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Background. The aim of this study was to evaluate coronary artery calcium scoring and the assessment of the risk factors in patients with myocardial infarction (MI). Methods. During the period of three years, 27 patients with MI were analyzed. The average age of patients was 66.1 years (46 to 81). Coronary arteries calcium was evaluated by multi row detector computed tomography (MTDC) Somatom Volume Zoom Siemensa, and, retrospectively by ECG gating data acquisition. Semi automated calcium quantification to calculate Agatston calcium score (CS) was performed with 4 x 2.5 mm collimation, using 130 ml of contrast medium, injected with an automatic injector, with the flow rate of 4 ml/sec. The delay time was determined empirically. At the same time several risk factors were evaluated. Results. Out of 27 patients with MI, 3 (11.1 %) patients had low CS (10-100), 5 (18.5%) moderate CS (101499), and 19 (70.4%) patients high CS (>500). Of risk factors, smoking was confirmed in 17 (63.0%), high blood pressure (HTA) in 10 (57.0%), diabetes mellitus in 7 (25.9%), positive family history in 5 (18.5%), pathological lipids in 5 (18.5%), alcohol abuse in 4 (1.8%) patients. Six (22.2%) patients had symptomsof angina pectoris. Conclusions. The research showed high correlation of MI and high CS (>500). Smoking, HTA, diabetes mellitus, positive family history and hypercholesterolemia are significant risk factors. Symptoms are relatively poor in large number of patients. Izhodišča. Namen raziskave je bil ocenitev pomembnosti ugotavljanja koronarne kalcifikacije kot dejavnika tveganja pri bolnikih z miokardnim infarktom. Metode. V obdobju treh let smo pri 27 bolnikih z miokardnim infarktom ugotavljali stopnjo koronarne kalcifikacije. Povprečna starost bolnikov je bila 66,1 let (46-81). Za merjenje kalcija v koronarnih arterijah smo uporabljali večrezno računalniško tomografijo (MTDC) Somatom Volume Zoom Siemens in retrospektivno obdelali podatke glede na z EKG-jem merjen srčni ritem. Polavtomatsko smo izračunali količino kalcija po Agatstonu (CS). Uporabljali smo 4 x 2,5 mm veliki kolimator in 130 ml kontrastnega sredstava, ki smo ga vbrizgali z avtomatskim injektorjem s hitrostjo 4 ml/s. Empirično smo določili zakasnitveni čas. Ocenili smo tudi različne dejavnike tveganja zamiokardni infarkt. Rezultati. Med 27 bolniki z miokardnim infarktom so 3 (11,1%) imeli nizek CS (10-100), 5 (18,5%) sreden CS (101-499), 19 (70,4%) bolnikov pa je imelo visok CS (>500). Ko smo ugotavljali druge dejavnike tveganja za miokardni infarkt, smo ugotovili, da je bilo 17 (63,0%) bolnikov kadilcev, 10 (57,0%) bolnikov je imelo povišan arterijski krvni tlak, 7 (25,9%) sladkorno bolezen, 5 (18,5%`) srčno bolezen v družini, 5 (18,5%) zvišane lipide v krvi, 4 (1,8%) pa so bili alkoholiki. Le šest (22,2%) bolnikov je navajalo simptome angine pektoris. Zaključki. Raziskava je pokazala veliko soodvisnost miokardnega infarkta in stopnje kalcifikacije koronarnih arterij (CS>500). Tudi v naši skupini preiskovanih bolnikov smo ugotovili večjo prisotnost preostalih dejavnikov tveganja za miokardni infarkt, kot so kajenje, zvišanje arterijskega krvnega tlaka, sladkorna bolezen, miokarni infarkt v družini in povišan holesterol v krvi. Pri večini bolnikov pa nismo ugotovili izrazitih simptomov. |
