Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri
Yıl: 2020 Cilt: 26 Sayı: 4 Sayfa Aralığı: 311 - 315 Metin Dili: Türkçe DOI: 10.4274/tnd.2020.60820 İndeks Tarihi: 12-06-2021
Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri
Öz: Amaç: Atriyal fibrilasyon (AF) yetişkin popülasyonun %1’ini etkileyen en yaygın kardiyak aritmidir. Bununla birlikte, AF’li hastalarda iskemik inmeler, özellikle ek vasküler risk faktörleri olan yüksek riskli hastalarda, alternatif mekanizmalarla tetiklenebilir. Bu hastaların bazılarında inmeye aterotrombotik mekanizmalar neden olabilir ve AF rastlantısal veya aterosklerotik hastalığın bir belirtisi olabilir. Bu durumda kardiyoembolik inmeyi büyük arter aterosklerozuna bağlı inmeden ayırt etmek zor olabilir. Bu çalışmanın amacı valvüler olmayan AF’li hastalarda non-kardioembolik iskemik inme sebeplerini saptamak ve kraniyoservikal aterosklerotik stenoz için risk faktörlerini belirlemektir.Gereç ve Yöntem: Bu çalışma iskemik inme ve valvüler olmayan AF tanısıyla Uludağ Üniversitesi Nöroloji Kliniği’nde takip edilen hastalarda, non-kardiyak inme oranını saptamak ve inme geçiren valvüler olmayan AF’si olan hastalarda kraniyoservikal aterosklerotik stenoz için risk faktörlerini belirlemektedir. Bu çalışmaya, 1 Ocak 2019 - 1 Mart 2020 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı’nda valvüler olmayan AF ve akut iskemik inme tanısı ile takip edilen 180 hasta retrospektif olarak taranarak dahil edilmiştir.Bulgular: Bu çalışmada akut iskemik inme geçiren valvüler olmayan AF’li hastalarda non-kardiyak inme oranı %20 olarak saptanmıştır. Bu hastalarda büyük damar aterosklerozuna bağlı iskemik inme %14,4 saptanmışken, AF’si olan tüm hastaların %9,5’ine stent takıldı. Kraniyoservikal aterosklerotik stenoz için dermografik özellikler, klinik özellikler ve risk faktörleri analiz edildiğinde erkek cinsiyet (p=0,020) ve sigara içiciliği (p<0,001) ile anlamlı istatistiksel sonuç elde edildi.Sonuç: İnme birçok karmaşık mekanizmanın sebep olduğu heterojen bir hastalık grubudur. İnme rekürrensinin önlenmesi etkin tedaviye erken başlamakla mümkündür. AF’si olan bir akut iskemik inme hastasında kritik arter stenozunun olması inme rekürrensine sebep olur ve bu nüks antikoagülan tedavi ile önlenemez. Anjiyografik kanıtlar akut iskemik inmeli hastalarda etnik ve ırksal farklılıkları da ortaya koymuştur. Bu sebeple kendi popülasyonumuzda yapılacak prospektif çalışmalarla daha kesin bilgilere ulaşılabilir.
Anahtar Kelime: Causes of Ischemic Stroke in Patients with Atrial Fibrillation
Öz: Objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1% of the adult population. However, ischemic strokes in patients with AF can be triggered by alternative mechanisms, especially in high-risk patients with additional vascular risk factors. In some patients, atherothrombotic mechanisms may cause stroke, and AF may be incidental or a symptom of atherosclerotic disease. In this case, it may be difficult to distinguish cardioembolic stroke from stroke due to large artery atherosclerosis. The aim of this study was to determine the causes of non-cardioembolic ischemic stroke in patients with non-valvular AF and to determine the risk factors for craniocervical atherosclerotic stenosis.Materials and Methods: This study identified risk factors for craniocervical atherosclerotic stenosis in patients followed up at the Uludağ University Faculty of Medicine Department of Neurology with a diagnosis of ischemic stroke and non-valvular AF. In this study, 180 patients who were followed up with a diagnosis of non-valvular AF and acute ischemic stroke between January 1st, 2019 - March 1st 2020, in Uludağ University Faculty of Medicine Department of Neurology, were retrospectively included.Results: In this study, the non-cardiac stroke rate was 20% in patients with non-valvular AF who had acute ischemic stroke. Ischemic stroke due to large vessel atherosclerosis was found in 14.4% of these patients, and 9.5% of all patients with AF were stented. When dermographic features, clinical features, and risk factors were analyzed for craniocervical atherosclerotic stenosis, a significant statistical result was obtained with male sex (p=0.020) and smoking (p<0.001). Conclusion: Stroke is a heterogeneous group of diseases caused by many complex mechanisms. Prevention of stroke recurrence is possible by starting effective treatment early. The presence of critical artery stenosis in a patient with acute ischemic stroke with AF causes stroke recurrence and this relapse cannot be prevented by anticoagulant treatment. Angiographic evidence also revealed ethnic and racial differences in patients with acute ischemic stroke. Therefore, more precise information can be obtained through prospective studies in our population.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | dinç y, Bakar M, Hakyemez B (2020). Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. , 311 - 315. 10.4274/tnd.2020.60820 |
| Chicago | dinç yasemin,Bakar Mustafa,Hakyemez Bahattin Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. (2020): 311 - 315. 10.4274/tnd.2020.60820 |
| MLA | dinç yasemin,Bakar Mustafa,Hakyemez Bahattin Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. , 2020, ss.311 - 315. 10.4274/tnd.2020.60820 |
| AMA | dinç y,Bakar M,Hakyemez B Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. . 2020; 311 - 315. 10.4274/tnd.2020.60820 |
| Vancouver | dinç y,Bakar M,Hakyemez B Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. . 2020; 311 - 315. 10.4274/tnd.2020.60820 |
| IEEE | dinç y,Bakar M,Hakyemez B "Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri." , ss.311 - 315, 2020. 10.4274/tnd.2020.60820 |
| ISNAD | dinç, yasemin vd. "Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri". (2020), 311-315. https://doi.org/10.4274/tnd.2020.60820 |
| APA | dinç y, Bakar M, Hakyemez B (2020). Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. Türk Nöroloji Dergisi, 26(4), 311 - 315. 10.4274/tnd.2020.60820 |
| Chicago | dinç yasemin,Bakar Mustafa,Hakyemez Bahattin Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. Türk Nöroloji Dergisi 26, no.4 (2020): 311 - 315. 10.4274/tnd.2020.60820 |
| MLA | dinç yasemin,Bakar Mustafa,Hakyemez Bahattin Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. Türk Nöroloji Dergisi, vol.26, no.4, 2020, ss.311 - 315. 10.4274/tnd.2020.60820 |
| AMA | dinç y,Bakar M,Hakyemez B Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. Türk Nöroloji Dergisi. 2020; 26(4): 311 - 315. 10.4274/tnd.2020.60820 |
| Vancouver | dinç y,Bakar M,Hakyemez B Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri. Türk Nöroloji Dergisi. 2020; 26(4): 311 - 315. 10.4274/tnd.2020.60820 |
| IEEE | dinç y,Bakar M,Hakyemez B "Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri." Türk Nöroloji Dergisi, 26, ss.311 - 315, 2020. 10.4274/tnd.2020.60820 |
| ISNAD | dinç, yasemin vd. "Atriyal Fibrilasyonlu Hastalarda İskemik İnme Sebepleri". Türk Nöroloji Dergisi 26/4 (2020), 311-315. https://doi.org/10.4274/tnd.2020.60820 |
