Katater Laboratuvarında Yardımcı Medikal Tedaviler
Özet
Koroner anjiyografi ve perkütan koroner girişimler (PKG), kardiyovasküler hastalıkların tanı ve tedavisinde günümüzde altın standart yöntemler olarak kabul edilmektedir. Bununla birlikte, bu işlemler sırasında tromboembolik komplikasyonlar, hemodinamik instabilite, vazospazm, aritmiler ve kontrast kaynaklı yan etkiler gelişebilmektedir. Bu nedenle farmakolojik ajanların doğru seçimi, uygun dozlanması ve güvenli kullanımı işlem başarısı ve hasta güvenliği açısından kritik öneme sahiptir. Antikoagülanlar (unfraksiyone heparin, düşük molekül ağırlıklı heparinler, bivalirudin) ve antiplatelet ajanlar (aspirin, P2Y12 reseptör inhibitörleri, GPIIb/IIIa antagonistleri) trombozun önlenmesinde temel rol oynamaktadır. Vazodilatörler (nitrogliserin, adenozin, kalsiyum kanal blokerleri, nikorandil), özellikle koroner spazm ve no-reflow fenomeni yönetiminde etkinlik göstermektedir. Antiaritmik ilaçlar (lidokain, amiodaron, adenozin) işlem sırasında gelişebilecek ventriküler ve supraventriküler aritmilerin kontrolünde kullanılmaktadır. Sedatif ve analjezik ajanlar (midazolam, fentanil, morfin) hasta konforunu artırırken, kontrast ajanlar damar yapılarının görüntülenmesi için vazgeçilmezdir. Ayrıca, destekleyici ajanlar (protamin, kortikosteroidler, antihistaminikler, dopamin/dobutamin, atropin) spesifik komplikasyonların önlenmesi veya tedavisinde kullanılmaktadır. Güncel kılavuzlar, ilaç seçiminin bireyselleştirilmesini, hasta özellikleri, eşlik eden komorbiditeler ve kanama-tromboz riski göz önünde bulundurularak yapılmasını önermektedir. Bu bölüm, girişimsel kardiyoloji pratiğinde kullanılan farmakolojik ajanları kapsamlı ve sistematik bir yaklaşımla ele alarak, komplikasyonların azaltılması ve klinik sonuçların iyileştirilmesine katkı sağlamayı amaçlamaktadır.
Referanslar
Laine M, Lemesle G, Dabry T, et al. Bivalirudin during percutaneous coronary intervention in acute coronary syndromes. Expert Opin Pharmacother. 2019;20(3):295-304. doi:10.1080/14656566.2018.1551361
Onishi A, St Ange K, Dordick JS, Linhardt RJ. Heparin and anticoagulation. Front Biosci (Landmark Ed). 2016;21(7):1372-1392. Published 2016 Jun 1. doi:10.2741/4462
Alexopoulos D, Varlamos C, Mpahara A, Lianos I. P2Y12 inhibitors for the treatment of acute coronary syndrome patients undergoing percutaneous coronary intervention: current understanding and outcomes. Expert Rev Cardiovasc Ther. 2019;17(10):717-727. doi:10.1080/14779072.2019.16755
Shah R, Rashid A, Hwang I, Fan TM, Khouzam RN, Reed GL. Meta-Analysis of the Relative Efficacy and Safety of Oral P2Y12 Inhibitors in Patients With Acute Coronary Syndrome. Am J Cardiol. 2017;119(11):1723-1728. doi:10.1016/j.amjcard.2017.03.011
Virk HUH, Escobar J, Rodriguez M, et al. Dual Antiplatelet Therapy: A Concise Review for Clinicians. Life (Basel). 2023;13(7):1580. Published 2023 Jul 18. doi:10.3390/life13071580
Krüger N, Krefting J, Kessler T, et al. Ticagrelor vs Prasugrel for Acute Coronary Syndrome in Routine Care. JAMA Netw Open. 2024;7(12):e2448389. Published 2024 Dec 2. doi:10.1001/jamanetworkopen.2024.48389
