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    (Türk Kardiyoloji Derneği, 2019) Şeker, Taner; Türkoğlu, Caner; Akkuş, Oğuz;
    entitled “The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention,” published in the Archives of the Turkish Society of Cardiology.[1] As we noted in the discussion section, “the lower in-hospital mortality of patients with VTA [visible thrombus aspiration] in our study may also be associated with a shorter door-to-balloon time, lower Killip class, and better TIMI [Thrombolysis in Myocardial Infarction] flow after TA [thrombus aspiration].” Delayed door-balloon time can be a reason for a higher Killip classification in patients without VTA, and these decompensated patients, naturally, cannot undergo revascularization during ST elevation myocardial infarction.
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    The relationship between visible thrombus aspiration material with no-reflow and in-hospital mortality ratio in patients with anterior ST-elevation myocardial infarction treated with primary percutaneous coronary intervention
    (Türk Kardiyoloji Derneği, 2019) Şeker, Taner; Türkoğlu, Caner; Akkuş, Oğuz; Gür, Mustafa
    Objective: The benefit of intracoronary thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation myocardial infarction (STEMI) is not yet fully clear. The aim of this study was to investigate the clinical impact of visible thrombus aspiration (VTA) material. Methods: A total of 295 patients with a Thrombolysis in Myocardial Infarction (TIMI) flow score of 0 or 1 after an anterior STEMI were included in the study. Manual TA devices were used before performing PCI. The patients were divided into 2 groups: (1) visible thrombus aspiration (VTA) group and (2) non-visible thrombus aspiration (non-VTA) group. No-reflow was defined as TIMI grade 0, 1, or 2 flow, or TIMI grade 3 with a myocardial blush of grade 0 or 1. The primary endpoint was the occurrence of no-reflow. Results: VTA was retrieved in 178 (60.3%) of the patients. A no-reflow determination was significantly less frequent in the VTA group (p<0.001). The ejection fraction and ST-segment resolution values were higher, and the in-hospital mortality, Killip class II-IV rating, and post-pPCI TIMI frame count were lower in the VTA group (p<0.05 for each). Conclusion: VTA predicted a lower rate of in-hospital mortality and no-reflow in patients with anterior STEMI who underwent pPCI.