Kosuyolu Heart J 2007;11(1)
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Heparin induced thrombocytopenia (HIT) may be a fatal complication of heparin administration

Assessment of Atrial Fibrillation Frequency in Octogenerian Patients with
Ifferent Gender Having Acute Coronary Syndrome in İntensive Care Unit

Mustafa Yıldız1, Ersan Tatli2, Çetin Gül2, Banu Şahin Yıldız3


1 Sakarya Üniversitesi İç Hastalıkları ve Kardiyoloji Kliniği

2 Trakya Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı

3 Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi İç Hastalıkları Kliniği

SUMMARY

Background: Atrial fibrillation is the most common cardiac arrhythmia and increases the risk of stroke, especially in the elderly patients. In this paper, we searched a new atrial fibrillation during intensive medical therapy and monitoring for the acute coronary syndrome in male and female octogenarian patients at intensive care unit.

Methods: We studied of 25 octogenarians (mean age: 83.5  3.1 years, 15 female), consecutive patients who underwent intensive medical therapy such as heparin, nitrat and fibrinolytic infusion because of acute coronary syndrome at intensive care unit. All patient underwent cardiac monitorization such as central venous cathaterization and respiratory monitorization.

Results: Baseline characteristics such as hypertension and hyperlipidemia, hematologic and biochemical values including complete blood count, glucose, urea, creatinin and lipid profiles between male and female were similar (p>0.05). A new developing atrial fibrillation were significantly increased in female octogenerian patients (n=6) as compared with male octogenerian patients (n=1) (p<0.05). The duration of stay in intensive care unit was 3.3 ± 2.1 day. The intensive medical therapy success rate was 96%. There was one mortality (female patient with atrial fibrillation) in intensive care unit. The causes of death included myocardial infarction complicating ventricular fibrillation.

Conclusions: The frequency of new developing atrial fibrillation in intensive care unit was significantly increased in female octogenerian patients as compared with male. Atrial fibrillation may be associated with worse outcomes during acute coronary syndrome in female octogenarian patients in intensive care unit.

Key words: Octogenarian, acute coronary syndrome, atrial fibrillation, intensive care unit

Yazışma Adresi:

Yrd. Doç. Dr. Mustafa Yıldız

Bayar Caddesi, Gülbahar Sok, Emniyet Sitesi, A Blok, A Kapısı, D: 6,

Kozyatağı, İstanbul

E-mail: mustafayilldiz@yahoo.com

Heparin induced thrombocytopenia (HIT) may be a fatal complication of heparin administration

Akut Koroner Sendrom Tanısı ile Yoğun Bakımda Takip Edilmekte Olan Farklı Cinsiyetteki
Seksen Yaş Grubu Hastalarda Atriyal Fibrilasyon Sıklığının Değerlendirilmesi

Assessment of Atrial Fibrillation Frequency in Octogenerian Patients with
Ifferent Gender Having Acute Coronary Syndrome in İntensive Care Unit

Mustafa Yıldız1, Ersan Tatli2, Çetin Gül2, Banu Şahin Yıldız3


1 Sakarya Üniversitesi İç Hastalıkları ve Kardiyoloji Kliniği

2 Trakya Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim Dalı

3 Dr Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi İç Hastalıkları Kliniği

ÖZET

Amaç: Atriyal fibrilasyon en sık gözlenen kardiyak ritm problemi olup özellikle yaşlı hastalarda inme riskini artırır. Bu çalışmada, yoğun bakım ünitesinde monitörize edilip yoğun medikal tedavi alan, akut koroner sendromlu seksen yaş grubundaki erkek ve kadın hastalarda yeni atriyal fibrilasyon gelişme sıklığı araştırılmıştır.

Metod: Yoğun bakım ünitesinde, akut koroner sendrom nedeni ile heparin, nitrat, fibrinolitik infüzyonu gibi yoğun medikal tedavi alan ardışık 25 seksen yaş grubu hasta (ortalama yaş: 83.5  3.1 yıl, 15 kadın) çalışmaya alındı. Tüm hastalara santral venöz kateterizasyonu gibi kardiyak ve respiratuar monitörizasyon uygulandı.

Bulgular: Hipertansiyon, hiperlipidemi gibi başvuru özellikleri ile tam kan sayımı, glükoz, üre, kreatinin ve lipid profili gibi hematolojik ve biyokimyasal değerler kadın ve erkekler açısından benzerdi (p>0,05). Yeni gelişmiş atriyal fibrilasyon seksen yaş grubundaki kadın hastalarda (n=6), erkeklere (n=1) göre anlamlı olarak daha yüksekti (p<0.05). Yoğun bakım ünitesinde kalış süresi 3.3 ± 2.1 gündü. Yoğun medikal tedavinin başarı oranı %94’dü. Yoğun bakım ünitesinde atriyal fibrilasyonlu bir kadın hasta öldü. Ölüm sebebi miyokard infarktüsüne eşlik eden ventriküler fibrilasyondu.

Sonuçlar: Yoğun bakım ünitesinde yeni gelişmiş atriyal fibrilasyon sıklığı seksen yaş grubundaki kadın hastalarda, erkeklere göre anlamlı olarak daha yüksekti. Atriyal fibrilasyon, yoğun bakım ünitesindeki seksen yaş grubu akut koroner sendromlu kadın hastalarda kötü sonlanım ile ilişkili olabilir.

Anahtar Kelimeler: Seksen yaş grubu, akut koroner sendrom, atriyal fibrilasyon, yoğun bakım ünitesi

SUMMARY

Background: Atrial fibrillation is the most common cardiac arrhythmia and increases the risk of stroke, especially in the elderly patients. In this paper, we searched a new atrial fibrillation during intensive medical therapy and monitoring for the acute coronary syndrome in male and female octogenarian patients at intensive care unit.

Methods: We studied of 25 octogenarians (mean age: 83.5  3.1 years, 15 female), consecutive patients who underwent intensive medical therapy such as heparin, nitrat and fibrinolytic infusion because of acute coronary syndrome at intensive care unit. All patient underwent cardiac monitorization such as central venous cathaterization and respiratory monitorization.

Results: Baseline characteristics such as hypertension and hyperlipidemia, hematologic and biochemical values including complete blood count, glucose, urea, creatinin and lipid profiles between male and female were similar (p>0.05). A new developing atrial fibrillation were significantly increased in female octogenerian patients (n=6) as compared with male octogenerian patients (n=1) (p<0.05). The duration of stay in intensive care unit was 3.3 ± 2.1 day. The intensive medical therapy success rate was 96%. There was one mortality (female patient with atrial fibrillation) in intensive care unit. The causes of death included myocardial infarction complicating ventricular fibrillation.

Conclusions: The frequency of new developing atrial fibrillation in intensive care unit was significantly increased in female octogenerian patients as compared with male. Atrial fibrillation may be associated with worse outcomes during acute coronary syndrome in female octogenarian patients in intensive care unit.

Key words: Octogenarian, acute coronary syndrome, atrial fibrillation, intensive care unit

Yazışma Adresi:

Yrd. Doç. Dr. Mustafa Yıldız

Bayar Caddesi, Gülbahar Sok, Emniyet Sitesi, A Blok, A Kapısı, D: 6,

Kozyatağı, İstanbul

E-mail: mustafayilldiz@yahoo.com

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