Topol EJ, Byzova TV, Plow EF. Platelet GPIIb-IIIa blockers. Lancet. 1999;353(9148):227-231. doi:10.1016/S0140-6736(98)11086-3
Mahadevan VS, McCarty D, Adgey AA. Platelet GPIIb/IIIa receptor blockers for failed thrombolysis in acute myocardial infarction, alone or as adjunct to other rescue therapies. Eur Heart J. 2002;23(19):1490-1491. doi:10.1053/euhj.2002.3273
Widimský P, Kočka V, Roháč F, Osmančík P. Periprocedural antithrombotic therapy during various types of percutaneous cardiovascular interventions. Eur Heart J Cardiovasc Pharmacother. 2016 Apr;2(2):131-40. doi: 10.1093/ehjcvp/pvv053. Epub 2015 Dec 11. PMID: 27418971; PMCID: PMC4853825
Tousoulis D, Andreotti F, Hackett D, Haider AW, Maseri A, Davies G. Early remodelling of coronary stenoses after thrombolytic treatment in patients with acute myocardial infarction. Br Heart J. 1995;74(3):229-234. doi:10.1136/hrt.74.3.229
Arnout J, Simoons M, de Bono D, Rapold HJ, Collen D, Verstraete M. Correlation between level of heparinization and patency of the infarct-related coronary artery after treatment of acute myocardial infarction with alteplase (rt-PA). J Am Coll Cardiol. 1992;20(3):513-519. doi:10.1016/0735-1097(92)90001-4
Bhatt DL, Lopes RD, Harrington RA. Diagnosis and Treatment of Acute Coronary Syndromes: A Review. JAMA. 2022;327(7):662-675. doi:10.1001/jama.2022.0358
Feng KY, Mahaffey KW. Cangrelor in clinical use. Future Cardiol. 2020;16(2):89-102. doi:10.2217/fca-2019-0095
Keating GM. Cangrelor: A Review in Percutaneous Coronary Intervention. Drugs. 2015;75(12):1425-1434. doi:10.1007/s40265-015-0445-3
Kondo T, Terada K. Coronary-Artery Vasospasm. N Engl J Med. 2017;376(25):e52. doi:10.1056/NEJMicm1614640
Shibutani H, Otsuka T, Häner J, Räber L. Stent-Based Treatment of Refractory Coronary Vasospasm. JACC Cardiovasc Interv. 2022;15(10):e123-e124. doi:10.1016/j.jcin.2022.02.031
Danson EJ, Bhindi R. In-stent coronary vasospasm. Int J Cardiol. 2016;206:141-142. doi:10.1016/j.ijcard.2016.01.070
Lei M, Wu L, Terrar DA, Huang CL. Modernized Classification of Cardiac Antiarrhythmic Drugs. Circulation. 2018;138(17):1879-1896. doi:10.1161/CIRCULATIONAHA.118.035455
Dan GA, Martinez-Rubio A. Antiarrhythmic drugs-clinical use and clinical decision making: a consensus document from EHRA and ESC WG on Cardiovascular Pharmacology endorsed by HRS, APHRS, and ISCP-Authors' reply. Europace. 2018;20(11):1873-1874. doi:10.1093/europace/euy217
Whitehead NJ, Clark AL, Williams TD, Collins NJ, Boyle AJ. Sedation and Analgesia for Cardiac Catheterisation and Coronary Intervention. Heart Lung Circ. 2020;29(2):169-177. doi:10.1016/j.hlc.2019.08.01
21.Martin ML, Lennox PH. Sedation and analgesia in the interventional radiology department. J Vasc Interv Radiol. 2003;14(9 Pt 1):1119-1128. doi:10.1097/01.rvi.0000086536.86489.82
Amiel MJ. Contrast media in angiography. State of the art and future prospects. Radiol Med. 1986;72(6 Suppl 1):2-8.
