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2020, vol. 77, br. 11, str. 1192-1200
Razvoj indeksa rizika od velikih vaskularnih događaja tokom godinu dana posle perkutane koronarne intervencije kod bolesnika sa akutnim koronarnim sindromom i dijabetesom melitusom
aGeneral Hospital Valjevo, Department of Cardiology and Invasive Cardiology, Valjevo
bKlinički centar Srbije, Klinika za kardiologiju, Beograd + Univerzitet u Beogradu, Medicinski fakultet

e-adresamarijamirkovic58va@gmail.com
Sažetak
Uvod/Cilj. Bolesnici sa akutnim koronarnim sindromom (AKS) i dijabetes melitusom (DM) imaju povećan rizik od pojave velikih neželjenih kardiovaskularnih događaja (VNKD) nakon perkutane koronarne intervencije (PKI), ali on je nedovoljno višedimenzionalno procenjen u odnosu na vrstu i težinu AKS i/ili DM i angiografske nalaze. Ova studija je imala za cilj da validira i razvije indeks metaboličkih, angiografsko-anatomskih i kliničkih faktora rizika za VNKD u toku jedne godine posle sprovedene PKI kod bolesnika sa AKS i DM. Metode. Sprovedena je prospektivna studija preseka kod bolesnika sa DM i AKS, kojima su u periodu PKI evidentirani sledeći faktori rizika: 1) metaboličke varijable - nivoi glikoziliranog hemoglobina (HbA1c), ukupnog holesterola i triglicerida u krvi; 2) endokrinološke varijable - terapija DM i tip DM; 3) modalitete AKS; 4) radiološke/anatomske varijable - SYNTAX skor i 5) kliničke varijable u modifikovanom starost, kreatinin, ejekciona funkcija (engl. age, creatinine, ejection fraction - ACEF) skoru. VNKD su evidentirani do godinu dana posle PKI. Rezultati. Nakon PKI, od konsekutivno uključenih 136 bolesnika, njih 55 razvilo je bar jedan VNKD u periodu praćenja od jedne godine. Konstruisan je visoko prediktivni indeks rizika kojim su procenjeni zasebni ili združeni rizici od VNKD (c statistika = 0,879) u studijskoj populaciji, a koji su definisani SYNTAX skorom > 21, modifikovanim ACEF skorom > 1,38, HbA1c ≥ 8%, trigliceridemijom ≥ 2,3 mmol/L kod bolesnika na insulinskoj terapiji, kao i modalitetom ACS - nestabilna angina pektoris. Konstruisani indeks rizika (IR) od VNKD (IRVNKD) imao je bolje prediktivne karakteristike u odnosu na SYNTAX skor (c statistika = 0,798), kao i ACEF skor. Zaključak. IRVNKD potencijalno može da ima veliku primenu u budućim istraživanjima faktora rizika od VNKD koji nastaju do jedne godine posle PKI kod bolesnika sa DM i AKS, jer se njime učinci ovih faktora višedimenzionalno validno i precizno mere.
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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/VSP181102026M
primljen: 02.11.2018.
revidiran: 16.02.2019.
prihvaćen: 22.02.2019.
objavljen onlajn: 15.03.2019.
objavljen u SCIndeksu: 11.12.2020.
metod recenzije: dvostruko anoniman
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