GÜLTEN TAÇOY, Kaan OKTAY, AKİF SERHAT BALCIOĞLU, Erdem Güliz YAZICI, Timur TİMURKAYNAK, Atiye ÇENGEL

Koroner anjiyografi için refereedilen hastalarda bozulmuş açlık glukoz toleransı ciddi koroner arter hastalığı riskini öngördürebilir mi ?

Bozulmuş glukoz toleransına sahip hastalarda kardiyo-vasküler hastalık gelişme riski yüksektir. Bu çalışma, koroner anjiyografi endikasyonu koyularak refere edilen hastalarda, işlem öncesi saptanmış olan bozulmuş açlık kan şekeri (AKŞ) değerlerinin koroner arter hastalığını (KAH) öngördürücü olup olamayacağının değerlendirmek amacıyla planlandı. 1999-2005 yılları arasında koroner anjiyografi yapılan ardışık 1058 hasta retrospektif olarak tarandı. Bu hasta-ların 349’unda normal açlık kan glukozu değerleri mev-cutken, 709 hastada bozulmuş açlık glukozu (100-125 mg/dl) saptandı. Hastalarda aterosklerotik risk faktörleri (sigara kullanma, hipertansiyon, aterosklerotik hastalık açısından ailesel öykü) değerlendirildi. Diabetes mellitus (AKŞ>125 mg/dl) saptanan hastalar çalışma dışı bırakıl-dı. Ciddi koroner arter hastalığı varlığı, major epikardi-yak koroner arterde %50 ve üzeri darlık olarak belir-lendi. Çalışmada, KAH riskinin bozulmuş açlık glukozu olan hastalarda artmış olduğu izlendi (HR 1.58 [95% CI, 1,18-2,11]) (p

Could impaired fasting blood glucose levels predict the risk of coronary artery disease in patients which referred to coronary angiography?

Patients with impaired fasting glucose (IFG) tolerance have increased risk for cardiovascular diseases. This study is performed to compare the effect of IFG levels on coronary artery disease (CAD) in patients who referred for elective coronary angiography (CA). A total 1058 consecutive patients who had undergone coronary angiography for suspected myocardial ischemia between 1999 and 2005 were selected from our database. Patients were classified according to fasting blood glucose levels into two groups. (Impaired fasting glucose (WHO criteria=100-125 mg/dl) was observed in 709 as group I and normal fasting glucose (NFG) in 349 patients as group II. Atherosclerotic risk factors (smoking, hypertension, family history of atherosclerotic disease) were obtained and routine physical examination was performed before coronary angiographic evaluation. Patients with diabetes mellitus (DM) were excluded. Lipoprotein analysis was also made from fasting plasma. Presence of CAD was defined as a stenosis of at least 20% and severe CAD of at least %50 in a coronary artery. The study demonstrated an increased risk for coronary artery disease compared to the normal group (HR 1.58 [95% CI, 1.18-2.11]) (p<0.05). In univariate analysis low HDL (<40mg/dl), hypertension, smoking and male gender were the other determinative factors for coronary artery disease (p<0.05). Patients who have multiple (>3) risk factors with IFG greater 103 mg/dl have greater risk for coronary artery disease compared to patients with NFG levels (p<0.027). Patients with IFG have a higher rate of coronary artery disease. Association of multiple risk factors with IFG (>103mg/dl) seems to increase the risk of CAD.

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