Öz
Objectives: Diabetes mellitus is considered to be equivalent to coronary artery disease(CHD). Both impaired fasting glucose(IFG) and impaired glucose tolerance (IGT) are risk factors for cardiovascular disease. We aimed to compare the mortality during hospitalization between IFG and diabetes in patients with acute coronary syndrome (ACS). Methods: The patients under 65 years of age, who had been diagnosed as ACS; were evaluated for mortality during the first 7 days. The patients were divided into three groups as the first group diabetic, the second group non-diabetic patients , the patients with IFG. Results: A total of 375 patients were enrolled. The mortality rate was found to be 6.7% in patients with diabetes, 2.6% in patients without diabetes , 7.0% in patients with an IFG. The mortality rate of the patients with IFG and the patients with diabetes were approximately the same and this rate was significantly higher than in those with normal blood glucose during the acute phase of ACS. Conclusion: The IFG affects mortality as much as diabetes. Fasting plasma glucose is beneficial, in determining the cardiovascular risks and in the modification of the therapy to reduce the risk of CHD
Anahtar Kelimeler
Acute coronary syndrome Impaired fasting glucose Diabetes Mortality
Kaynakça
- American Diabetes Association .Diagnosis and classification of diabetes mellitus. By Diabetes Care 2004;27: 5-10,
- Abacı A, Oğuzhan A, Karaman S, et al. Effects of diabetes mellitus on formatıon of coronary vessels. Circulatıon 1999; 99 : 2239-2242.
- Zimmet P, Albertik KGMM.The changing face of macrovascular disease in noninsulin dependent diabetes mellitus in different cultures : an epidemic in progress Lancet 1997; 350 :S1-S4.
- Haffner SM, Stern M, Hazuda HP, et al. Cardiovascular risk factor in confirmed prediabetıc individuals. Does the clock for coronary artery disease start ticking before the onset of clinical diabetes. JAMA 1990; 263: 2893- 2898.
- Wheathcoft SB, Williams IL, Shah AM, et al. Pathophisiological impications of insulin resistance on vasculer endothelial function diabetic medicine 2003; 20: 255-268
- Peterson DT, Greene WC, Reaven GM. Effect of experimental diabetes mellitus on kidney ribosomal protein synthesis. Diabetes 1971;20:649-54.
- Ryden L, Armstrong PW, Cleland JG, et al. Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus. Result from the ATLAS trial. Eur Heart J 2000;21:1967-1978.
- Ledru F, Ducimetieve P,Battoglia S, et al. New Diagnostic criteria for diabetes coronery artery disease insights from an angiographic study. I Am Coll Cardiol 2001, 37 :1543-1550.
- Laakso M. Hyperglisemia and cardiovascular disease in type 2 diabetes. Diabetes 1999;48:937-942.
- Hsueh WA, Laur RE. Cardiovascular risk continuum : implications of insulin resistance and diabetes AMJ Med 1998; 105: 4-14.
- Schachiner V, Britten MB,Zeiher AM . Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation 2000; 101:1899-1906.
- Yılmaz MT, Salman S. Diabetik hastada postprandial glukoz düzeyinin önemi. Aktüel Tıp Derg 2003;8 :14- 18.
- Haffner SM, Lehta S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in and in nondiabetic subjects with and without prior myocardial infarction. Engl J Med 1998, 339 :229-234.
- Rodriguez BL,Curb JD, Burcfiel CM, et al. Impaired glucose tolerance diabetes and cardiovascular disease risk factor profiles. The Honolulu Heart Program. Diabetes Care 1996;19: 587-590.
- Tominago M, Eguchi H, Monaka H, Igarahi H, Kato T, Sekikama A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glocose. The FURAGATO diabetes study. Diabetes Care 1999; 22 : 920-924.
- Nurkalem Z, Sargın M, Alper A, et al. Nondiabetik AKS vakalarında postprandial hipergliseminin koroner lezyonlarla ilişkisinin araştırılması. Endokrinolojide Yönelişler 2003;12 : 175-179.
- Hanefeld M, Koehler C, Schaper F, Fuecker K, Henkel E, Temelkova T, Postprandial plasma glucose is an independent risk factor for increased carotid intima media thickness in non-diabetic individuals. Atherosclerosis 1998;144 : 229-235.
- Balkau B, Bertrais S, Ducimetieve P, Eschvege E . Is there a glycemic threshold for mortality risk. Jpn Heart J 1991;31 : 35-43.
- Alain D,Baron MD. Vascular reactivity. Am J Cardiol 1999; 84: 251-271.
