Zinat Nadia HATMİ, Jalilian NASSRİN, Pakravan ALİ, Sabouri A KASHANI

Koroner Arter Hastalığı Olanlarda Koroner Olayları Tahmin Etmek İçin Ayak Bileği-Kol İndeksi ve Farklı Lipid Oranları

AMAÇ: Koroner arter hastalığı (KAH) anjiyografik olarak doğrunlanmış olan hastalarda risk derecelendirmesi daha kesin yapılabilir. Hangi faktörün klinik uç noktaları en iyi tahmin ettireceğini belirlemek zor olduğundan dolayı, çoklu risk faktörleriyle risk derecelendirmesi için düzgün bir model oluşturulması KAH hastalarında prognozu iyileştirebilir. Akut koroner sendromda değişik faktörlerin prognozdaki rollerini değerlendirmek için çoklu risk faktörlerini içeren yüksek kanıt düzeyi olan çalışma yoktur. Bu çalışma KAH hastalarında klinik uç noktalar için değişik prognostic faktörlerin önemini belirlemeyi amaçlamıştır. YÖNTEM: Bu çalışma 521 kayıt edilmiş eş zamanlı başlangıcı olan KAH hastasının prospektif kohort çalışmasıdır. Bu hastaların 184'ü anjiyografik olarak Ayak Bileği-Kol İndeksi

Ankle Brachial Index Compared With Different Lipid Ratios to Predict Coronary Events in Patients with Coronary Artery Disease

AIM: Risk stratification in patients with angiographically confirmed coronary artery disease (CAD) could be made more precise. Since it is very difficult to determine which risk factors best predict clinical endpoints, a gentle design of risk stratification model with multiple risk factors may develop prognosis in CAD patients. There is no study with a high level of evidence including multiple risk factors to evaluate the prognostic role of different factors in acute coronary syndrome. This study aimed at determining the importance of different prognostic factors for clinical endpoints in CAD patients METHODS: A prospective concurrent inception cohort study consisting of 521documented CAD patients 184 of whom were exposed participants who were angiographically documented CAD patients with ABI<0.9, while the no-exposed consisted of 337 CAD patients with ABI>=0.9. After 15 months, the incidence of myocardial infarction (MI), angina pectoris, and death from heart attack were measured. RESULTS: Prognostic factors including age, family history of CAD, cigarette smoking, gender, diabetes, dyslipidemia, hypertension and physical activity were associated with the incidence of future cardiovascular end points. Quantitative measures like LDL-C, cholesterol, fasting blood sugar (FBS), ABI, and the ratios of TC/HDL-C to LDL-C/HDL-C significantly increased the risk of MI, UA and NSTEMI. Multivariable adjusted relations revealed that HDL-C <=34 Mg/dl significantly increased the risk of future UA, HDL-C <=53 Mg/dl and sedentary life style increased the risk of MI. CONCLUSION: Multivariate adjusted relationships revealed that HDL-C<=34 Mg/dl was a strong predictor of unstable angina pectoris after 15 months of follow up period. HDL-C<=53 Mg/dl and physical inactivity were associated with increased risk of MI after 15 months. Of the lipid ratios the strongest predictors for developing future MI and unstable angina were TC/HDL-C and LDL-C/HDL-C

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