Utjecaj prethodne terapije statinima na tijek i ishod akutnog divertikulitisa

master's thesis

• Title (english): The influence of prior statin therapy on the course and outcome of acute diverticulitis
• Author: Tomo Trstenjak
• Mentor: Ivan Gornik (mentor)
• Committee member: Ana Vujaklija Brajković (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Ivan Gornik (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Emergency Medicine

Abstract

Lijekovi iz skupine statina putem inhibicije enzima HMG-CoA-reduktaze smanjuju razinu kolesterola u krvi. Kroz nekoliko godina njihove široke primjene otkriveni su dodatni pleiotropni učinci statina. Pokazalo se da statini posjeduju antiupalna, antioksidativna, antiagregacijska i antiproliferacijska svojstva. Glavni cilj ovog istraživanja bio je utvrditi utjecaj navedenih svojstava na ishod i tijek akutnog divertikulitisa.
U provedenoj studiji retrospektivno je promatrano 120 pacijenata koji su u razdoblju od 1. siječnja 2023. do 1. siječnja 2024. obrađeni na OHBP-u Kliničkog bolničkog centra Zagreb radi epizode akutnog divertikulitisa. Pacijenti sa statinima i pacijenti bez statina u terapiji upareni su prema rezultatima sklonosti (engl. propensity score) te su definirani pokazatelji težine bolesti (vrijednosti CRP-a, leukocita, postotak hospitaliziranih, trajanje hospitalizacije).
Pronađena je korelacija između terapije statinima i navedenih pokazatelja težine bolesti. Razina CRP-a, leukocita i postotak hospitaliziranih pacijenata ukazivali su na blaži tijek bolesti u pacijenata na terapiji statinima, dok je trajanje hospitalizacije bilo podjednako u obje skupine pacijenata.
Laboratorijski pokazatelji zajedno s postotkom hospitaliziranih pacijenata ukazali su na pozitivan učinak terapije statinima na ishod i tijek akutnog divertikulitisa. Ti su rezultati u skladu s rezultatima drugih studija koje su proučavale učinak statina na druge upalne bolesti. Eventualna praktična primjena dokazanoga ponajprije se treba razmotriti u određenoj populaciji bolesnika s učestalim recidivima bolesti, kao i u pacijenata s teškom epizodom akutnog divertikulitisa u anamnezi.
Buduće prospektivne studije s velikim brojem pacijenata i jasno definiranim ishodima bolesti upotpuniti će rezultate ovog istraživanja i jasnije definirati potencijalnu praktičnu primjenu dokazanog.

Abstract (english)

Drugs from the statin group reduce blood cholesterol levels by inhibiting the enzyme HMG-CoA reductase. Over several years of widespread use, additional pleiotropic effects of statins have been discovered. Statins possess anti-inflammatory, antioxidant, anti-aggregatory, and anti-proliferative properties. The main aim of this study was to determine the impact of these properties on the outcome and course of acute diverticulitis.
In the conducted study, 120 patients who were treated at the Emergency Department of the Clinical Hospital Center Zagreb for an episode of acute diverticulitis between 1st of January, 2023 and 1st of January, 2024 were retrospectively observed. Patients on statins and patients without statins in their therapy were matched based on propensity scores, and indicators of disease severity (CRP values, leukocyte count, percentage of hospitalized patients, duration of hospitalization) were defined.
A correlation was found between statin therapy and the aforementioned indicators of disease severity. CRP levels, leukocyte count, and the percentage of hospitalized patients indicated a milder course of the disease in patients on statin therapy, while the duration of hospitalization was the same in both groups of patients.
Laboratory indicators along with the percentage of hospitalized patients indicated a positive effect of statin therapy on the outcome and course of acute diverticulitis. These results are consistent with the results of other studies that have examined the effect of statins on other inflammatory diseases. The potential practical application of the findings should primarily be considered in a specific population of patients with frequent recurrences of the disease, as well as those with a severe episode of acute diverticulitis in their history.
Future prospective studies with a larger number of patients and clearly defined disease outcomes will complement the results of this study and more clearly define the potential practical application of the finding.

• Keywords: statini; akutni divertikulitis; upala; hitna medicina
• Keywords (english): statins; acute diverticulitis; inflammation; emergency medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:660317
• 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: 2024-07-01 18:51:45