Arterial stiffness predicts risk for long-term recurrence in patients with type 2 diabetes admitted for acute coronary event.

Autor: Levisianou D; 2nd Department of Internal Medicine, Nikea General Hospital, 3 D.Mantouvalou str, Nikea, Greece. dimlevi@yahoo.gr, Foussas S, Skopelitis E, Adamopoulou E, Xenopoulou T, Destounis A, Koukoulis G, Skoularigis I, Melidonis A, Triposkiadis F
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2013 Mar; Vol. 99 (3), pp. 315-20. Date of Electronic Publication: 2012 Dec 20.
DOI: 10.1016/j.diabres.2012.11.023
Abstrakt: Objectives: to investigate the predictive value of arterial stiffness (AS) estimation for long-term recurrences in patients with type 2 diabetes (DM2) following acute coronary event.
Patients and Methods: prospective observational study involving 119 DM2 patients without history of coronary heart disease admitted with ST-segment elevation myocardial infarction (STEMI). Medical history, anthropometrics, smoking, HbA1c, lipid profile, troponine-I levels, and left ventricular ejection fraction (LVEF) were recorded. Carotid-femoral pulse wave velocity (cf-PWV) was measured 1 month after discharge. Patients were followed up for 36 months or to reach an end-point: cardiovascular death, acute coronary event, angioplasty or hospitalization for acute heart failure. To facilitate analysis, patients were divided into two groups according to cf-PWV, using the accepted cut-off value of 12m/s.
Results: overall, 34 patients had a recurrence. In Kaplan-Meier analysis patients with cf-PWV>12m/s had mean time-to-event 353±43 days compared to 505±115 days for patients with cf-PWV≤12m/s, log rank=0.0252. In multivariate analysis factors independently associated with recurrence were age (66.53±6.87 vs. 61.54±10.77 years, p=0.015), LVEF (41.66±8.21 vs. 47.58±8.11%, p=0.001) and cf-PWV (13.94±2.91 vs. 12.35±2.77m/s, p=0.008).
Conclusions: AS estimation in patients with DM2 after STEMI discriminate patients at higher risk for 3-year recurrence, and maybe valuable for distinguishing patients likely to require a more rigorous therapeutic intervention.
(Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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