Öz
Amaç
Non-obstrüktif koroner arterli miyokard enfarktüsü (MINOCA), koroner arter hastalığı olan miyokard enfarktüsüne (MICAD) kıyasla farklı patofizyolojik mekanizmalara sahip heterojen bir tablodur. MINOCA belirtilerinin kabul sırasında tanınması, hastalığın teşhis edilmesini hızlandırır ve kişiye özel tedaviyi mümkün kılabilir.
Yöntem ve Gereçler
Türkiye’deki tek bir üçüncü basamak kardiyoloji merkezinde, Ocak 2015 ile Aralık 2020 tarihleri arasında akut miyokard enfarktüsü (AME) tanısıyla yatırılan 1.163 hastayı retrospektif olarak analiz ettik. Hastalar, koroner anjiyografi bulgularına göre MINOCA (n=87) veya MICAD (n=1,076) olarak 2 gruba ayrıldı. Hastaların klinik, demografik ve laboratuvar parametreleri karşılaştırıldı.
Bulgular
Çok değişkenli analiz sonucunda, kadın cinsiyetinin [odds oranı (OO) 1,417, %95 güven aralığı (GA) 1,112-2,018; p=0,048) ve düşük yoğunluklu lipoprotein (LDL) kolesterolünün (OO 0,992, %95 GA 0,985-0,998; p=0,017) MINOCA oluşumunun bağımsız öngörücüleri olduğunu saptamıştır; ancak yaş, tek değişkenli analizde anlamlı iken çok değişkenli analiz sonucunda anlamlılığı kaybetmiştir.
Sonuç
Kadın cinsiyeti ve düşük LDL kolesterol seviyeleri, Türk popülasyonunda AME hastalarında MINOCA’yı bağımsız olarak öngörmektedir.
Anahtar Kelimeler: MINOCA, akut koroner sendrom, prediktörler
Kaynakça
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