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Akutna krvarenja iz gornjeg dela gastrointestinalnog trakta su urgentna stanja sa velikim morbiditetom, i još uvek zna ajnim mortalitetom uprkos unapre enoj dijagnostici i terapiji. Cilj rada je ispitivanje determinanti težine krvarenja duodenalnih pepti kih ulkusa. Istraživanje je obuhvatilo 304 bolesnika hospitalizovanih zbog akutnog krvarenja iz gornjeg dela gastrointestinalnog trakta u petogodišnjem periodu. Le eni su u Klini ko-bolni kom centru Bežanijska Kosa u Beogradu. Dijagnoza je postavljena gastroduodenoskopijom. Od 304 bolesnika krvare i pepti ki ulkus imalo je 197/65% bolesnika. Krvare i duodenalni ulkus imalo je 144/73,1% bolesnika, sa naj eš om bulbarnom lokalizacijom 124/86,12%; 78/62,9% sa lezijom na zadnjem zidu bulbusa. 48/35,1% krvare ih duodenalnih ulkusa bilo je u Forrest Ib stadijumu; 68/47,2% imalo je veli inu ulkusne lezije 1,1-2,0 cm. Utvr ena je statisti ki zna ajna pozitivna korelacija izme u veli ine ulkusne duodenalne lezije i intenziteta krvarenja (p<0,005). Kod 68/79/86,1% bolesnika le enih endoskopski hemostaza je bila uspešna, pri emu se kod 13/19,1% dogodio recidiv krvarenja. Recidiv je kod 11/84,6% bio lokalizovan na zadnjem zidu bulbusa duodenuma. Klju ne re i: duodenum, ulkus, hemoragija

Background/Aim. The fundamental objective of primary percutaneous coronary intervention (PKI) in myocardial infarction is to provide early, complete and sustained flow in the occluded artery that has led to myocardial ischemia or necrosis. The aim of this study was to determine the predictive power of a combination of GRACE, SYNTAX I, and SYNTAX II scores in predicting major cardiovascular adverse events and one-year mortality in patients with STEMI and NSTEMI myocardial infarction after primary PCI. Methods. Our study included 400 patients who had their first acute myocardial infarction and underwent percutaneous coronary intervention, treated and followed for one year at the Clinical Hospital Center Zvezdara at the Department of Interventional Cardiology. By monitoring the defined clinical parameters, a comparative analysis of risk scores was performed: GRACE, SYNTAX I and SYNTAX II, their sensitivity, specificity as well as predictive possibilities in predicting adverse outcomes were determined. Results. The incidence of major adverse cardiovascular outcomes in our sample was 12,8%. Patients with STEMI entity had significantly higher values of GRACE, SYNTAX I and SYNTAX II scores. The highest value for predicting the occurrence of major adverse cardiovascular outcomes was shown by the SYNTAX II score (score value 29,3) with a sensitivity of 88,2% and a specificity of 76,8%. The GRACE score is a significant predictor of SYNTAX I and SYNTAX II scores, a two-way correlation was observed between the high score values of all three scores. Conclusion. The presented scores for assessment of clinical and angiographic indicators, showed good predictive power in assessing the outcome of adverse cardiovascular events in both clinical entities of acute myocardial infarction during one year follow up. By using the proposed scores to assess adverse outcomes, we can single out high-risk patients in order to prevent outcomes and reduce mortality. This suggests its suitability for clinical use in this patient population.

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