The Importance of Insulin Resistance Assessing as the Effectiveness Predictor in Rehabilitation and Observation of Patients after Acute Myocardial Infarction
| Autor: | Tatyana V. Pshenichnikova, Svetlana E. Ushakova, Michail V. Alexandrov |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Embryology
medicine.medical_specialty Rehabilitation business.industry medicine.medical_treatment 030209 endocrinology & metabolism Cell Biology 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Insulin resistance Internal medicine Cardiology medicine Myocardial infarction Anatomy business Developmental Biology |
| Zdroj: | Bulletin of Rehabilitation Medicine. 20:59-66 |
| ISSN: | 2078-1962 |
| Popis: | One of the goals for the management of patients after acute myocardial infarction is to achieve and maintain the optimal level of lowdensitylipoproteins (LDL), which is a factor that determines the prognosis in patients with coronary heart disease. A relevant objectiveis to extract from a number of trophic indicators that indicate disturbance in the adipose tissue distribution and functioning and thatincrease the risk of repeated cardiovascular disasters, the predictors of the low-density lipoprotein targets achieving effectivenessduring rehabilitation and subsequent dispensary follow-up of patients who have suffered a myocardial infarction. Aim. To assess the role of trophological factors, in particular insulin resistance, in achieving LDL cholesterol target values during rehabilitationand follow-up of patients after acute myocardial infarction. Material and methods. The study included 68 men (age from 55 to 65 years) after myocardial infarction underwent rehabilitation atthe Ivanovo State Medical Academy Clinic. The dynamics of the lipidogram parameters over the course of 6 months was evaluated. Todescribe the trophological status of the patients several metabolic and anthropometrical indicators were applied (weight, body massindex, waist circumference, ratio of waist circumference to the hips circumference, index of the central obesity, visceral adiposity index,percentage of fatty tissue, and metabolic index of insulin resistance). A regression model was created to determine significant factorsassociated with achieving low-density lipoprotein cholesterol targets values. Results. The effectiveness of dyslipidemia correction in patients with myocardial infarction was lower in the group of people with signsof insulin resistance. Among the trophic indicators, predictors that have a prognostic value in achieving the target level of low-densitylipoprotein cholesterol are identified: the initial level of low-density lipoprotein cholesterol, the central obesity index, the metabolicinitial index and after 6 months of follow-up. Conclusion. In the course of rehabilitation and subsequent follow-up, it is advisable to distinguish among patients after acute myocardialinfarction, persons with a metabolically unhealthy phenotype and insulin resistance. If an increase in the metabolic central obesityindex is recorded, it is possible to regard the manifestations of insulin resistance as a predictor of the ineffectiveness of achieving thegoals of lipid-lowering therapy and adjust therapeutic and preventive measures. |
| Databáze: | OpenAIRE |
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