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Impacto dos Índices Aterogênicos em Estenose do Enxerto de Veia Safena / Impact of Atherogenic Indexes in Saphenous Vein Graft Stenosis
Yavuz, Fethi; Kilic, Salih; Kaplan, Mehmet; Yıldırım, Arafat; Kucukosmanoglu, Mehmet; Dogdus, Mustafa.
  • Yavuz, Fethi; Health Sciences University. Adana Research and Training Hospital. Department of Cardiology. Adana. TR
  • Kilic, Salih; Health Sciences University. Adana Research and Training Hospital. Department of Cardiology. Adana. TR
  • Kaplan, Mehmet; Health Sciences University. Adana Research and Training Hospital. Department of Cardiology. Adana. TR
  • Yıldırım, Arafat; Health Sciences University. Adana Research and Training Hospital. Department of Cardiology. Adana. TR
  • Kucukosmanoglu, Mehmet; Health Sciences University. Adana Research and Training Hospital. Department of Cardiology. Adana. TR
  • Dogdus, Mustafa; Uşak University. Research and Training Hospital. Department of Cardiology. Uşak. TR
Arq. bras. cardiol ; 115(3): 538-544, out. 2020. tab, graf
Article in English, Portuguese | LILACS, SES-SP | ID: biblio-1131322
RESUMO
Resumo Fundamento Os enxertos de veias safenas (EVS) são frequentemente usados em pacientes submetidos a cirurgia de revascularização do miocárdio (CRM). Objetivos Avaliar as relações entre índices aterogênicos e estenose de EVS.

Métodos:

No total, 534 pacientes (27,7% mulheres, com idade média de 65±8,4 anos) submetidos a CRM e angiografia coronariana eletiva foram incluídos no estudo. Pacientes com pelo menos uma estenose EVS ≥50% foram alocados ao grupo estenose EVS (+) (n=259) e pacientes sem estenose foram classificados como EVS (-) (n=275). O índice aterogênico plasmático (IAP) e o coeficiente aterogênico (CA) foram calculados a partir dos parâmetros lipídicos de rotina dos pacientes. A significância foi estabelecida no nível p<0,05. Resultados O número de pacientes com histórico de hipertensão (HT), diabetes mellitus (DM), acidente vascular cerebral e insuficiência cardíaca (IC) se mostrou significativamente maior no grupo EVS (+) do que no grupo EVS (-). O colesterol total, triglicerídeos e colesterol LDL mostraram-se significativamente mais altos e o colesterol HDL mostrou-se menor no grupo EVS (+) do que no grupo EVS (-). IAP (p<0,001) e CA (p<0,001) apresentaram-se significativamente mais altos no grupo EVS (+) do que no grupo EVS (-). A análise ROC mostra que tanto o IAP quanto o CA mostraram-se melhores que o colesterol HDL, colesterol LDL e colesterol não HDL na predição de estenose de EVS. Na análise multivariada, histórico de DM, HT, acidente vascular cerebral, IC, número de enxertos de safena, colesterol HDL, colesterol LDL, colesterol não HDL, IAP e CA foram fatores de risco independentes para estenose de EVS. Conclusão O IAP e o CA foram preditores independentes de estenose de EVS. Além disso, tanto o IAP quanto o CA têm melhor desempenho na predição de estenose de EVS do que o colesterol LDL, colesterol HDL e colesterol não HDL. (Arq Bras Cardiol. 2020; 115(3)538-544)
ABSTRACT
Abstract Background Saphenous vein grafts (SVG) are frequently used in patients that have undergone coronary artery bypass graft (CABG) surgery.

Objectives:

To evaluate the relationship between atherogenic indexes and SVG stenosis. Methods Altogether, 534 patients (27.7% women, mean age 65±8.4 years) that underwent CABG and elective coronary angiography were included in the study. Patients with at least one SVG stenosis ≥50% were allocated to the stenosis group SVG (+) (n=259) and patients without stenosis were categorized as SVG (-) (n=275). Atherogenic index of plasma (AIP) and atherogenic coefficient (AC) were calculated from the patients' routine lipid parameters. The level of significance was p<0.05. Results The number of patients with a history of hypertension (HT), diabetes mellitus (DM), stroke, and heart failure was significantly higher in the SVG (+) group than in the SVG (-) group. Total cholesterol, triglycerides, LDL-C were significantly higher and HDL-C was lower in the SVG (+) group than in the SVG (-) group. AIP (p<0.001) and AC (p<0.001) were significantly higher in the SVG (+) group than in the SVG (-) group. The receiver operating characteristic (ROC) analysis show that both AIP and AC were better than HDL-C, LDL-C and non-HDL-C at predicting SVG stenosis. In the multivariate analysis, history of DM, HT, stroke, heart failure (HF), number of saphenous grafts, HDL-C, LDL-C, non-HDL-C, AIP and AC were found to be independent risk factors for SVG stenosis. Conclusion AIP and AC were independent predictors of SVG stenosis. Moreover, both AIP and AC have better performance in predicting SVG stenosis than LDL-C, HDL-C and non-HDL-C. (Arq Bras Cardiol. 2020; 115(3)538-544)
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Transplants Type of study: Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English / Portuguese Journal: Arq. bras. cardiol Year: 2020 Type: Article Institution/Affiliation country: Health Sciences University/TR / U&#351;ak University/TR

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Full text: Available Index: LILACS (Americas) Main subject: Coronary Artery Disease / Transplants Type of study: Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English / Portuguese Journal: Arq. bras. cardiol Year: 2020 Type: Article Institution/Affiliation country: Health Sciences University/TR / U&#351;ak University/TR