članak: 1 od 1  
Vojnosanitetski pregled
2009, vol. 66, br. 11, str. 887-891
jezik rada: srpski
originalan članak
doi:10.2298/VSP0911887P

Povezanost oblika atrijalne fibrilacije sa pojavom tromboembolijskih komplikacija
Klinički centar Srbije, Institut za kardiovaskularne bolesti, Beograd

e-adresa: spotpara@sbb.rs + tanjapotpara@hotmail.com

Sažetak

Uvod/Cilj. Atrijalna fibrilacija (AF) povećava rizik od ishemijskog moždanog udara i drugih tromboembolijskih (TE) komplikacija. Cilj ove studije bio je da se ispita povezanost kliničkih oblika i pojave TE komplikacija. Metode. U ovo longitudinalno opservaciono istraživanje bili su uključeni bolesnici sa nevalvularnom AF, ambulantno i/ili bolnički lečeni u Kliničkom centru Srbije u periodu 1992-2003, u skladu sa međunarodnim preporukama za dijagnostiku i lečenje AF. Klinički oblici AF definisani su prema poslednjim ACC/AHA/ESC preporukama za dijagnostiku i lečenje AFs komplikacije iz 2006. Dijagnozu cerebrovaskularnih ili perifernih TE postavljali su isključivo neurolog, odnosno vaskularni hirurg. Rezultati. Tokom perioda praćenja od 9,9 ± 6 godina TE komplikacije zabeležene su kod 88/1 100 bolesnika (8%). U momentu TE komplikacija 46/88 bolesnika (52,3%) imalo je permanentnu AF. Bolesnici sa permanentnom AF od početka studije bili su značajno stariji i češće su imali pridružena srčana oboljenja, kao i dijabetes melitus. Kumulativni TE rizik tokom praćenja bio je sličan kod bolesnika sa paroksizmalnom i permanentnom AF, a značajno viši nego kod bolesnika sa perzistentnom AF. Međutim, u multivarijantnom Coxovom proporcionalnom hazardnom regresionom modelu sa oblicima AF, kliničkim i ehokardiografskim karakteristikama i terapijom za prevenciju TE na početku studije i u momentu TE komplikacije kao nezavisnim varijablama, klinički oblik AF nije identifikovan kao nezavisni prediktor TE rizika. Zaključak. Prevenciju TE komplikacija AF treba određivati prema dokazanim faktorima rizika, nezavisno od kliničkog oblika AF.

Ključne reči

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