非ST段抬高型心肌梗死患者糖尿病视网膜病变与冠状动脉病变血管造影严重程度的关系

University Heart Journal Pub Date : 2022-01-31 DOI:10.3329/uhj.v18i1.57880

Heru Al Amin, A. Choudhury, S. Ahsan, B. Dutta, M. M. Hossain, N. Alam, Kofil Uddin, Partha Pratim Saha

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引用次数: 0

摘要

背景:床侧眼科检查是诊断糖尿病视网膜病变的一种简单方法，已被证明是各种心血管疾病(包括冠状动脉疾病(CAD))预后不良的预测指标。视网膜病变是临床上相当常见的发现，可以预测冠心病(CHD)的风险。本研究旨在发现非stemi患者糖尿病视网膜病变与冠状动脉疾病严重程度之间的关系。方法:本横断面观察性研究于2019年3月至2020年8月在孟加拉国达卡国家心血管疾病研究所和医院(NICVD)心内科进行。本研究共纳入120例糖尿病合并NSTEMI患者，在指数住院期间接受冠状动脉造影和盆腔镜检查并盆腔摄影。研究对象根据糖尿病视网膜病变分为两组(一组:NSTEMI合并糖尿病视网膜病变;II组:无糖尿病视网膜病变的NSTEMI组)。通过Gensini评分确定冠状动脉病变的严重程度，并评估糖尿病视网膜病变与Gensini评分的相关性。结果:糖尿病视网膜病变组Gensini评分明显高于非糖尿病视网膜病变组(62.2±27.7∶43.3±25.3,p<0.001)。Gensini评分随糖尿病视网膜病变严重程度的增加而增加(P <0.001)。糖尿病视网膜病变患者发生严重冠心病的风险为13.03 (95% CI =2.410 ~ 70.419) (P<0.003)。结论:糖尿病视网膜病变的存在和严重程度与非st段抬高型心肌梗死(NSTEMI)患者血管造影显示的严重冠状动脉疾病相关，可作为CAD严重程度的独立预测因子。作为一项床边评估，在进行冠状动脉造影之前，它似乎是危险分层的补充。大学心脏杂志2022;18 (1): 50-53

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Association of Diabetic Retinopathy with Angiographic Severity of Coronary Artery Disease in Patients with Non- ST Elevation Myocardial Infarction

Background: Bed side ophthalmoscopic examination is a simple measure of diagnosis of diabetic retinopathy and has been shown to be a predictor of poor outcome in various cardiovascular conditions including coronary artery disease (CAD). Retinopathy lesions are fairly common findings in clinic settings and may predict risk of coronary heart disease (CHD). The present study was intended to find the relationship between diabetic retinopathy with the severity of coronary artery disease in patients with NSTEMI. Methods: This cross-sectional observational study was conducted in the Department of cardiology, National Institute of Cardiovascular Diseases and Hospital (NICVD), Dhaka, Bangladesh, from March 2019 to August 2020. A total of 120 DM with NSTEMI patients undergoing coronary angiogram and also fundoscopic examination with fundal photography during the index hospitalization were included in this study. Study subjects were divided into two groups on the basis of diabetic retinopathy (Group-I: NSTEMI with diabetic retinopathy ; Group- II: NSTEMI without diabetic retinopathy). Severity of coronary artery disease was determined by Gensini score and correlation between diabetic retinopathy and Gensini score was assessed. Results: Gensini score was significantly higher in patients with diabetic retinopathy than that in patients without diabetic retinopathy (62.2±27.7 vs. 43.3±25.3,p<0.001).Gensini score increased with increasing severity of diabetic retinopathy(P <0.001).The risk of having severe CAD in patient with diabetic retinopathy was 13.03 (95% CI =2.410-70.419) (P<0.003).A significant correlation between diabetic retinopathy and Gensini score was noted (p value <0.001) Conclusion: It may be concluded that presence and severity of diabetic retinopathy is associated with angiographically severe coronary artery disease in patient with non-ST elevation myocardial infarction (NSTEMI) and it may be considered as an independent predictor of severity of CAD. As is a bed side assessment, so before performing coronary angiography ,it appears to be additive for risk stratification. University Heart Journal 2022; 18(1): 50-53

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University Heart Journal

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