Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye.
Department of Cardiology, Kahramanmaraş Sütçü Imam University, Kahramanmaraş, Türkiye.
Turk Kardiyol Dern Ars. 2024 Jan;52(1):1-9. doi: 10.5543/tkda.2023.98033.
Earthquakes can significantly impact both the occurrence and the management of acute coronary syndromes (ACS). This study aimed to investigate the effects of an earthquake on patients with ACS by comparing their clinical and angiographic features before and after the event.
We utilized a retrospective observational cohort design, involving 260 ACS patients who underwent coronary angiography. Data on patient characteristics, clinical variables, and procedural details were extracted from medical records. Statistical analyses were conducted to compare the ACS groups pre- and post-earthquake and to assess outcomes, which included in-hospital mortality and complications.
After the earthquake, the ACS patients were older and predominantly male. The distribution of ACS subtypes remained similar between the groups. The use of anticoagulation before the procedure decreased after the earthquake, while the usage of other medications remained stable. The incidence of non-critical coronary arteries decreased post-earthquake, and there was a higher frequency of non-intervention in this group. Intervention in the left anterior descending coronary artery was more common after the earthquake. In-hospital mortality was associated with post-earthquake ACS, certain ACS subtypes, shock at admission, bifurcation stenting, and the no-reflow phenomenon. Complete revascularization was found to reduce mortality. The duration of intensive care unit stays was longer before the earthquake, while in-hospital mortality was higher after the earthquake. Gender differences were observed in coronary ectasia, with females being more affected post-earthquake.
Earthquakes significantly influence the clinical and angiographic features of ACS cases, thereby affecting mortality rates and revascularization outcomes.
地震可显著影响急性冠状动脉综合征（ACS）的发生和处理。本研究旨在通过比较地震前后 ACS 患者的临床和血管造影特征，探讨地震对 ACS 患者的影响。
我们采用回顾性观察性队列设计，纳入 260 例行冠状动脉造影的 ACS 患者。从病历中提取患者特征、临床变量和手术细节的数据。对 ACS 组地震前后的特征进行比较，并评估包括院内死亡率和并发症在内的结局。
地震后，ACS 患者年龄较大，且以男性为主。ACS 亚型的分布在两组间无差异。地震后术前抗凝药物的使用减少，而其他药物的使用保持稳定。非临界冠状动脉的发生率在地震后降低，且该组中不干预的频率更高。地震后，左前降支冠状动脉的介入治疗更为常见。院内死亡率与地震后 ACS、某些 ACS 亚型、入院时休克、分叉支架置入和无复流现象相关。完全血运重建可降低死亡率。地震前 ICU 停留时间较长，而地震后院内死亡率较高。在冠状动脉扩张方面观察到性别差异，女性在地震后受影响更大。
地震显著影响 ACS 病例的临床和血管造影特征，从而影响死亡率和血运重建结局。
