RESUMO
OBJECTIVE: To determine the prevalence of coronary artery disease (CAD) risk factors (RF) and myocardial ischemia in a sample of asymptomatic diabetic patients treated on an outpatient basis. METHODS: From 80 type 2 diabetic patients initially recruited at an university outpatient endocrinology clinic, with no symptoms and/or CAD diagnosis, only 61 patients completed the study protocol, being 52,5% females, with a mean age of 56.3 +/- 10.9 years. The patients were interviewed searching for RF and underwent electrocardiogram, echocardiogram and perfusional myocardial scintigraphy (PMS) at rest and under stress. According to the PMS results they were divided into two groups: an ischemic and a normal one . RESULTS: The RF identified were: male gender (48%), age > or = 55 years (51%), family history of premature atherosclerotic disease (16%), history of smoking (46%), hypertension (44%), sedentary lifestyle (62%), overweight/obesity (67%), HDL- cholesterol < 45 mg/dl (69%), LDL- cholesterol > or = 100 mg/dl (85%) and triglycerides > or = 150 mg/dl (54%). Ischemic MPS were diagnosed in 15% of the patients. The variables associated with this diagnosis were: male gender (p=0.007), low HDL levels (p=0.046), history of smoking (p=0.038), left ventricular hypertrophy (LVH) (p=0.043) and left ventricle ejection fraction (LVEF) < 60% (p=0.01). CONCLUSION: A high prevalence of associated RF was observed, as well as a significant prevalence of 15% for myocardial ischemia. The variables identified as predictors of a myocardial ischemia diagnosis were: male gender, low HDL-cholesterol, past smoking, LVH and LVEF < 60%.
Assuntos
Doença da Artéria Coronariana , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/diagnóstico por imagem , Programas de Rastreamento , Idoso , Brasil/epidemiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Angiopatias Diabéticas/epidemiologia , Métodos Epidemiológicos , Feminino , Coração/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico por imagem , Pacientes Ambulatoriais/estatística & dados numéricos , Cintilografia , Compostos Radiofarmacêuticos , Fatores Sexuais , Tecnécio Tc 99m SestamibiRESUMO
Trata das ações de saúde desenvolvidas no Brasil e no Ceará, conceituando os movimentos da Reforma Sanitária, Medicina Social, Integral, Preventiva e Comunitária, dentro da realidade do ensino médico. Apresenta a experiência do IMEP, sua história, realizações e propostas assim como a atual política de saúde do País e seus reflexos no Ceará. (AU)