Riscul cardiovascular: diabet zaharat tip 2 vs. accidente cardio -/ cerebrovasculare în antecedente

Abstract

Cardiovascular risk:diabetes mellitus vs. prior myocardial infarction/stroke Cardiovascular disease is the leading cause of morbidity and mortality in individuals with type 2 diabetes. Purpose: To investigate the hypothesis that cardiovascular (CV) risk(mortality) in diabetic subjects without prior evidence of CV events is equal to that in nondiabetic subjects with prior myocardial infarction or stroke. Materials and Methods: The study included 450 consecutive patients (≤70yo) with acute myocardial infarction or stroke hospitalized at “Sfînta Treime” Hospital, in 2012. The study sample was divided into diabetic and nondiabetic patients, patients with/without previous history of CV events. Results: In hospital mortality from myocardial infarction in nondiabetic subjects with and without prior myocardial infarction/stroke were 30.3% and 18.7 %, respectively (P<0.001). In hospital mortality from myocardial infarction in diabetic subjects with and without prior myocardial infarction/stroke were 50.0% and 29.2%, respectively (P<0.001). In hospital mortality from stroke in nondiabetic subjects with and without prior myocardial infarction/stroke were 36.2% and 22.8%, respectively (P<0.001). In hospital mortality from stroke in diabetic subjects with and without prior myocardial infarction/stroke were 64.3% and 25.8%, respectively (P<0.001). Conclusions: Diabetic patients without previous myocardial infarction/ stroke have as high a risk of myocardial infarction/stroke as nondiabetic patients with previous myocardial infarction/stroke.

Afecțiunile cardiovasculare (CV) constituie cea mai importantă cauză a creșterii morbidității și mortalității la pacienți cu diabet zaharat(DZ). Scop: Investigarea ipotezei conform căreia riscul CV (mortalitatea) la pacienți cu DZ fără anamnestic de infarct miocardic acut(IMA) sau accident vascular cerebral (AVC)este echivalent cu cel al pacienților fără DZ (nonDZ) cu anamnestic IMA/AVC. Materiale și Metode: Studiul a inclus 450 pacienți (≤70ani) cu IMA sau AVC spitalizați la spitalul municipal “Sfînta Treime” în 2012. Lotul de studiu a fost divizat in pacienți cu și fără diabet, pacienți cu/făăa anamnestic de accidente macrovasculare. Rezultate: Mortalitatea intraspitalicească la pacienți nondiabetici cu infarct moicardic acut cu/fără antecedente de IMA/AVC este 30.3%/18.7 %, respectiv (P<0.001). Mortalitatea intraspitalicească la pacienți diabetici cu infarct moicardic acut cu/fără antecedente de IMA/AVC este 50.0%/29.2%, respectiv (P<0.001). Mortalitatea intraspitalicească la pacienți nondiabetici cu accident vascular cerebral cu/fără antecedente de IMA/AVC este 36.2%/ 22.8%, respectiv (P<0.001). Mortalitatea intraspitalicească la pacienți diabetici cu AVC cu/fără antecedente de IMA/AVC este 64.3%/ 25.8%, respectiv, (P<0.001). Concluzii: Pacienții diabetici fără anamnestic de infarct miocardic acut sau accident vascular cerebral au risc CV (mortalitate) echivalent cu cel al pacienților fără diabet cu anamnestic IMA/AVC.