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  • Küçük Resim
    Öğe
    Comparison of clinical outcomes in patients who underwent bare metal coronary stenting versus coronary by-pass surgery
    (2013) Tanboğa, İbrahim Halil; Kurt, Mustafa; Aksakal, Enbiya; Kaygın, Mehmet Ali; Kaya, Ahmet; Işık, Turgay; Çolak, Abdürrahim; Sevimli, Serdar
    Giriş: Biz bu çalışmamızda, koroner baypas greftleme cerrahisi ile çıplak metal stent uygulanmış hastalarda SYNTAX (Sx) skoru ile değerlendirilen koroner lezyon kompleksitelerinin klinik sonlanımlar üzerine etkisini incelemeyi amaçladık.Hastalar ve Yöntem: Çalışma grubumuz çıplak metal stent uygulanmış (n= 265) ve koroner baypas cerrahisine giden (n= 294) 459 hastadan oluşmaktadır. Koroner arter hastalığı kompleksitesi Sx skoru ile değerlendirilmiştir. Sx skoru, hafi f Sx skoru (<= 22), orta Sx skoru ve yüksek Sx skoru (>= 33) olmak üzere üç gruba ayrılmıştır.Bulgular: Çalışma süresince orta dönem takipte herhangi bir nedenle revaskülarizasyon sıklığı hem tüm grupta hem de Sx alt gruplarında perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Orta dönem takipte herhangi bir nedenden ölüm sıklığı düşük ve orta Sx gruplarında tedavi grupları arasında benzer bulunmuştur. Ancak yüksek Sx skoru grubunda orta dönem takipte herhangi bir nedenden ölüm sıklığı perkütan koroner girişim uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazladır. Tüm popülasyonda herhangi bir nedenden dolayı ölüm için düzeltilmiş risk perkütan koroner girişim ve koroner baypas cerrahisi arasında benzerken [hazard ratio, %95 GA: 0.88 (0.38-2.05), p= 0.780], herhangi bir nedenle revaskülarizasyon için düzeltilmiş risk koroner baypas cerrahisi grubuna göre perkütan koroner girişim grubunda belirgin olarak daha fazlaydı [hazard ratio, %95 GA: 0.12 (0.05-0.30), p< 0.001].Sonuç: Sx skoru ile değerlendirilen koroner lezyon kompleksitesi herhangi bir nedenle revaskülarizasyon sıklığı ile daha yakın ilişkilidir. Yüksek Sx skoru gubunda herhangi bir nedenden ölüm çıplak metal stent uygulanan hastalarda koroner baypas cerrahisine giden hastalara göre daha fazlaydı
  • Küçük Resim
    Öğe
    Thrombus aspiration in patients with ST elevation myocardial infarction : meta-analysis of 16 randomized trials
    (2015) Tanboğa, İbrahim Halil; Topçu, Selim; Aksakal, Enbiya; Kurt, Mustafa; Kaya, Ahmet; Oduncu, Vecih; Sevimli, Serdar
    Objective: The mortality rate is high in some patients undergoing primary percutaneous coronary intervention (PPCI) because of ineffective epicardial and myocardial perfusion. The use of thrombus aspiration (TA) might be beneficial in this group but there is contradictory evidence in current trials. Therefore, using PRISMA statement, we performed a meta-analysis that compares PPCI+TA with PPCI alone. Methods: Sixteen studies in which PPCI (n=5262) versus PPCI+TA (n=5256) were performed, were included in this meta-analysis. We calculated the risk ratio (RR) for epicardial and myocardial perfusion, such as the Thrombolysis In myocardial Infarction (TIMI) flow, myocardial blush grade (MBG) and stent thrombosis (ST) resolution (STR), and clinical outcomes, such as all-cause death, recurrent infarction (Re-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), stent thrombosis (ST), and stroke. Results: Postprocedural TIMI-III flow frequency, postprocedural MBG II-III flow frequency, and postprocedural STR were significantly high in TA+PPCI compared with the PPCI alone group. However, neither all-cause mortality [6.6% vs. 7.4%, RR=0.903, 95% confidence interval (CI): 0.785-1.038, p=0.149] nor Re-MI (2.3% vs. 2.6%, RR=0.884, 95% CI: 0.693-1.127, p=0.319), TVR/TLR (8.2% vs. 8.0%, RR=1.028, 95% CI: 0.900-1.174, p=0.687), ST (0.93% vs. 0.90%, RR=1.029, 95% CI: 0.668-1.583, p=0.898), and stroke (0.5% vs. 0.5%, RR=1.073, 95% CI: 0.588-1.959, p=0.819) rates were comparable between the groups. Conclusion: This meta-analysis is the first updated analysis after publishing the 1-year result of the “Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction” trial, and it showed that TA did not reduce the rate of all-cause mortality, Re-MI, TVR/TLR, ST, and stroke. (Anatol J Cardiol 2015; 15: 175-87)
  • Küçük Resim
    Öğe
    Thrombus aspiration in patients with ST elevation myocardial infarction: Meta-analysis of 16 randomized trials
    (Kare Publ, 2015) Tanboga, Ibrahim Halil; Topcu, Selim; Aksakal, Enbiya; Kurt, Mustafa; Kaya, Ahmet; Oduncu, Vecih; Sevimli, Serdar
    Objective: The mortality rate is high in some patients undergoing primary percutaneous coronary intervention (PPCI) because of ineffective epicardial and myocardial perfusion. The use of thrombus aspiration (TA) might be beneficial in this group but there is contradictory evidence in current trials. Therefore, using PRISMA statement, we performed a meta-analysis that compares PPCI+TA with PPCI alone. Methods: Sixteen studies in which PPCI (n=5262) versus PPCI+TA (n=5256) were performed, were included in this meta-analysis. We calculated the risk ratio (RR) for epicardial and myocardial perfusion, such as the Thrombolysis In myocardial Infarction (TIMI) flow, myocardial blush grade (MBG) and stent thrombosis (ST) resolution (STR), and clinical outcomes, such as all-cause death, recurrent infarction (Re-MI), target vessel revascularization/target lesion revascularization (TVR/TLR), stent thrombosis (ST), and stroke. Results: Postprocedural TIMI-III flow frequency, postprocedural MBG II-III flow frequency, and postprocedural STR were significantly high in TA+PPCI compared with the PPCI alone group. However, neither all-cause mortality [6.6% vs. 7.4%, RR=0.903, 95% confidence interval (CI): 0.785-1.038, p=0.149] nor Re-MI (2.3% vs. 2.6%, RR=0.884, 95% CI: 0.693-1.127, p=0.319), TVR/TLR (8.2% vs. 8.0%, RR=1.028, 95% CI: 0.900-1.174, p=0.687), ST (0.93% vs. 0.90%, RR=1.029, 95% CI: 0.668-1.583, p=0.898), and stroke (0.5% vs. 0.5%, RR=1.073, 95% CI: 0.588-1.959, p=0.819) rates were comparable between the groups. Conclusion: This meta-analysis is the first updated analysis after publishing the 1-year result of the Thrombus Aspiration during ST-Segment Elevation Myocardial Infarction trial, and it showed that TA did not reduce the rate of all-cause mortality, Re-MI, TVR/TLR, ST, and stroke.