Avtor/Urednik		Ploj, Tom
Naslov		Klinična ocena bolnika med stenokardijo, obseg koronarne bolezni in izid zdravljenja pri nestabilni angini pektoris
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Medicinska fakulteta
Leto izdaje		2002
Obseg		str. 44
Jezik		slo
Abstrakt		Background and objectives. The choice of treatment for patients presenting with acute coronary syndromes (ACS) without ST elevation depends on the risk stratification. Several studies succeeded to predict adverse ischemic events as well as angiographic morphology on the basis of clinical, electrocardiographic and laboratory variables. None of the studies however, measured clinical variables during an ischemic episode. Clinical observation during an ischemic episode allows definition of the ischemic threshold in a similar way as stress testing. We postulate that ischemic threshold reflects coronary reserve, therefore predicts diseased angiographic morphology. The objective of our study was to define predictive power of clinical observations during an ischemic episode for the prediction of angiographic findings and adverse ischemic events prior to hospital discharge. Methods. In a retrospective study on patients with ACS without ST elevation we calculated a change in systolic blood pressure (deltaSBP) and heart rate (deltaHR) at the beginning of the ischemic episode with regard to the baseline value. We also determined the duration of the episode, the total dose of morphine required to alleviate the symptoms and the number of ischemic episodes in 24 hours. We used multivariate logistic regression to define connection between the above variables and the adverse events prior to hospital discharge (need for revascutarization, infarction, death). In a subgroup of patients who underwent coronary angiography, we used multivariate regression models to define connection between the above variables and the severity of coronary artery disease. The later was defined by a modified Jenkins score, a stenosis of the left main coronary artery (LMCA), triple vessel disease, left coronary system disease and a percent of narrowing of the culprit artery. (Abstract truncated at 2000 characters).
Deskriptorji		ANGINA PECTORIS CORONARY DISEASE ANGINA, UNSTABLE MYOCARDIAL ISCHEMIA PREDICTIVE VALUE OF TESTS ELECTROCARDIOGRAPHY CORONARY ANGIOGRAPHY TREATMENT OUTCOME MORPHINE BLOOD PRESSURE HEART RATE PATIENT DISCHARGE SEVERITY OF ILLNESS INDEX RETROSPECTIVE STUDIES MULTIVARIATE ANALYSIS