Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus
AIM. To study the prognostic value of multifocal atherosclerosis (MFA) in patients with diabetes mellitus (DM) at high risk for myocardial ischemia who need coronary angiography (CAG). MATERIALS AND METHODS. The investigation included 148 patients: 25 with type 1 DM (DM1), 73 with type 2 DM (DM2), a...
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2014-10-01
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doaj-f1ecf6c9079b437b892ab4e5f11a96b22020-11-25T03:12:10Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422014-10-018610202628575Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitusS A GrachevaM S BiragovaA M GlazunovaI I KlefortovaM Sh ShamkhalovaM I DzhavelidzeT V SoldatovaA V Il'inM V ShestakovaÉ F TugeevaIu I BuziashviliAIM. To study the prognostic value of multifocal atherosclerosis (MFA) in patients with diabetes mellitus (DM) at high risk for myocardial ischemia who need coronary angiography (CAG). MATERIALS AND METHODS. The investigation included 148 patients: 25 with type 1 DM (DM1), 73 with type 2 DM (DM2), and 50 without DM who had undergone CAG. Duplex ultrasound scanning of lower limb vessels and brachiocephalic and renal arteries was carried out in all the patients. RESULTS. Involvement of two or more vascular beds was noted in 60% of the patients with DM1, in 68.4% of those with DM2, and in 34% of those without DM (p < 0.05). Regression analysis showed that the risk factors of MFA were defined to be myocardial infarction (MI) in the history (OR=2.4; p=0.02), DM (OR=3.9; p=0.0002), smoking (OR=2.4; p=0.05), elevated creatinine (OR=6.5; p=0.002) and fibrinogen (OR=6.8, p=0.004) levels. Among the DM patients, there were 26.5% of those who had achieved a main assessment criterion (a combined end point (CEP)), such as death, urgent hospitalization for heart failure, nonfatal MI, nonfatal stroke, lower extremity amputation, double creatinine levels, and achievement of end-stage renal failure during a 24-month follow-up. In patients without carbohydrate metabolic disturbances, this indicator was 12% (p=0.01). During the prospective study, a total of 6.1% of patients died in the DM group; all the patients in the non-DM group completed the study. Calculation of survival rates by the Kaplan-Meier method indicated that the DM patients with concurrent atherosclerotic lesion had achieved CEP significantly more frequently than the comparison group. Such differences were absent among the persons without carbohydrate metabolic disturbances. CONCLUSION. The regression analysis has shown that prior MI, DM, smoking, creatinine and fibrinogen levels are factors associated with the development of MFA in the examined groups. In the patients with DM, concurrent atherosclerosis of two or more vascular beds is an important factor for the progression of cardiovascular and renal diseases.https://ter-arkhiv.ru/0040-3660/article/view/31559diabetes mellitusmultifocal atherosclerosischronic kidney diseasesurvival rates |
collection |
DOAJ |
language |
Russian |
format |
Article |
sources |
DOAJ |
author |
S A Gracheva M S Biragova A M Glazunova I I Klefortova M Sh Shamkhalova M I Dzhavelidze T V Soldatova A V Il'in M V Shestakova É F Tugeeva Iu I Buziashvili |
spellingShingle |
S A Gracheva M S Biragova A M Glazunova I I Klefortova M Sh Shamkhalova M I Dzhavelidze T V Soldatova A V Il'in M V Shestakova É F Tugeeva Iu I Buziashvili Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus Терапевтический архив diabetes mellitus multifocal atherosclerosis chronic kidney disease survival rates |
author_facet |
S A Gracheva M S Biragova A M Glazunova I I Klefortova M Sh Shamkhalova M I Dzhavelidze T V Soldatova A V Il'in M V Shestakova É F Tugeeva Iu I Buziashvili |
author_sort |
S A Gracheva |
title |
Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus |
title_short |
Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus |
title_full |
Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus |
title_fullStr |
Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus |
title_full_unstemmed |
Risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus |
title_sort |
risk factors for and prognostic value of multifocal atherosclerosis in patients with diabetes mellitus |
publisher |
"Consilium Medicum" Publishing house |
series |
Терапевтический архив |
issn |
0040-3660 2309-5342 |
publishDate |
2014-10-01 |
description |
AIM. To study the prognostic value of multifocal atherosclerosis (MFA) in patients with diabetes mellitus (DM) at high risk for myocardial ischemia who need coronary angiography (CAG). MATERIALS AND METHODS. The investigation included 148 patients: 25 with type 1 DM (DM1), 73 with type 2 DM (DM2), and 50 without DM who had undergone CAG. Duplex ultrasound scanning of lower limb vessels and brachiocephalic and renal arteries was carried out in all the patients. RESULTS. Involvement of two or more vascular beds was noted in 60% of the patients with DM1, in 68.4% of those with DM2, and in 34% of those without DM (p < 0.05). Regression analysis showed that the risk factors of MFA were defined to be myocardial infarction (MI) in the history (OR=2.4; p=0.02), DM (OR=3.9; p=0.0002), smoking (OR=2.4; p=0.05), elevated creatinine (OR=6.5; p=0.002) and fibrinogen (OR=6.8, p=0.004) levels. Among the DM patients, there were 26.5% of those who had achieved a main assessment criterion (a combined end point (CEP)), such as death, urgent hospitalization for heart failure, nonfatal MI, nonfatal stroke, lower extremity amputation, double creatinine levels, and achievement of end-stage renal failure during a 24-month follow-up. In patients without carbohydrate metabolic disturbances, this indicator was 12% (p=0.01). During the prospective study, a total of 6.1% of patients died in the DM group; all the patients in the non-DM group completed the study. Calculation of survival rates by the Kaplan-Meier method indicated that the DM patients with concurrent atherosclerotic lesion had achieved CEP significantly more frequently than the comparison group. Such differences were absent among the persons without carbohydrate metabolic disturbances. CONCLUSION. The regression analysis has shown that prior MI, DM, smoking, creatinine and fibrinogen levels are factors associated with the development of MFA in the examined groups. In the patients with DM, concurrent atherosclerosis of two or more vascular beds is an important factor for the progression of cardiovascular and renal diseases. |
topic |
diabetes mellitus multifocal atherosclerosis chronic kidney disease survival rates |
url |
https://ter-arkhiv.ru/0040-3660/article/view/31559 |
work_keys_str_mv |
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