Učestalost uzimanja adekvatne antiishemijske terapije u bolesnika naručenih za invazivnu kardiološku obradu

master's thesis

• Title (english): Frequency of adequate anti-ischemic therapy sessions in patients scheduled for invasive cardiac treatment
• Author: Adela Šolić
• Mentor: Tomislav Letilović (mentor)
• Committee member: Tajana Filipec Kanižaj (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tomislav Letilović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Ishemijska bolest srca najčešći je razlog upućivanja bolesnika na invazivnu kardiološku obradu – koronarnu angiografiju. Obzirom na to većina bolesnika uzima antiishemijsku terapiju prije upućivanja na navedenu pretragu. Literaturni podaci ukazuju na to kako postoje značajne razlike u vrsti antiishemijske terapije koju ovi bolesnici uzimaju, a s obzirom na neke njihove kliničke karakteristike. Cilj ovoga rada bio je istražiti navedene razlike među bolesnicima upućenim na koronarnu angiografiju, s obzirom na prisutnost odnosno odsutnost najčešćih rizičnih čimbenika za koronarnu bolest. Ovim radom obuhvaćeno je ukupno 300 pacijenata Zavoda za kardiologiju KB Merkur. Obradom prikupljenih podataka uočili smo kako bolesnici stariji od 65 godina češće uzimaju blokatore kalcijskih kanala i dugodjelujuće nitrate u odnosu na one mlađe od 65 godina. Nadalje, muškarci su značajno rjeđe uzmali beta blokatore i kalcijske antagoniste od žena. Bolesnici s hipertenzijom su češće uzimali beta blokatore i kalcijske antagoniste u odnosu na bolesnike bez hipertenzije. U bolesnika s hiperlipidemijom, uočeno je učestalije uzimanje trimetazidina i dugodjelujućih nitrata u odnosu na bolesnike bez hiperlipidemije. Bolesnici sa šećernom bolesti češće su uzimali beta blokatore, a rjeđe kalcijske antagoniste u odnosu na one bez šećerne bolesti. Na kraju nismo uočili razlike u uzimanju antiishemijske terapije s obzirom na prisutnost/odsutnost povišenog BMI odnosno pušenja. Zaključno ovaj rad pokazuje kako prisutnost tipičnih rizičnih čimbenika za koronarnu bolest značajno utječe na vrstu antiishemijske terapije koju bolesnici uzimaju prije upućivanja na invazivnu kardiološku dijagnostiku. Razloge ovakvih razlika često je moguće pronaći u samim rizičnim čimbenicima. Neke uočene razlike teže su objašnjive i vjerojatno zahtijevaju dodatna klinička ispitivanja.

Abstract (english)

Ischemic heart disease is the most common reason for referral of patients to invasive cardiac treatment - coronary angiography. Hence the majority of patients is taking antiischemic therapy prior to the specified search. Literature data indicate that there are significant differences between the specific types of the antiischemic therapy received by these patients, considering some of their clinical characteristics. The aim of this study was to investigate these differences among patients referred to coronary angiography, with respect to the presence or absence of the most common risk factors for coronary heart disease. This study included a total of 300 patients of the Department of Cardiology KB Merkur. While processing the collected data, we have noticed that patients older than 65 years often took calcium channel blockers and long-acting nitrates compared to those younger than 65 years. Furthermore, men were significantly less likely to take beta blockers and calcium channel blockers compared to women. Patients with hypertension often took beta blockers and calcium channel blockers compared to those without hypertension. Patients with hyperlipidemia took trimetazidine and long-acting nitrates more frequently compared to those without hyperlipidemia. Patients with diabetes were more likely to use beta blockers and less frequently calcium channel blockers compared to those without diabetes. In the end, we did not observe differences in the intake of the antiischemic therapy due to the presence/absence of elevated BMI or smoking. In conclusion, this study shows that presence of the typical risk factors for coronary heart disease significantly affects the type of the antiischemic therapy received by the patients before undergoing invasive cardiac diagnostics. The reasons for such differences are often possible to be found in risk factors, whereas some of them are difficultly explainable and therefore require additional clinical trials.

• Keywords: infarkt miokarda; ishemija miokarda; reperfuzija ishemije miokarda; perkutana koronarna intervencija; liječenje infarkta miokarda
• Keywords (english): myocardial infarction; myocardial ischemia; myocardial ischemia reperfusion; percutaneous coronary intervention; myocardial infarction treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:562249
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-28 09:28:29