ST yükselmeli miyokard infarktüsünde hastane içi atriyal fibrilasyon gelişmesinin belirleyicileri ve önemi
Küçük Resim Yok
Tarih
2008
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda ST elevasyonlu miyokard infarktüsü (STEMİ) ile başvuran hastalarda, hastane içi atriyal fibrilasyon (AF) gelişmesi açısından prediktörleri ve yeni gelişen AF’nin hastane içi gelişen komplikasyon ve mortalite üzerine etkisini belirlemeyi amaçladık. Gereç ve Yöntem: Çalışmaya toplam 90 STEMİ ile başvuran hasta alındı. Hastalar; ardışık hastane içi AF gelişmeyen 50 hasta (Grup I) ve ardışık hastane içi AF gelişen 40 hasta (Grup II) olarak ikiye ayrıldı. Grup II ise AF’un erken ya da geç gelişmesine göre iki kısımda incelendi. Gruplar arasındaki farklar; demografik özellikler, elektrokardiyografik, ekokardiyografik, koroner anjiyografik parametreler ve kan değerleri incelenerek belirlendi. Aynı zamanda hastane içi yatış süresi, komplikasyon ve hastane içi mortalite saptandı. Bulgular: Grup I’de yaş ortalaması 60.112.1 yıl, geç AF’de 73.010.7 yıl olarak bulundu (p0.05). Grup II’de ise hipertansiyon sıklığı %40, grup I’de %72 (p0.05)’di. Killip sınıfı ve TIMI risk skoru erken AF grubunda sırasıyla 2.250.85 ve 6.12.6 olarak bulundu. Erken AF ve grup I arasında Killip sınıfı ve TIMI risk skorunda anlamlı farklılık vardı (p0.05). Geç AF grubunda ejeksiyon fraksiyonu (EF) ve sol atriyum çapı sırasıyla %36.07.6 ve 3.90.35 cm. olarak bulunurken grup I’de aynı değerler %46.07.1 ve 3.60.4 cm. olarak hesaplandı (p0.05). Gensini skoru açısından gruplar arası fark yoktu (p0.05). Spontan sinüs ritmine dönüş %75 (30/40 ) hastada izlendi (p0.05). Hastane yatış süresi erken ve geç AF grubunda sırasıyla 6.22.5 gün ve 7.53.2 gün ve grup I için 3.21.7 gün olarak tesbit edildi. (p0.05). Hastane içi ölüm (HİÖ); geç AF’de %20(4/20) oranında izlendi ve grup I’de ise HİÖ gözlenmedi (p0.05). Sonuç: Akut miyokard infarktüsü seyri sırasında hastane içi AF gelişmesini etkileyen pek çok faktör vardır. AF gelişen hastalar laboratuar değerleri ve klinik olarak daha ciddi bulgulara sahiptirler. Bu komplikasyonun gelişmesi hastanede yatış süresini uzatmakta ve mortaliteyi artırmaktadır.
Aim: In this study we aimed to determine the predictors of new-onset atrial fibrillation (AF) in acute myocardial infarction (AMI) and the effects of AF to hospital stay and in-hospital complications and mortality. Material and Method: The study population included 90 patients with ST segment elevated MI (STEMI). The patients were divided two groups. First of this groups was consecutive 50 patients which no-AF develop in hospital (Grup I). Second of this groups was consecutive 40 patients which new-onset AF developed in hospital (Group II). Also second group was divided two subgroups. First of this subgroups was named early AF because of AF developed in first 24 hours in hospital. Second of this subgroups was named late AF because of AF developed after 24 hours in hospital. The differences of groups were determined by using some parameters such as; demographical features, electrocardiographic sings, echocardiographic measurement, angiographic scores and blood values. Hospital stay and in-hospital complications and mortality were determined. Results: Median age was 60.1±12.1 years in group I and 73.0±10.7 years in late AF group (p<0.05). The frequency of hypertension were 40% in group I and 72% in group II (p<0.05). Killip classes and TIMI risk scores were calculated as 2.0±0.65 ve 6.1±2.6 respectively in early AF group. There were differences in Killip classes and TIMI scores between early AF group and group I (p<0.05). Ejection fractions and left atrial diameter were calculated as 36.0%±7.6 and 3.9±0.35 cm. and 46.0%±7.1 ve 3.6±0.4 cm. in late AF group and group I respectively (p <0.05). Spontane sinus rhythm restoration was observed as 75% (30/40) (p<0.05). Hospital stay were found as 6.2±2.5 days, 7.5±3.2 days and 3.2±1.7 days in early AF group, late AF group and group I respectively (p<0.05). In-hospital mortaliy we re observed 20%(4/20) in late AF group and there were not observe in-hospital mortality in group I (p<0.05). Conclusion: New-onset AF during AMI in hospital was affected a lot of factors. The patients which developed new-onset AF during hospital in AMI had more severe clinical and laboratory outcomes likes hospital stay and in-hospital mortality than no-AF group
Aim: In this study we aimed to determine the predictors of new-onset atrial fibrillation (AF) in acute myocardial infarction (AMI) and the effects of AF to hospital stay and in-hospital complications and mortality. Material and Method: The study population included 90 patients with ST segment elevated MI (STEMI). The patients were divided two groups. First of this groups was consecutive 50 patients which no-AF develop in hospital (Grup I). Second of this groups was consecutive 40 patients which new-onset AF developed in hospital (Group II). Also second group was divided two subgroups. First of this subgroups was named early AF because of AF developed in first 24 hours in hospital. Second of this subgroups was named late AF because of AF developed after 24 hours in hospital. The differences of groups were determined by using some parameters such as; demographical features, electrocardiographic sings, echocardiographic measurement, angiographic scores and blood values. Hospital stay and in-hospital complications and mortality were determined. Results: Median age was 60.1±12.1 years in group I and 73.0±10.7 years in late AF group (p<0.05). The frequency of hypertension were 40% in group I and 72% in group II (p<0.05). Killip classes and TIMI risk scores were calculated as 2.0±0.65 ve 6.1±2.6 respectively in early AF group. There were differences in Killip classes and TIMI scores between early AF group and group I (p<0.05). Ejection fractions and left atrial diameter were calculated as 36.0%±7.6 and 3.9±0.35 cm. and 46.0%±7.1 ve 3.6±0.4 cm. in late AF group and group I respectively (p <0.05). Spontane sinus rhythm restoration was observed as 75% (30/40) (p<0.05). Hospital stay were found as 6.2±2.5 days, 7.5±3.2 days and 3.2±1.7 days in early AF group, late AF group and group I respectively (p<0.05). In-hospital mortaliy we re observed 20%(4/20) in late AF group and there were not observe in-hospital mortality in group I (p<0.05). Conclusion: New-onset AF during AMI in hospital was affected a lot of factors. The patients which developed new-onset AF during hospital in AMI had more severe clinical and laboratory outcomes likes hospital stay and in-hospital mortality than no-AF group
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
MN Kardiyoloji
WoS Q Değeri
Scopus Q Değeri
Cilt
15
Sayı
3
