Prikaz osnovnih podataka o disertaciji
Prognoza bolesnika sa dijabetes melitusom i višesudovnom koronarnom arterijskom bolešću lečenih perkutanim koronarnim intervencijama
Prognosis of patients with diabetes mellitus and multivessel coronary artery disease treated by percutaneous coronary interventions
dc.contributor.advisor | Nedeljković, Milan | |
dc.contributor.other | Beleslin, Branko | |
dc.contributor.other | Đorđević-Dikić, Ana | |
dc.contributor.other | Tomašević, Miloje | |
dc.creator | Mirković, Marija | |
dc.date.accessioned | 2019-12-24T16:07:30Z | |
dc.date.available | 2019-12-24T16:07:30Z | |
dc.date.available | 2020-07-03T08:52:13Z | |
dc.date.issued | 2019-09-18 | |
dc.identifier.uri | https://nardus.mpn.gov.rs/handle/123456789/11636 | |
dc.identifier.uri | http://eteze.bg.ac.rs/application/showtheses?thesesId=7001 | |
dc.identifier.uri | https://fedorabg.bg.ac.rs/fedora/get/o:20536/bdef:Content/download | |
dc.identifier.uri | http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=51737359 | |
dc.description.abstract | Pacijenti sa akutnim koronarnim sindromom (AKS) i dijabetes melitusom (DM) imaju povećan rizik za pojavu velikih neželjenih kardiovaskularnih događaja (VNKD) nakon perkutane koronarne intervencije (PKI), a koji je nedovoljno višedimenzionalno procenjen u odnosu na vrstu i težinu AKS i/ili DM i angiografske nalaze. Cilj: Studija je imala za cilj da proceni i uporedi prediktivnu kliničku vrednost modifikovanog SYNTAX skora u odnosu na prediktivnu kliničku vrednost SYNTAX skora na jednogodišnju pojavu VNKD kod bolesnika sa DM (sa dijagnozom dužom od jedne godine i višesudovnom bolešću) i akutnim koronarnim sindromom (AKS), lečenih metodom PKI. Materijal i metode: Sprovedena je prospektivna studija preseka kod pacijenata sa DM i AKS, kojima su u periodu PKI evidentirani sledeći faktori rizika: 1) metaboličke varijable – glikozilirani hemoglobin (HbA1c), ukupni holesterol, trigliceridemija; 2) endokrinološke varijable – terapija DM, tip DM; 3) modaliteti AKS 4) radiološke / anatomske varijable – SYNTAX skor i 5) kliničke varijable u modifikovanom ACEF skoru i klinički SYNTAX skor. VNKD evidentirani su do godinu dana posle PKI. Rezultati: Nakon PKI, od konsekutivno uključenih 136 pacijenata, njih 55 razvilo je bar jedan VNKD u periodu praćenja od jedne godine. Konstruisana su dva visoko prediktivna indeksa rizika za VNKD (IRVNKD). Prvi indeks rizika – IRNVKD (c statistic = 0.879) definisan je SYNTAX skorom > 21, modifikovanim ACEF skom > 1.38, HbA1c ≥ 8 (%), trigliceridemijom ≥ 2.3 (mmol/L) kod pacijenata na insulinsulinskoj terapiji, kao i modalitetom ACS – nestabilna angina pektoris. IRVNKD ima bolje prediktivne karakteristike u odnosu na SYNTAX skor (c statistic = 0.798), kao i ACF skor, ali ne i u odnosu na klinički SYNTAX skor (c statistic = 0.820). Drugi indeks rizika – IRNVKD II (c statistic = 0.923) definisan je istim faktorima rizika kao i IRNVKD, izuzev HbA1c ≥ 8 (%), a koji dodatno kao faktor rizika sadrži i prisustvo trosudovne bolesti. IRNVKD II imao je značajno bolje prediktivne karakteristike u odnosu na sve pomenute skorove, ali i u odnosu na IRNVKD... | sr |
dc.description.abstract | Patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) have an increased risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), which is not estimated sufficiently-multidimensionally in terms of type and severity of the ACS and/or DM and angiographic findings. The Aim: The study was intended to estimate and compare the predictive clinical value of the modified SYNTAX score versus the predictive clinical value of the SYNTAX score to the one-year appearance of MACE after conducted PCI in patients with DM (with diagnosis longer than one year and multivessel disease) and acute coronary syndrome (ACS). Material and methods: A prospective cross-section study was performed in patients with DM and ACS. In the PCI period the following risk factors where were recorded: 1) age and metabolic variables – glycosylated hemoglobin (HbA1c), total cholesterol, triglyceridemia; 2) endocrinological variables – DM therapy, tip of DM; 3) ACS modality; 4) radiological / anatomical variable – SYNTAX score and 5) clinical variables in modified ACEF score and clinical SYNTAX score. One-year MACE were recorded. Results: From a total of 136 consecutive patients, 55 of them developed at least one MACE in one-year follow-up. Two highly predictable MACE risk indexes (MACERI) were constructed. The first risk index – MACERI (c statistic = 0.879) was defined by: SYNTAX score > 21, modified ACEF > 1.38, HbA1c ≥ 8 (%), triglyceridemia ≥ 2.3 (mmol / L) in patients on insulin therapy and ACS modality – unstable angina pectoris. MACERI has better predictive characteristics than SYNTAX score (c statistic = 0.798) as well as ACF score, but not in relation to clinical SYNTAX score (c statistic = 0.820)... | en |
dc.format | application/pdf | |
dc.language | sr | |
dc.publisher | Универзитет у Београду, Медицински факултет | sr |
dc.rights | openAccess | en |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.source | Универзитет у Београду | sr |
dc.subject | glikozilirani hemoglobin | sr |
dc.subject | glycosylated hemoglobin | en |
dc.subject | trigliceridi | sr |
dc.subject | faktori rizika | sr |
dc.subject | akutni koronarni sindrom | sr |
dc.subject | perkutana koronarna intervencija | sr |
dc.subject | dijabetes melitus | sr |
dc.subject | triglycerides | en |
dc.subject | risk factors | en |
dc.subject | acute coronary syndrome | en |
dc.subject | percutaneous coronary interventions | en |
dc.subject | diabetes mellitus | en |
dc.title | Prognoza bolesnika sa dijabetes melitusom i višesudovnom koronarnom arterijskom bolešću lečenih perkutanim koronarnim intervencijama | sr |
dc.title.alternative | Prognosis of patients with diabetes mellitus and multivessel coronary artery disease treated by percutaneous coronary interventions | en |
dc.type | doctoralThesis | en |
dc.rights.license | BY-NC-ND | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/10506/IzvestajKomisije21221.pdf | |
dc.identifier.fulltext | https://nardus.mpn.gov.rs/bitstream/id/10505/Disertacija.pdf | |
dc.identifier.fulltext | https://nardus.mpn.gov.rs/bitstream/id/10506/IzvestajKomisije21221.pdf | |
dc.identifier.fulltext | http://nardus.mpn.gov.rs/bitstream/id/10505/Disertacija.pdf | |
dc.identifier.rcub | https://hdl.handle.net/21.15107/rcub_nardus_11636 |