Влияние концентрации глюкозы в плазме крови и длительности анамнеза сахарного диабета 2 на величину показателя SYNTAX Score II у пациентов с инфарктом миокарда без подъема сегмента ST

Цель    Цель заключалась в оценке корреляции уровня глюкозы в плазме натощак, HbA1c и длительности анамнеза сахарного диабета 2 типа (СД2) с показателем SYNTAX score (SS) II у пациентов с инфарктом миокарда без подъема сегмента ST (ИМбпST).
Материал и методы    Уровень глюкозы и HbA1C были измерены у 398 пациентов с ИМбпST при поступлении в стационар. SS II рассчитывалась с помощью онлайн-калькулятора. Пациенты были стратифицированы в соответствии с SS II (≤21,5, 21,5–30,6 и ≥30,6), определенным как низкий, средний и высокий риск, соответственно.
Результаты    37,7% испытуемых страдали диабетом. Корреляция глюкозы плазмы натощак (R = 0,402, R2 = 0,162, p <0,001) и HbA1c (R = 0,359, R2 = 0,129, p <0,001) с SS II была слабой в общей популяции. Продолжительность СД2 очень сильно коррелировала с SS II (R = 0,827, R2 = 0,347). Для прогнозирования высокого уровня SS II в исследуемой популяции, концентрация глюкозы плазмы натощак ≥98,5 мг / дл продемонстрировала чувствительность 58% и специфичность 60%, а уровень HbA1c≥6,05 продемонстрировал чувствительность 63% и специфичность 69%. Длительность анамнеза СД2 (скорректированное отношение шансов (OR): 1,182; 95% доверительный интервал (CI): 1,185–2,773) и уровень глюкозы (OR: 0,987; 95% CI: 0,976-0,9959) были значимо связаны с высоким SS II после поправки на другие факторы риска. Длительность анамнеза СД2 (Beta = 0,439) сильно влияла на дисперсию SS II, тогда как уровень HbA1c (Beta = 0,063) вносил слабый вклад.
Заключение    Длительность анамнеза СД 2 типа представляет собой важный фактор риска для больных с тяжелой ишемической болезнью сердца.

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