Izazovi u proceni kardiovaskularnog rizika kod sindroma opstruktivne apneje-hipopneje u snu: primenljivost postojećih skorova

  • Milovan Stojanović Institute for Treatment and Rehabilitation “Niška Banja”, Niš, Serbia; †University of Niš, Faculty of Medicine, Niš, Serbia
  • Marina Deljanin Ilić Institute for Treatment and Rehabilitation “Niška Banja”, Niš, Serbia; †University of Niš, Faculty of Medicine, Niš, Serbia
  • Lidija Ristić †University of Niš, Faculty of Medicine, Niš, Serbia; University Clinical Center Niš, ‡Clinic for Lung Diseases, Niš, Serbia
  • Zoran Stamenković University Clinical Center Niš, Clinic for Lung Diseases, Niš, Serbia
  • Dejana Gojković Institute for Treatment and Rehabilitation “Niška Banja”, Niš, Serbia
  • Goran Koraćević University of Niš, Faculty of Medicine, Niš, Serbia University Clinical Center Niš, §Clinic for Cardiovascular Diseases, Niš, Serbia
DOI: https://doi.org/10.2298/VSP250422053S
Ključne reči: apneja u snu, opstruktivna;, apneja, spavanje poremećaji, sindromi;, koronarna bolest;, hipertenzija;, faktori rizika.

Sažetak


Uvod/Cilj. Sindrom opstruktivne apneje-hipopneje u snu (obstructive sleep apnea-hypopnea syndrome – OSAHS) povezan je sa povećanim kardiovaskularnim rizikom (KVR). Cilj rada bio je da se ispita KVR kod obolelih od hipertenzije i OSAHS korišćenjem skorova rizika Systematic Coronary Risk Evaluation 2 (SCORE2), SCORE2-Dijabetes i American College of Cardiology/American Heart Association for atherosclerotic cardiovascular disease (ACC/AHA ASCVD). Metode. Zbog strogih krterijuma isključenja od 410 uzastopnih bolesnika obolelih od OSAHS, 92 hipertenzivna bolesnika sa umerenim ili teškim OSAHS uključena su u studiju. Svi ispitanici podvrgnuti su proceni KVR-a korišćenjem SCORE2, SCORE2-Dijabetes i ACC/AHA ASCVD skorova rizika. Takođe, svi bolesnici, osim sedmoro sa ekstremnom gojaznošću (težina preko 130 kg) koji nisu mogli da urade test, podvrgnuti su testu fizičkim opterećenjem, a šestoro njih zahtevalo je dalju dijagnostičku procenu korišćenjem stres ehokardiografije (troje), kompjuterizovane tomografije koronarnih arterija (dvoje) i/ili invazivne koronarne angiografije (troje). Rezultati. Rezultati su pokazali značajno opterećenje umerenim do visokim KVR-om prema svim skorovima. Teški oblik OSAHS bio je povezan sa višim procentom umerenog do visokog KVR-a, posebno prema ACC/AHA ASCVD kalkulatoru. Nije pokazana značajna korelacija između indeksa apneje-hipopneje i KVR-a. Takođe, kod troje bolesnika, invazivna koronarna angiografija pokazala je višesudovnu koronarnu bolest koja je zahtevala revaskularizaciju miokarda. Zaključak. Opšti sistemi bodovanja KVR-a mogu neadekvatno prikazati specifični KVR kod obolelih  od  OSAHS,  što  naglašava potrebu za prilagođenom procenom rizika i pojačanim ranim otkrivanjem koronarne arterijske bolesti u ovoj populaciji. Naši rezultati naglašavaju klinički značaj detekcije koronarne arterijske bolest kod osoba sa OSAHS.

 

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Objavljeno
2025/08/28
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Vol. 82 Br. 08 (2025): Vojnosanitetski pregled
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