Međusobni odnos Finskog skora rizika od dijabetesa i stepena težine koronarne arterijske bolesti

  • Predrag Đurić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Zorica Mladenović Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Aleksandra Grdinić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Dragan Tavčiovski Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Zoran Jović Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia
  • Marijan Spasić Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia
  • Žaklina Davičević-Elez Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
DOI: https://doi.org/10.2298/2271
Ključne reči: coronary artery disease||, ||koronarna bolest, disease progression||, ||bolest, progresija, risk assessement||, ||rizik, procena, diabetes mellitus, type 2||, ||diabetes melitus, tip 2, risk factors||, ||faktori rizika,

Sažetak


Uvod/Cilj.

Finski skor rizika od dijabetesa (FINDRISC) koji obuhvata nekoliko parametara (godine života, istorija arterijske hipertenzije, indeks telesne mase – BMI, fizička (ne)aktivnost, obim struka, konzumiranje voća, ranije registrovana hiperglikemija, porodično opterećenje za dijabetes) ima puno značaja za identifikaciju bolesnika sa poremećajem glikoregulacije i za procenu 10-godišnjeg rizika od nastanka dijabetesa melitusa tipa 2. Pošto skor FINDRISC čine parametri koji su faktori rizika od koronarne arterijske bolesti (KAB), naš cilj bio je da ispitamo međusobni odnos ovog skora i nekih njegovih pojedinačnih parametara i stepena težine KAB kod bolesnika sa simptomima stabilne angine pektoris na 2 načina: prema skoru Synergy between Percutaneaus Coronary Intervention with Percutaneans Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) i prema broju zahvaćenih krvnih sudova srca. Metode. Ispitivanjem je obuhvaćeno 70 bolesnika, hospitalizovanih u Klinici za kardiologiju Vojnomedicinske akademije zbog tegoba tipa stabilne angine pektoris, koji su davali odgovore na pitanja iz upitnika FINDRISC, i kojima su određivane vrednosti inflamatornih markera [sedimentacija eritrocita (SE), leukociti, C-reaktivni protein (CRP), lipidni status (ukupni holesterol, HDL holesterol, trigliceridi), kao i glikemija]. Svim ispitanicima je urađena koronarografija radi utvrđivanja stepena težine KAB prema skoru SYNTAX, kao i prema broju zahvaćenih krvnih sudova srca: jednosudovna, dvosudovna ili trosudovna (hemodinamski značajnim stenozama su smatrane stenoze koje zahvataju više od 70% lumena krvnog suda). Svi bolesnici bili su podeljeni u III grupe u zavisnosti od vrednosti skora FINDRISC (grupa I:5–11 poena, grupa II:12–16 poena, grupa III:17–22 poena). Rezultati. Ispitivanjem je bilo obuhvaćeno 52 muškarca i 18 žena. Od 70 ispitanika uključenih u studiju, 14 je imalo normalan koronarografski nalaz. Utvrđena je statistički značajna povezanost između skora FINDRISC, kao i njegovih pojedinačnih parametara (godine, indeks telesne mase, obim struka) sa stepenom težine koronarne arterijske bolesti  prema skoru SYNTAX (p < 0.001), kao i prema broju zahvaćenih krvnih sudova srca (p = 0,007). Šansa za postojanje višesudovne bolesti između grupa III i I iznosila je 5,143 (95% CI 1,299–20,360, p = 0,002), a između grupe II i grupe I 5,867 (95% CI 1,590–21,525, p = 0,007). Nije bilo statistički značajne razlike između grupe II i grupe III 1,141; (95% CI 0,348- 3,734). U grupi I prosečna vrednost SYNTAX skora iznosila je 5,18, a više od 70% bolesnika je imalo normalan koronarografski nalaz. U grupi II prosečna vrednost SYNTAX skora iznosila je 17,06, a više od 70% bolesnika je imalo dvosudovnu ili trosudovnu KAB. U III grupi prosečna vrednost SYNTAX skora je iznosila 18,89,  dvosudovnu i trosudovnu KAB imalo je 36,36%, tj. 31,82% ispitanika. U multiploj regresionoj analizi, gde je skor SYNTAX bio zavisna varijabla, a godine života, BMI, obim struka i skor FINDRISC nezavisne varijable nađeno je da je samo skor FINDRISC bio nezavisan prediktor SYNTAX skora. Zaključak.

Dobijeni rezultati pokazuju da postoji značajna povezanost skora FINDRISC i njegovih pojedinačnih parametara (godine života, indeks telesne mase, obim struka) sa stepenom težine koronarne arterijske bolesti prema SYNTAX skoru, kao i prema broju zahvaćenih krvnih sudova srca. Skor FINDRISC može biti koristan za identifikaciju bolesnika koji imaju povišen rizik od nastanka koronarne arterijske bolesti.

Biografija autora

Predrag Đurić, Clinic of Cardiology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
mr sci med, cardiologist

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Objavljeno
2015/04/23
Broj časopisa
Vol. 71 Br. 5 (2014)
Rubrika
Originalni članak