FAKTORI RIZIKA ZA NASTANAK KRVARENJA U AKUTNOM KORONARNOM SINDROMU
Sažetak
Savremeni terapijski pristup kod bolesnika sa akutnim koronarnim sindromom (AKS) jeste opravdan i efikasan, ali nosi sa sobom veći rizik od nastanka krvarenja. Cilj istraživanja, koje je obuhvatilo 177 bolesnika sa AKS, hospitalizovanih na Klinici za kardiovaskularne bolesti u Nišu u periodu od marta do septembra 2013. godine, bio je utvrditi osnovne faktore rizika za nastanak krvarenja. Na osnovu prisustva krvarenja, bolesnici su najpre bili podeljeni na bolesnike sa krvarenjem i bolesnike bez krvarenja. Bolesnici sa krvarenjem dalje su podeljeni na bolesnike sa značajnim krvarenjem i bolesnike sa manje značajnim krvarenjem. Prilikom istraživanja u obzir su uzeti sledeći podaci: demografski i anamnestički podaci, oblik AKS-a, osnovne laboratorijske analize, kao i primenjena terapija za AKS. U grupi bolesnika sa krvarenjem bilo je statistički značajno više nepušača (χ2 = 6,527, p = 0,038), bolesnika sa hroničnom insuficijencijom bubrega (HBI) (χ2 = 4,192, p = 0,041) i bolesnika sa povišenim CRP vrednostima (p = 0,039). U podgrupi bolesnika sa značajnim krvarenjem bilo je statistički značajno više bolesnika sa HBI (36,4% prema 6,5%; Fišer test: p = 0,007) i povišenim CRP vrednostima (z = 2,452, p = 0,014). U podgrupi bolesnika sa manje značajnim krvarenjima, vrednosti hemoglobina bile su statistički značajno niže u odnosu na ostale bolesnike (t = 3,496, p = 0,003). Interesantno je pomenuti da su vrednosti hemoglobina, klirens kreatinina i broj leukocita (kao marker inflamacije) sastavne komponetnte PRECISE DAPT skoring sistema, koji se pojavio 2017. godine, nakon našeg istraživanja.
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