Comparison of Acute Coronary Syndromes in the Earthquake Zone before and in the First Month after the Earthquake: A Single-center and Retrospective Analysis.

Fuat Polat, Ünal Öztürk
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Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: Earthquakes significantly influence the clinical and angiographic features of ACS cases, thereby affecting mortality rates and revascularization outcomes.

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震前和震后第一个月震区急性冠状动脉综合征的比较:单中心回顾性分析。
目的:地震会对急性冠状动脉综合征(ACS)的发生和治疗产生重大影响。本研究旨在通过比较地震前后急性冠状动脉综合征患者的临床和血管造影特征,研究地震对患者的影响:我们采用了回顾性观察队列设计,涉及 260 名接受冠状动脉造影术的 ACS 患者。我们从病历中提取了患者特征、临床变量和手术细节等数据。统计分析比较了震前和震后的 ACS 组别,并评估了结果,包括院内死亡率和并发症:结果:地震发生后,ACS 患者年龄较大,以男性为主。两组间急性心肌梗死亚型的分布情况相似。地震后,手术前使用抗凝药物的人数减少,而其他药物的使用情况保持稳定。非危急冠状动脉的发病率在地震后有所下降,该组中未进行干预的频率较高。左前降支冠状动脉的介入治疗在震后更为常见。院内死亡率与震后急性冠状动脉综合征、某些急性冠状动脉综合征亚型、入院时休克、分叉支架植入术和无回流现象有关。完全血运重建可降低死亡率。地震前重症监护室的住院时间较长,而地震后的院内死亡率较高。在冠状动脉异位方面观察到了性别差异,女性在震后受影响更大:结论:地震对急性冠状动脉综合征病例的临床和血管造影特征有重大影响,从而影响死亡率和血管重建结果。
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