Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
Yıl: 2021 Cilt: 22 Sayı: 4 Sayfa Aralığı: 287 - 293 Metin Dili: İngilizce DOI: 10.4274/imj.galenos.2021.08365 İndeks Tarihi: 22-05-2022
Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis
Öz: Introduction: Successful revascularization of lesions located in the left main and/or proximal left anterior descending (LM and/or pLAD) coronary artery improves survival than medical therapy only. Therefore, accurate identification of highrisk patients with suspected stable angina pectoris is critical for outpatient clinics. Since the septal perforators of the left anterior descending coronary artery are the main source of blood supply of the left anterior fascicle, we hypothesized that the presence of left anterior fascicular block (LAFB) can predict obstructive stenoses of LM and/or pLAD coronary arteries in patients with suspected stable angina pectoris. Methods: We consecutively enrolled 790 patients referred for invasive coronary angiography due to suspected stable angina pectoris. Results: The number of patients with LAFBs was 68 (8.6%). Furthermore, 218 patients (27.6%) had obstructive coronary artery disease (CAD). The prevalence of obstructive CAD, revascularization with coronary artery bypass graft surgery, and obstructive LM and/or pLAD coronary artery lesions was higher in patients with LAFB. From univariate analysis, the presence of LAFB was significantly associated with predicting obstructive LM and/or pLAD lesions (odds ratio: 3,587; 95% confidence interval: 1,465-5,785; p=0.005). However, this association disappeared after adjustment for other cardiovascular risk factors. Conclusion: In patients with suspected stable angina pectoris, LAFB is not frequently a “normal variant” and is associated with known cardiovascular risk factors. It acts as a marker rather than a determinant of obstructive LM and/or pLAD coronary artery lesions.
Anahtar Kelime: Sol Anterior Fasiküler Bloğun Stabil Anginalı Hastalarda Sol Ana ve/veya Proksimal Sol Ön İnen Koroner Arter Hastalığının Belirlenmesinde Öngördürücü Değerinin Araştırılması: Bir Eğilim Skoru Eşleştirme Analizi
Öz: Amaç: Sol ana ve/veya proksimal sol ön inen (LM ve/veya pLAD) koroner arterde yer alan lezyonların başarılı revaskülarizasyonu, yalnızca medikal tedaviye kıyasla sağkalımı artırmaktadır. Bu nedenle, stabil angina pektoris şüphesi olan hastalarda bu bölgelerdeki kritik darlıklar için yüksek riskli hastaların saptanması önemlidir. Sol ön inen koroner arterin septal perforatörleri, sol anterior fasikülün ana kan besleme kaynağı olduğundan, stabil angina pektoris şüphesi olan hastalarda sol anterior fasiküler blok (LAFB) varlığının, LM ve/veya pLAD koroner arterlerinin obstrüktif stenozlarını öngörebileceği hipotez olarak düşünüldü. Yöntemler: Stabil anjina pektoris şüphesi nedeniyle invaziv koroner anjiyografi için sevk edilen ardışık 790 hasta çalışmaya alındı. Bulgular: LAFB’li hasta sayısı 68 (%8,6) idi. Ayrıca 218 hastada (%27,6) obstrüktif koroner arter hastalığı saptandı. LAFB’li hastalarda; obstrüktif koroner arter hastalığı, koroner arter by pass greft cerrahisi ile revaskülarizasyon tedavisi ve obstrüktif LM ve/veya pLAD koroner arter lezyonu prevalansı daha yüksekti. LAFB’nin varlığı, tek değişkenli analizde obstrüktif LM ve/veya pLAD lezyonlarını öngörmede istatiksel olarak önemli bir değişkendi (odds ratio: 3.587; %95 güven aralığı: 1.465- 5.785; p=0,005). Ancak bu ilişki, diğer kardiyovasküler risk faktörleri için düzeltme yapıldıktan sonra ortadan kalktı. Sonuç: Stabil anjina pektoris şüphesi olan hastalarda LAFB “normal bir variant” değildir ve bilinen kardiyovasküler risk faktörleri ile ilişkilidir, ancak obstrüktif LM ve/veya pLAD koroner arter lezyonunun bağımsız bir yordayıcısı olmaktan çok bir belirteç görevi görmektedir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Çırakoğlu Ö, sahin s, Yilmaz A (2021). Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. , 287 - 293. 10.4274/imj.galenos.2021.08365 |
| Chicago | Çırakoğlu Ömer Faruk,sahin sinan,Yilmaz Ahmet Seyda Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. (2021): 287 - 293. 10.4274/imj.galenos.2021.08365 |
| MLA | Çırakoğlu Ömer Faruk,sahin sinan,Yilmaz Ahmet Seyda Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. , 2021, ss.287 - 293. 10.4274/imj.galenos.2021.08365 |
| AMA | Çırakoğlu Ö,sahin s,Yilmaz A Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. . 2021; 287 - 293. 10.4274/imj.galenos.2021.08365 |
| Vancouver | Çırakoğlu Ö,sahin s,Yilmaz A Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. . 2021; 287 - 293. 10.4274/imj.galenos.2021.08365 |
| IEEE | Çırakoğlu Ö,sahin s,Yilmaz A "Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis." , ss.287 - 293, 2021. 10.4274/imj.galenos.2021.08365 |
| ISNAD | Çırakoğlu, Ömer Faruk vd. "Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis". (2021), 287-293. https://doi.org/10.4274/imj.galenos.2021.08365 |
| APA | Çırakoğlu Ö, sahin s, Yilmaz A (2021). Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. İstanbul Medical Journal, 22(4), 287 - 293. 10.4274/imj.galenos.2021.08365 |
| Chicago | Çırakoğlu Ömer Faruk,sahin sinan,Yilmaz Ahmet Seyda Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. İstanbul Medical Journal 22, no.4 (2021): 287 - 293. 10.4274/imj.galenos.2021.08365 |
| MLA | Çırakoğlu Ömer Faruk,sahin sinan,Yilmaz Ahmet Seyda Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. İstanbul Medical Journal, vol.22, no.4, 2021, ss.287 - 293. 10.4274/imj.galenos.2021.08365 |
| AMA | Çırakoğlu Ö,sahin s,Yilmaz A Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. İstanbul Medical Journal. 2021; 22(4): 287 - 293. 10.4274/imj.galenos.2021.08365 |
| Vancouver | Çırakoğlu Ö,sahin s,Yilmaz A Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis. İstanbul Medical Journal. 2021; 22(4): 287 - 293. 10.4274/imj.galenos.2021.08365 |
| IEEE | Çırakoğlu Ö,sahin s,Yilmaz A "Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis." İstanbul Medical Journal, 22, ss.287 - 293, 2021. 10.4274/imj.galenos.2021.08365 |
| ISNAD | Çırakoğlu, Ömer Faruk vd. "Evaluation of the Predictive Value of Left Anterior Fascicular Block on Determination of Left Main and/or Proximal Left Anterior Descending Coronary Artery Disease in Patients with Stable Angina: A Propensity Score Matching Analysis". İstanbul Medical Journal 22/4 (2021), 287-293. https://doi.org/10.4274/imj.galenos.2021.08365 |
