Silent myocardial ischemia and related risk factors in patients with type 2 diabetes mellitus

Yıl 2010, Cilt: 37 Sayı: 2, 140 - 144, 01.06.2010

Mehmet Zorlu Ayşen Helvacı Muharrem Kıskaç Servet Yolbaş Cüneyt Ardıç Mustafa Oran Mine Adaş

Öz

Objectives: The aim of this study was to investigate the frequency of silent myocardial ischemia (SMI) in patients with Type 2 diabetes mellitus (DM) who do not have isch­emic cardiac disease. Materials and Methods: To examine the relationship between ischemic cardiac disease and related factors such as blood pressure, lipid profile, smoking, gender, family history, body mass index (BMI), microalbuminuria, hsCRP, 150 diabetic patients who have never had any known coroner artery disease, exertional or rest dyspnea and labored breathing, aged between 35 and 70 years were included. Effort testing (treadmill) were performed to examine the existence of SMI. Results: Effort testing gave positive result for SMI in 20 patients and negative in 130 patients. Coronary angiog­raphy was performed in 20 patients with positive effort testing results. The frequency of SMI was found as %13.3 by effort testing. The frequency of SMI (including non-crit­ical patients) was %10.6 (16 patients) by using coronary angiography, which 13(8.6%) had critical and 3(2%) had non-critical coronary stenosis. No significant differences were found in age, gender, diabetic duration, trigliserid, HDL- cholesterol, blood pressure, BMI and hsCRP levels between positive and negative SMI patients with Type 2 DM. Conclusion: We determined that high LDL-Cholesterol and HbA1c and existence of microalbuminuria indicated significant SMI risk for patients with Type 2 DM.

Anahtar Kelimeler

Diabetes mellitus, silent myocardial isch­emia, lipoproteins, electrocardiography

Tip 2 diyabetes mellituslu hastalarda sessiz miyokard iskemisi ve ilişkili risk faktörleri

Öz

Amaç: İskemik kalp hastalığı olmayan Tip 2 diyabetes mellituslu (DM) hastalarda sessiz miyokardiyal iskemisi (SMI) sıklığını araştırmak amaçlandı. Gereç ve Yöntem: Diyabetik hastalardaki kan basıncı, li­pid profili, sigara kullanımı, cinsiyet, aile öyküsü, vücut kit­le indeksi (VKİ), mikroalbüminüri, duyarlı C-reaktif protein (hsCRP) düzeyleri ölçülerek, efor testi sonuçları ile ilişkisi araştırıldı. önceden bilinen koroner arter hastalığı bulun­mayan, efor veya istirahat dispnesi tanımlamayan, 35-70 yaş arası ve kan basıncı 140/80 mmHg\'nın altında olan, 150 diyabetik hasta çalışmaya alındı. Bu hastalara sessiz miyokard iskemisi sıklığını araştırmak üzere efor testi ya­pıldı ve test pozitif çıkanlara anjiyografi uygulandı. Bulgular: Efor testi yapılan hastalardan 20\'sinde (%13.3) efor testi sonucunda miyokard iskemisi saptanırken, 130 (%87.7) hastada test sonucu negatif bulundu. Efor testi pozitif olan 20 hastaya iskemiyi doğrulamak için koroner anjiyografi yapıldı. Anjiyografi sonucunda 13 (%8.6) has­tada koroner arter darlığı, 3 (%2) hastada ise kritik olma­yan darlık saptandı. Böylece toplam olarak 16 (%10.6) hastada miyokard iskemisi saptandı. Tip 2 DM\'li sessiz iskemi pozitif ve negatif olan hastalar arasında yaş, cinsiyet, diyabet süresi, trigliserid, HDL-K, kan basıncı, VKİ ve hsCRP değerleri arasında anlamlı fark saptanmadı. Sonuç: Tip 2 DM\'li hastalarda yüksek LDL-K, kötü glisemik kontrol (yüksek HbA1c) ve mikroalbüminürinin bulunması sessiz iskemi açısından anlamlı risk oluşturmaktadır.

Anahtar Kelimeler

Diyabetes mellitus, sessiz miyokar­diyal iskemi, lipoproteinler, vücut kitle indeksi, elektrokar­diyografi

Kaynakça

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