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| Format: | Artículo científico |
| Language: | en |
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Medical Education Cooperation with Cuba
2012
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| Online Access: | https://www.redalyc.org/articulo.oa?id=437542161005 |
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Table of Contents:
- Lipid Levels as Predictors of Silent Myocardial Ischemia in a Type 2 Diabetic Population in Havana Yamilé Peña José E. Fernández-Britto Jorge Bacallao Juan F. Batista María L. de León Medicina Cuba Lipids Single cardiac gated SPECT INTRODUCTION Silent myocardial ischemia is frequent in type 2 dia- betics, therefore, symptoms cannot be relied upon for diagnosis and followup in these patients. Various studies relate blood lipid levels to cardiovascular diseases, and several authors describe certain lipo- proteins as independent predictors of ischemia. OBJECTIVE Identify blood lipid levels that predict silent myocardial ischemia in a type 2 diabetic population in Havana. METHODS From May 2005 through May 2009, assessment was done of 220 asymptomatic type 2 diabetics in ten polyclinics in Havana using laboratory tests and Single-Photon Emission-Com- puted Tomography, synchronized with electrocardiogram, known as gated SPECT (gSPECT). Coronary angiography was used for con- fi rmation when gSPECT detected ischemia. Patients were classi fi ed into two groups: gSPECT positive and gSPECT negative. Descrip- tive statistics (mean and standard deviation) were calculated for all variables and mean comparison tests were conducted. Classi fi ca- tion trees were developed relating lipid values to gSPECT results, identifying optimal cutoff points for their use as indicators of silent myocardial ischemia in the total study population and for each sex separately. RESULTS GSPECT found silent myocardial ischemia in 29.1% of those examined, and 68.4% of angiograms found multivessel disease. gSPECT-positive diabetics had higher levels of total cholesterol, LDL, and triglycerides (p < 0.05). HDL levels were lower in this group (p < 0.05). Classi fi cation trees showed optimal cutoff points, indicators for silent ischemia, for: HDL ≤ 44 mg/dL, LDL >119.9 mg/dL, and triglycer- ides >107.2 mg/d; 80.4% of diabetics with these HDL and triglyceride values had ischemia. HDL was the most important normalized variable when the entire population was analyzed. Analysis by sex showed a greater percentage of silent ischemia in men (33.3%) than in women (24.8%). The most important normalized variables were LDL of >100.8 mg/dL for men and HDL of ≤ 44 mg/dL for women. CONCLUSIONS A considerable percentage of the study population had silent myocardial ischemia. Type 2 diabetics with ischemia had higher levels of total cholesterol, LDL and triglycerides. HDL levels were signi fi cantly lower in these patients. The association of low HDL with high triglycerides was a strong indicator of myocardial ischemia in type 2 diabetics without clinical cardiovascular signs. 2012 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542161005 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.1 Vol.14