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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina


O. Terzić, M. Dilić, S. Pehar, A. Mlaćo, S. Kazić and A. Kurtćehajić
Institute of Vascular Disease, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Background: The role of multiple risk factors (MRF) in development of occlusive arterial disease (AOD) in diabetics is well known from the literature. Aim of the study is to show the value of score for multiple risk factors, especially fibrinogen and HbA1C, in prediction and outcome of diabetic angiopathy
Methods: Group of 61 diabetics (41 M, 20F) in various stages of diabetic angiopathy, average age of 63.6 y and average diabetes lasting 14.8 y was observed. Two groups were formed according to AOD: group with insufficiency of arterial flow without ischaemia (clinical stage Fontaine II)-20 pts. (32.8%), and group with clear ischaemic changes, diabetic ulceration or gangrene (clinical stage FIII/FIV)- 41 pts. (67.2%). We observed 9 clinical variables: age, gender, hypertension (HTA), hyperlipoproteinemia (hlp), fibrinogen (fib), HbA1C, coronary heart disease (CHD), obesity (obes) and tobacco (tob). Patients were distributed as follows: age>60y 70.5%, male 67%, HTA 47.5%, hlp 29.5%, fib 46% (average 14.21 nmol/l), HbA1C above normal 90.2% (average 8.33%), CHD 56%, obes. 20% and tob 52.5%. Score of MRF for entire group is 4.68 (X/9).
Group of patients within clinical stage FII has score of MRF of 4.9, average fibrinogen 12.16 nmol/l and HbA1C 7.66%. After treatment result is convenient: clinical improvement in 17 pts. (85%), with no changes 3 (15%) and no one worsen. Group of pts. within clinical stage FIII/FIV has score of MRF of 4.95, but average fibrinogen 15.22 nmol/l and HbA1C 8.66%. After treatment result is clinical improvement in 10 pts. (24.4%), with no changes in 5 (12.2%) pts and 26 (63.4%) had lower limb amputation. In a group with amputation observed parameters were worse: score of MRF is 5.42, average fibrinogen 15.47 and HbA1C 8.84. Patients with clinical improvement after treatment had score of MRF 4.37, average fibrinogen was 12.91 nmol/l and HbA1C 8.0%.
According to clinical variables, group was in a high risk. Values of fibrinogen and HbA1C were highly significant in patients who had inconvenient outcome of their AOD, which correlate with high score of MRF (5.42).

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