- Kawano H, Motoyama T, Hirashima O, et al. Hyperglicemia rapidly surresses flow mediated endothelium-dependent vasodilatation of brachial artery. J Am Coll Cardiol 1999; 34 : 146-154. 262
Öz
Giriş: Diyabet artık koroner arter hastalığının eşdeğeri sayılmaktadır.Ayrıca hem bozulmuş açlık glukozu(IFG) hemde bozulmuş karbonhidrat toleransı (IGT) kardiyovasküler hastalık için birer risk faktörüdür.Bu çalışmada akut koroner sendrom (AKS) tanısı alan; diyabetli ve IFG li hastalar arasında hastane içi mortalitenin karşılaştırılması amaçlanmıştır. Yöntem: Çalışmaya akut AKS tanısı alan 65 yaş altı hastalar alındı ,ilk 7 gündeki mortaliteleri değerlendirildi.Hastalar açlık kan şekerine göre diyabeti olan, diyabeti olmayan ve bozulmuş açlık glukozu olanlar olmak üzere üç gruba ayrıldı. Bulgular: Toplam 375 hasta çalışmaya dahil edildi. Tüm hastalarda hospitalizasyon dönemindeki mortalite; diyabeti olan hastalarda % 6.7, diyabeti olmayanlarda % 2.6, bozulmuş açlık glukozu olanlarda %7.0 olarak bulundu.AKS sonrası erken dönemde mortalite IFG ve diyabetli hastalarda yaklaşık aynı oranda tespit edildi. Bu oran normal kan şekeri olanlardan anlamlı derecede yüksek tespit edildi. Sonuç: Dolayısıyla IFG; diyabet gibi koroner kalp hastalığı için risk faktörüdür ve mortalite üzerinde onun kadar etkilidir.Sonuç olarak,açlık plazma glukozu,kardiyovasküler hastalık riskinin belirlenmesinde ve koroner arter hastalık riskini azaltıcı yaklaşımların belirlenmesinde son derece faydalıdır.
Anahtar Kelimeler: Akut koroner sendrom, Bozulmuş açlık glikozu, Diyabet, Mortalite
Anahtar Kelimeler
Akut koroner sendrom Bozulmuş açlık glikozu Diyabet Mortalite
Kaynakça
- American Diabetes Association .Diagnosis and classification of diabetes mellitus. By Diabetes Care 2004;27: 5-10,
- Abacı A, Oğuzhan A, Karaman S, et al. Effects of diabetes mellitus on formatıon of coronary vessels. Circulatıon 1999; 99 : 2239-2242.
- Zimmet P, Albertik KGMM.The changing face of macrovascular disease in noninsulin dependent diabetes mellitus in different cultures : an epidemic in progress Lancet 1997; 350 :S1-S4.
- Haffner SM, Stern M, Hazuda HP, et al. Cardiovascular risk factor in confirmed prediabetıc individuals. Does the clock for coronary artery disease start ticking before the onset of clinical diabetes. JAMA 1990; 263: 2893- 2898.
- Wheathcoft SB, Williams IL, Shah AM, et al. Pathophisiological impications of insulin resistance on vasculer endothelial function diabetic medicine 2003; 20: 255-268
- Peterson DT, Greene WC, Reaven GM. Effect of experimental diabetes mellitus on kidney ribosomal protein synthesis. Diabetes 1971;20:649-54.
- Ryden L, Armstrong PW, Cleland JG, et al. Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus. Result from the ATLAS trial. Eur Heart J 2000;21:1967-1978.
- Ledru F, Ducimetieve P,Battoglia S, et al. New Diagnostic criteria for diabetes coronery artery disease insights from an angiographic study. I Am Coll Cardiol 2001, 37 :1543-1550.
- Laakso M. Hyperglisemia and cardiovascular disease in type 2 diabetes. Diabetes 1999;48:937-942.
- Hsueh WA, Laur RE. Cardiovascular risk continuum : implications of insulin resistance and diabetes AMJ Med 1998; 105: 4-14.
- Schachiner V, Britten MB,Zeiher AM . Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation 2000; 101:1899-1906.
- Yılmaz MT, Salman S. Diabetik hastada postprandial glukoz düzeyinin önemi. Aktüel Tıp Derg 2003;8 :14- 18.
- Haffner SM, Lehta S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in and in nondiabetic subjects with and without prior myocardial infarction. Engl J Med 1998, 339 :229-234.
- Rodriguez BL,Curb JD, Burcfiel CM, et al. Impaired glucose tolerance diabetes and cardiovascular disease risk factor profiles. The Honolulu Heart Program. Diabetes Care 1996;19: 587-590.
- Tominago M, Eguchi H, Monaka H, Igarahi H, Kato T, Sekikama A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glocose. The FURAGATO diabetes study. Diabetes Care 1999; 22 : 920-924.
- Nurkalem Z, Sargın M, Alper A, et al. Nondiabetik AKS vakalarında postprandial hipergliseminin koroner lezyonlarla ilişkisinin araştırılması. Endokrinolojide Yönelişler 2003;12 : 175-179.
- Hanefeld M, Koehler C, Schaper F, Fuecker K, Henkel E, Temelkova T, Postprandial plasma glucose is an independent risk factor for increased carotid intima media thickness in non-diabetic individuals. Atherosclerosis 1998;144 : 229-235.
- Balkau B, Bertrais S, Ducimetieve P, Eschvege E . Is there a glycemic threshold for mortality risk. Jpn Heart J 1991;31 : 35-43.
- Alain D,Baron MD. Vascular reactivity. Am J Cardiol 1999; 84: 251-271.
- Kawano H, Motoyama T, Hirashima O, et al. Hyperglicemia rapidly surresses flow mediated endothelium-dependent vasodilatation of brachial artery. J Am Coll Cardiol 1999; 34 : 146-154. 262
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 22 Nisan 2015 |
| Yayımlandığı Sayı | Yıl 2014 Cilt: 27 Sayı: 1 |