Profile of Cardiovascular Risk Factors in Ischemic Heart Disease in Patients with Normal and Impaired Carbohydrate Metabolism
Aim of investigation — to conduct the comparative analysis of profile of general population cardiovascular risk factors in patients with ischemic heart disease (IHD) on a background of normal and impaired carbohydrate metabolism. Materials and methods. In order to evaluate the incidence of different forms of IHD depending on the state of carbohydrate metabolism, the following groups were formed: group I — 113 patients with type 2 diabetes mellitus (DM), group II — 69 persons with impaired glucose tolerance (IGT) and group III — 60 individuals without carbohydrate metabolism disorders. In future, subgroups of patients with IHD were formed from these groups to compare cardiovascular risk factors profile: 32 patients with type 2 DM and IHD, 14 persons with IGT and IHD, 10 individuals with IHD without carbohydrate metabolism disorders. Results. Silent myocardial ischemia (SMI) was detected in 21 (18.6 %) patients with type 2 DM, in 5 (7.2 %) persons with IGT and in 2 patients (3.3 %) with a normal carbohydrate metabolism. From indexes that characterize cardiovascular risk factors and have a high prognostic value in relation to the presence of SMI, the combination of such predictors, as sex, type 2 DM duration, family history of IHD and/or type 2 DM, the content of HbA1c, high density lipoproteins, the presence of hypertrophy and type 1 left ventricular diastolic dysfunction, have the greatest ability to predict the development of the discussed pathology in patients with type 2 DM. Conclusions. A profile of general population risk factors of cardiovascular diseases in patients with type 2 DM and IHD is most unfavorable. In persons with early violations of carbohydrate metabolism and with normal carbohydrate metabolism, it does not differ statistically significant. Patients with type 2 DM and SMI, as compared to the patients with type 2 DM without IHD, have statistically significantly more severe violations of general population risk factors for cardiovascular disease (smoking, family history of IHD and/or type 2 DM, disorders in the hemostasis system, dyslipidemia), as well as additional risk factors (hyperglycaemia, diabetic nephropathy, left ventricular dysfunction).
Bulugahapitiya U, Siyambalapitiya S, Sithole J, Idris I. Is diabetes a coronary risk equivalent? Systematic review and meta-analysis. Diabet. Med. 2009;26:142-148. doi: 10.1111/j.1464-5491.2008.02640.x.
van Dieren S, Beulens JW, Kengne AP. Prediction models for the risk of cardiovascular disease in patients with type 2 diabetes: a systematic review. Heart. 2012;98:360-369. doi: 10.1136/heartjnl-2011-300734.
Juutilainen A, Lehto S, Rönnemaa T. Type 2 diabetes as a “coronary heart disease equivalent”: an 18-year prospective population-based study in Finnish subjects. Diabetes Care. 2005;28:2901-2907. doi: 10.2337/diacare.28.12.2901.
Rodriguez-Poncelas A, Coll-de-Tuero G, Saez M. Comparison of different vascular risk engines in the identification of type 2 diabetes patients with high cardiovascular risk. BMC Cardiovasc. Disord. 2015;15(1):121. doi: 10.1186/s12872-015-0120-3.
Rydén L, Grant PJ, Anker SD. ESC guidelines on diabetes, prediabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). Eur. Heart J. 2013;34:3035-3087. doi: 10.1093/eurheartj/eht108.
Seshasai SR, Kaptoge S, Thompson A. Diabetes mellitus, fasting glucose, and risk of cause-specific death. The Emerging risk factors collaboration. N. Engl J. Med. 2011;364:829-884. doi: 10.1056/NEJMoa1008862.
Shah AD, Langenberg C, Rapsomaniki E. Type 2 diabetes and incidence of a wide range of cardiovascular diseases: a cohort study in 1,9 million people. Lancet. 2015;26 (385):86. doi: 10.1016/S0140-6736(15)60401-9.
Timbie JW, Hayward RA, Vijan S. Variation in the net benefit of aggressive cardiovascular risk factor control across the US population of patients with diabetes mellitus. Arch. Intern. Med. 2010;170:1037-1044. doi: 10.1001/archinternmed.2010.150.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2018