Objective: Radial artery spasm (RAS), is a major drawback for the routine use of radial Access during coronary interventions and anxiety is a well-documented predictor of RAS. In this study, we aimed to assess the relationship between RAS and level of anxiety (LOA) which was quantified with different scales. Material and Methods: 123 consecutive patients scheduled for elective coronary angiography were enrolled. Demographic and procedural relevant features were noted, and then, patients were asked to fill three anxiety scales; Beck Anxiety Inventory (BAI), Spielberger State Anxiety Inventory (SSAI) and Spielberger Trait Anxiety Inventory (STAI). Clinical RAS was accepted to exist if 2 or more of predefined clinical features had been met. Results: RAS was observed in 20 patients (16.3%). In the RAS (+) group, the frequency of female gender, low body mass index, total procedure time, and procedures carried out with more than one puncture attempts were significantly higher, whereas smokers were less. BAI and SSAI scores of RAS (+) group were significantly higher. According to the pre-defined cut-off values of all abovementioned scales, only SSAI based comparison revealed the higher frequency of patients with considerable LOA in RAS(+) group (%, 45 vs 75, p=0.013). When regression analyses were performed, total procedure time (HR: 2.96, 95% CI=0.96-9.11; p=0.032) and having an SSAI score over 40 (HR: 2.49, 95% CI=1.09?5.71; p=0.024) were designated as independent predictors of RAS. Conclusion:Anxiety is a considerable risk factor for RAS occurrence but the testing method of LOA also matters. Regarding our results, SSAI was an accurate one for anticipating RAS.
Keywords: Anxiety; coronary angiography; radial artery; test anxiety scale
Amaç: Radiyal arter spazmı (RAS), bu yolun koroner girişimler sırasında rutin kullanımını kısıtlayan en önemli etkenlerden biridir ve anksiyete RAS için belgelenmiş bir risk belirtecidir. Bu çalışmada, RAS ile farklı ökçeklerle değerlendirilen anksiyete düzeyi arasındaki ilişkinin araştırılması hedeflenmiştir. Gereç ve Yöntemler: Planlı elektif koroner anjiyografi yapılacak 123 ardışık hasta çalışmaya dahil edildi. Hastaların demografik ve işlemle ilişkili özellikleri not edildi. Hastalardan üç farklı anksiyete ölçeğini doldurmaları istendi. Bunlar: Beck Anksiyete Ölçeği (BAÖ), Spielberger State Anksiyete Ölçeği (SSAÖ) and Spielberger Trait Anksiyete Ölçeği (STAÖ). Önceden belirlenmiş klinik özelliklerden en az 2 tanesi gözlendiğinde, RAS olduğu kabul edildi. Bulgular: RAS, 20 hastada (%16,3) gözlendi. RAS (+) grupta, kadın cinsiyet, düşük beden kitle endeksi ve birden çok kez ponksiyon yapılarak gerçekleştirilen işlemlerin sıklığına ek olarak toplam işlem süresi daha fazlayken; sigara içenlerin oranı daha düşüktü. RAS (+) grubun, BAÖ ve SSAÖ skorları anlamlı olarak yüksekti. Yukarıda adı geçen tüm ölçekler için daha önceden belirlenmiş eşik değerler baz alındığında; sadece SSAÖ?ne göre belirgin anksiyetesi olan hastaların sıklığı RAS (+) grupta daha fazlaydı (%45 ve 75, p=0,013). Regresyon analizi sonuçlarına göre, toplam işlem zamanı (HR: 2,96, %95 GA=0,96-9,11; p=0,032) ve SSAÖ skorunun 40 ve üzerinde olması (HR: 2,49, %95 GA=1,09?5,71; p=0,024) RAS için bağımsız prediktör olarak belirlendi. Sonuç: Anksiyete, RAS için kaydadeğer bir risk belirteci olmakla birlikte, ölçüm yöntemi de ciddi önem arz etmektedir. Sonuçlarımıza göre, RAS öngördürme bakımından SSAÖ?nin tutarlı bir yöntem olduğu tespit edilmiştir.
Anahtar Kelimeler: Anksiyete; anksiyete değerlendirme ölçeği; koroner anjiyografi; radiyal arter
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