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| MULTIFOCAL
ATHEROSCLEROTIC DISEASE IN DIABETICS |
| .O.
Terzić, M. Dilić, S. Pehar and A. Mlaćo |
| Institute
of Vascular Diseases, Clinical Center University of Sarajevo,
Sarajevo, Bosnia and Herzegovina |
Background:
Atherosclerosis is systemic disease with possible expression on
various vascular beds, especially accelerated in diabetics. Aim
of the study is to show possible connection between score of multiple
risk factors (MRF) with localisation, clinical stage and outcome
of arterial occlusive disease (AOD) in diabetics. Methods: Group
of 61 diabetics (41 M, 20F) average age of 63.6 yrs. and average
diabetes lasting 14.8 yrs, all of them in various stages of diabetic
angiopathy was observed. According to their coronary heart disease
(CHD) two groups were formed: group with clear clinical signs
of CHD and group in which those signs are not proven (without
any sign of CHD). 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%). According to coronary status two groups are formed:
with clear clinical signs of CHD 34 pts (55.7%) and non-CHD group..
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>60 yrs. 70.5%, male 67%, HTA
47.5%, hlp 29.5%, fib 46% (average 14.21 ?mol/l), HbA1C above
normal 90.2% (average 8.33%), CHD 56%, obes. 20% and tob 52.5%.
Score of MRF for entire group was 4.68 (x/9). Results: In a group
of patients with unifocal expression (AOD) were 27 pts. (44.3%)
with score of MRF of 4.2. In clinical stage FII 33% pts with score
MRF 4.4 and in FIII/FIV 67% with MRF score of 4.1. In a group
of patients with multifocal expression (AOD+CHD) were 34 pts (55.7%)
and score of MRF 5.5. In clinical stage FII 32% with score of
MRF 5.3, and in stage FIII/FIV 68% with score of MRF 5.6 Conclusion:
According to clinical variables group was in high risk. Number
of patients with multifocal atherosclerotic disease is significantly
higher than those with unifocal what correlate with high score
of MRF in both observed groups.
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