Brinker JA. Selection of a contrast agent in the cardiac catheterization laboratory. Am J Cardiol. 1990;66(14):26F-33F. doi:10.1016/0002-9149(90)90638-h
Fischer HW, Thomson KR. Contrast media in coronary arteriography: a review. Invest Radiol. 1978;13(5):450-459. doi:10.1097/00004424-197809000-00010
Vatti RR, Ali F, Teuber S, Chang C, Gershwin ME. Hypersensitivity reactions to corticosteroids. Clin Rev Allergy Immunol. 2014;47(1):26-37. doi:10.1007/s12016-013-8365-z
Nakamura M, Yamano T, Asae Y, Takahata M, Shiono Y, Tanaka A. Coronary Vasospasm Complicated by Intercoronary Communication. Circ J. 2022;86(9):1477. doi:10.1253/circj.CJ-22-0083
Halna du Fretay X, Mohammed Saeed D, Benamer H. Mort subite et angor spastique: quelle stratégie diagnostique et thérapeutique? [Diagnosis and treatment of spastic angina revealed by cardiac arrest]. Ann Cardiol Angeiol (Paris). 2014;63(6):465-470. doi:10.1016/j.ancard.2014.09.036
Jenkins K, Pompei G, Ganzorig N, Brown S, Beltrame J, Kunadian V. Vasospastic angina: a review on diagnostic approach and management. Ther Adv Cardiovasc Dis. 2024;18:17539447241230400. doi:10.1177/17539447241230400
Boer C, Meesters MI, Veerhoek D, Vonk ABA. Anticoagulant and side-effects of protamine in cardiac surgery: a narrative review. Br J Anaesth. 2018;120(5):914-927. doi:10.1016/j.bja.2018.01.023
Calligaris SD, Ricca M, Conget P. Cardiac stress test induced by dobutamine and monitored by cardiac catheterization in mice. J Vis Exp. 2013;(72):50050. Published 2013 Feb 10. doi:10.3791/50050
Campos AM, da Cunha AB. Dobutamine stress echocardiography as a predictor of coronary lesion severity on coronary angiography. Rev Port Cardiol. 2007;26(5):505-518
Sharma A, Obiagwu C, Mezue K, et al. Role of Vasodilator Testing in Pulmonary Hypertension. Prog Cardiovasc Dis. 2016;58(4):425-433. doi:10.1016/j.pcad.2015.09.006
Aranda M, Pearl RG. Inhaled nitric oxide and pulmonary vasoreactivity. J Clin Monit Comput. 2000;16(5-6):393-401. doi:10.1023/a:1011468005527
Calkins H, Hindricks G, Cappato R, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017;14(10):e275-e444. doi:10.1016/j.hrthm.2017.05.012 bu af
Hsu JC, Darden D, Glover BM, et al. Performance and acute procedural outcomes of the EnSite Precision™ cardiac mapping system for electrophysiology mapping and ablation procedures: results from the EnSite Precision™ observational study. J Interv Card Electrophysiol. 2022;65(1):141-151. doi:10.1007/s10840-022-01239-4 bu eps
Lei M, Wu L, Terrar DA, Huang CL. Modernized Classification of Cardiac Antiarrhythmic Drugs. Circulation. 2018;138(17):1879-1896. doi:10.1161/CIRCULATIONAHA.118.035455
Hagiwara A, Sato A, Kitazawa H, Aizawa Y. J Waves Augmented by Isoproterenol and Pacing. Intern Med. 2023;62(18):2753-2754. doi:10.2169/internalmedicine.1081-22 izoproteranol
Cheung CC, Mellor G, Deyell MW, et al. Comparison of Ajmaline and Procainamide Provocation Tests in the Diagnosis of Brugada Syndrome. JACC Clin Electrophysiol. 2019;5(4):504-512. doi:10.1016/j.jacep.2019.01.026—
Critelli G, Gallagher JJ. Metodiche alternative ai farmaci in terapia antiaritmica [Methods of alternatives to drugs in antiarrhythmia therapy]. Cardiologia. 1983;28(3):185-200. antiaritmik
Roest AA, Vandenbussche FP, Klumper FJ, Oepkes D, Rijlaarsdam ME, Blom NA. Behandeling van foetale supraventriculaire tachycardie met antiaritmica via de navelstrengvene [Treatment of foetal supraventricular tachycardia with antiarrhythmic medication administered through the umbilical vein]. Ned Tijdschr Geneeskd. 2008;152(7):389-392.
Pancholy SB, Shah S, Patel TM. Radial Artery Access, Hemostasis, and Radial Artery Occlusion. Interv Cardiol Clin. 2015;4(2):121-125. doi:10.1016/j.iccl.2015.01.004
Ommen SR, Mital S, Burke MA, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e558-e631. doi:10.1161/CIR.0000000000000937
Authors/Task Force members, Elliott PM, Anastasakis A, et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J. 2014;35(39):2733-2779. doi:10.1093/eurheartj/ehu284
