, Genereux P, Caixeta A, Cristea E, Lansky A, Mehran R, et al. Prognostic value of the SYNTAX score in patients with acute coronary syndromes undergoing percutaneous coronary intervention: analysis from the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial. Journal of the American College of Cardiology. 2011; 57(24): 2389- 97.
  • 9. Magro M, Nauta S, Simsek C, Onuma Y, Garg S, van der Heide E, et al. Value of the SYNTAX score in patients treated by primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: The MI SYNTAXscore study. American heart journal. 2011; 161(4): 771- 81.
  • 10. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Global heart. 2012; 7(4): 275- 95.
  • 11. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European heart journal. 2007; 28(12): 1462- 536.
  • 12. Ryden L, Standl E, Bartnik M, Van den Berghe G, Betteridge J, de Boer MJ, et al. Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). European heart journal. 2007; 28(1): 88- 136.
  • 13. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European heart journal. 2011; 32(14): 1769- 818.
  • 14. Authors/Task Force m, Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). European heart journal. 2014; 35(37): 2541- 619.
  • 15. Malkin CJ, George V, Ghobrial MS, Krishnan A, Siotia A, Raina T, et al. Residual SYNTAX score after PCI for triple vessel coronary artery disease: quantifying the adverse effect of incomplete revascularisation. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2013; 8(11): 1286- 95.
  • 16. Uyarel H, Onat A, Yuksel H, Can G, Ordu S, Dursunoglu D. [Incidence, prevalence, and mortality estimates for chronic atrial fibrillation in Turkish adults]. Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir. 2008; 36(4): 214- 22.
  • 17. Pedersen OD, Bagger H, Kober L, Torp-Pedersen C. The occurrence and prognostic significance of atrial fibrillation/-flutter following acute myocardial infarction. TRACE Study group. TRAndolapril Cardiac Evalution. European heart journal. 1999; 20(10): 748- 54.
  • 18. Baykan M, Çelik Ş, Erdöl C, Durmuş İ, Örem C, Küçükosmanoğlu M, et al. Effects of P‐wave Dispersion on Atrial Fibrillation in Patients with Acute Anterior Wall Myocardial Infarction. Annals of Noninvasive Electrocardiology. 2003; 8(2): 101- 6.
  • 19. Asanin M, Perunicic J, Mrdovic I, Matic M, Vujisic‐Tesic B, Arandjelovic A, et al. Prognostic significance of new atrial fibrillation and its relation to heart failure following acute myocardial infarction. European journal of heart failure. 2005; 7(4): 671- 6.
  • 20. Ozaydin M, Turker Y, Erdogan D, Karabacak M, Dogan A, Varol E, et al. The association between previous statin use and development of atrial fibrillation in patients presenting with acute coronary syndrome. International journal of cardiology. 2010; 141(2): 147- 50.
  • 21. Ramani G, Zahid M, Good CB, Macioce A, Sonel AF. Comparison of frequency of new-onset atrial fibrillation or flutter in patients on statins versus not on statins presenting with suspected acute coronary syndrome. The American journal of cardiology. 2007; 100(3): 404- 5.
  • 22. Pizzetti F, Turazza FM, Franzosi MG, Barlera S, Ledda A, Maggioni AP, et al. Incidence and prognostic significance of atrial fibrillation in acute myocardial infarction: the GISSI-3 data. Heart. 2001; 86(5): 527- 32.
  • 23. Avezum A, Makdisse M, Spencer F, Gore JM, Fox KA, Montalescot G, et al. Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE). American heart journal. 2005; 149(1): 67- 73.
  • 24. Wong C-K, White HD, Wilcox RG, Criger DA, Califf RM, Topol EJ, et al. New atrial fibrillation after acute myocardial infarction independently predicts death: the GUSTO-III experience. American heart journal. 2000; 140(6): 878- 85.
  • 25. Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, et al. Acute myocardial infarction complicated by atrial fibrillation in the elderly. Circulation. 2000; 101(9): 969- 74.
  • 26. Al-Khatib SM, Pieper KS, Lee KL, Mahaffey KW, Hochman JS, Pepine CJ, et al. Atrial fibrillation and mortality among patients with acute coronary syndromes without ST-segment elevation: results from the PURSUIT trial. The American journal of cardiology. 2001; 88(1): 76- 9.
  • 27. Crenshaw BS, Ward SR, Granger CB, Stebbins AL, Topol EJ, Califf RM. Atrial fibrillation in the setting of acute myocardial infarction: the GUSTO-I experience. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. Journal of the American College of Cardiology. 1997; 30(2): 406- 13.
  • 28. Danchin N, Fauchier L, Marijon E, Barnay C, Furber A, Mabo P, et al. Impact of early statin therapy on development of atrial fibrillation at the acute stage of myocardial infarction: data from the FAST-MI register. Heart. 2010; 96(22): 1809- 14.
  • 29. Dziewierz A, Siudak Z, Rakowski T, Jakala J, Dubiel JS, Dudek D. Prognostic significance of new onset atrial fibrillation in acute coronary syndrome patients treated conservatively. Cardiol J. 2010; 17(1): 57- 64.
  • 30. Gorenek B, Kudaiberdieva G. Atrial fibrillation in acute ST-elevation myocardial infarction: clinical and prognostic features. Current cardiology reviews. 2012; 8(4): 281- 9.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Araştırma Articlesi
Authors

Ali Bağcı 0000-0002-8792-6329

Fatih Aksoy 0000-0002-6480-4935

Tülay Oskay This is me 0000-0003-2801-7819

İsmail Barkın Işık 0000-0002-7193-827X

Yasin Türker 0000-0002-5157-4624

Yunus Emre Okudan This is me 0000-0003-1330-1884

Ahmet Altınbaş 0000-0002-1813-9305

Ercan Varol 0000-0003-3460-6011

Mustafa Karabacak 0000-0001-6879-5522

Publication Date December 6, 2018
Submission Date October 5, 2018
Published in Issue Year 2018 Volume: 9 Issue: 3

Cite

Vancouver Bağcı A, Aksoy F, Oskay T, Işık İB, Türker Y, Okudan YE, Altınbaş A, Varol E, Karabacak M. Akut miyokard infarktüsünde yeni gelişen atriyal fibrilasyon ile SYNTAX skoru arasındaki ilişki. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2018;9(3):7-14.

SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.