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Atrial Fibrilasyonu Olan İskemik Serebrovasküler İnme Geçirmiş Hastalarda Rekürren Serebrovasküler İnme ile Kırmızı Kan Hücresi Dağılım Genişliği Arasındaki İlişki

Year 2023, Volume: 7 Issue: 2, 161 - 166, 31.08.2023
https://doi.org/10.29058/mjwbs.1341892

Abstract

Amaç: Atriyal fibrilasyon tromboembolik olaylara sebep olan bir sık görülen bir aritmi türüdür.
Kardiyoembolik inme önemli bir morbidite ve mortalite nedenidir. Kırmızı kan hücresi dağılım genişliği
(KDG, ‘Red blood cell distribution width’:RDW), kronik inflamasyon ve yüksek oksidatif stres durumunda
artabilen bir belirteçtir. Çalışmamızda akut iskemik inme geçiren atriyal fibrilasyon hastalarında KDG
düzeyi ile tekrarlayan erken serebrovasküler inme sıklığı arasındaki ilişkiyi incelemek amaçlandı.
Gereç ve Yöntemler: İskemik inme tanısı alarak nöroloji servisine yatış yapılan, kardiyoloji
konsültasyonu esnasında elektrokardiyografisinde atriyal fibrilasyon saptanan hastalar çalışmaya
dahil edildi. Hastaların kronik hastalık durumu, kullanılan ilaçlar, yatış sırasında rutin yapılmış olan kan
tetkikleri, ekokardiyografi bulguları kayıt altına alındı. Hastalar 3 ay süresince takip edildi.
Bulgular: Çalışmaya dahil edilen 164 hastanın yaş ortalaması 73,6 ± 9,3 idi. Hastaların 97’si (%59,1)
kadın, 67’si (%40,9) erkek cinsiyette idi. Doksan günlük takip sonucunda 31(%18,9) hastanın tekrarlayan
iskemik inme geçirdiği saptandı. Tekrarlayan inme geçirenler ile geçirmeyenler arasında yaş, cinsiyet,
kronik hastalık, dislipidemi, sigara kullanımı, ejeksiyon fraksiyonu, CHA2DS2-VASc skoru, NIHHS
Skoru düzeyleri, serum CRP düzeyleri, kan trombosit sayısı arasında istatistiksel olarak anlamlı fark
saptanmazken; KDG düzeyleri (14,6 ± 1,4 vs 13,3 ± 0,8) tekrarlayan inme geçiren hastalarda daha
yüksek saptandı (p <0,001). İskemik inme risk faktörlerinin dahil edilerek uygulandığı çok değişkenli
lojistik regresyon analizi modelinde; KDG seviyelerinin (OR: 3,125; %95 GA: 2,088–5,5603; P < 0,001)
bağımsız olarak tekrarlayan inme riskini artırdığı görüldü.
Sonuç: KDG serebrovasküler inme geçirmiş atriyal fibrilasyon hastalarında 90 gün içinde tekrarlayan
serebrovaskuler inme görülmesini öngörmede önemli biyobelirteçlerden biri olarak kullanılabilir. Benzer
hastalarda sıklıkla bakılan kan KDG düzeyinin prognoz açısından değerlendirilmesi önerilir

References

  • 1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991 Aug;22(8):983-8.
  • 2. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 9;285(18):2370-5.
  • 3. Writing Group Members; Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB; American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016 Jan 26;133(4):e38-360.

The Relationship Between Recurrent Cerebrovascular Stroke and Erythrocyte Distribution Width in Atrial Fibrillation Patients with Cerebrovascular Stroke

Year 2023, Volume: 7 Issue: 2, 161 - 166, 31.08.2023
https://doi.org/10.29058/mjwbs.1341892

Abstract

Aim: Atrial fibrillation is a common type of arrhythmia that causes thromboembolic events. Cardioembolic
stroke is an important cause of morbidity and mortality. Red blood cell distribution width (RDW) is a
marker that can increase in chronic inflammation and high oxidative stress. In our study, we aimed to
examine the relationship between the RDW level and the frequency of recurrent early cerebrovascular
stroke in atrial fibrillation patients who had acute ischemic stroke.
Material and Methods: Patients who were admitted to the neurology service with the diagnosis of
ischemic stroke and had atrial fibrillation in their electrocardiography during the cardiology consultation were included in the study. The patients' chronic disease status, medications used, routine blood tests during hospitalization, and
echocardiographic findings were recorded. The patients were followed for 3 months.
Results: The mean age of 164 patients included in the study was 73.6 ± 9.3 years. Ninetyseven (59,1%) of the patients were female and 67
(40,9%) were male. As a result of the 90-day follow-up, 31 patients (18.9%) had recurrent ischemic stroke. While there was no statistically
significant difference between age, gender, chronic disease, dyslipidemia, smoking, ejection fraction, CHA2DS2-VASc score, NIHHS score
levels, serum CRP levels, blood platelet count between those who had recurrent stroke and those who did not; RDW levels (14.6 ± 1.4 vs
13.3 ± 0.8) were found to be higher in patients with recurrent stroke (p <0.001). In the multivariate logistic regression analysis model, in which
ischemic stroke risk factors are included; RDW levels (OR: OR: 3.125 ; 95% GA: 2.088 –5.5603; p < 0.001) were found to independently
increase the risk of recurrent stroke.
Conclusion: RDW can be used as one of the important biomarkers in predicting recurrent cerebrovascular stroke within 90 days in atrial
fibrillation patients who have had a cerebrovascular stroke. It is recommended to evaluate the blood RDW level, which is frequently checked
in similar patients, in terms of prognosis.

References

  • 1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991 Aug;22(8):983-8.
  • 2. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 9;285(18):2370-5.
  • 3. Writing Group Members; Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB; American Heart Association Statistics Committee; Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation. 2016 Jan 26;133(4):e38-360.
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Details

Primary Language Turkish
Subjects Cardiology
Journal Section Research Article
Authors

Mustafa Ozan Çakır 0000-0002-0941-1928

Publication Date August 31, 2023
Acceptance Date August 18, 2023
Published in Issue Year 2023 Volume: 7 Issue: 2

Cite

Vancouver Çakır MO. Atrial Fibrilasyonu Olan İskemik Serebrovasküler İnme Geçirmiş Hastalarda Rekürren Serebrovasküler İnme ile Kırmızı Kan Hücresi Dağılım Genişliği Arasındaki İlişki. Med J West Black Sea. 2023;7(2):161-6.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.

This journal is published three annually in April, August and December.
The publication language of the journal is Turkish and English.