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Journal of Medical Biochemistry
2015, vol. 34, br. 2, str. 160-169
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 03/01/2020
PMC ID: PMC4922321
doi: 10.2478/jomb-2014-0037
Oksidovani lipoprotein niske gustine i visokosenzitivni C-reaktivni protein kod nedijabetičara, predijabetičara I dijabetičara u akutnoj fazi prvog infarkta miokarda lečenog primarnom perkutanom koronarnom intervencijom
aKlinički centar Srbije, Klinika za kardiologiju, Beograd + Univerzitet u Beogradu, Medicinski fakultet
bUniversity of Belgrade, School of Pharmacy, Clinical Centre of Serbia, Center for Medical Biochemistry
cUniverzitet u Beogradu, Medicinski fakultet, Institut za medicinsku statistiku i informatiku
dKlinički centar Srbije, Klinika za kardiologiju, Beograd
eUniverzitet u Beogradu + Srpska akademija nauke i umetnosti (SANU), Beograd

e-adresa: danijelatrif@gmail.com

Projekat

145053

Sažetak

Uvod: Oksidovani lipoprotein niske gustine (ox-LDL) i visokosenzitivni C-reaktivni protein (hs-CRP) povišeni su u dijabetes melitusu (DM) i povezani sa ubrzanom aterosklerozom. Malo je poznata njihova dinamika u akutnoj fazi infarkta miokarda sa elevacijom ST segmenta (STEM I), naročito u zavisnosti od prisustva DM ili predijabetesa (pre-DM). Ova studija je analizirala promenu koncentracija ox-LDL i hs-CRP u akutnoj fazi STEMI u odnosu na prisustvo pre-DM i DM kod bolesnika lečenih primarnom perkutanom koronarnom intervencijom (pPKI). Metode: Kod 103 konsekutivna bolesnika sa prvim prednjim STEMI, hs-CRP i ox-LDL mereni su pre pPCI, drugog i sedmog dana nakon pPKI. Rezultati: Bolesnici su podeljeni u tri grupe: nedijabetičari, predijabetičari i dijabetičari. U svakoj grupi maksimalna koncentracija ox-LDL bila je na prijemu, smanjivala se drugog dana i postizala najniže vrednosti sedmog dana (p< 0,001). Dijabetičari su uvek imali najviše vrednosti oxLDL u poređenju sa predijabetičarima i nedijabetičarima (na prijemu: p= 0,028, drugog dana: p=0,056 i sedmog dana: p= 0,004). Koncentracija hs-CRP je u svakoj grupi rasla od prijema, postizala maksimalne vrednosti drugog dana i smanjivala se sedmog dana (p< 0,001). Značajna razlika u koncentraciji hs-CRP između nedijabetičara i predijabetičara registrovana je na prijemu (p= 0,018) i drugog dana (p= 0,026). U multivarijantnoj analizi DM je bio nezavisan prediktor visokih koncentracija ox-LDL. I ox-LDL i hs-CRP su značajno korelisali sa Killip klasom, ejekcionom frakcijom leve komore, koncentracijom NT-proBNP i maksimalnom vrednošću troponina I. Zaključak: Kod bolesnika sa prvim STEMI lečenim pPKI postojale su značajne razlike u koncentraciji ox-LDL i hsCRP između nedijabetičara, predijabetičara i dijabetičara. Koncentracije ox-LDL i hs-CRP značajno su korelisale sa parametrima srčane insuficijencije.

Ključne reči

oksidovani LDL; visokosenzitivni C-reaktivni protein; akutni infarkt miokarda; dijabetes melitus

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