Zaburzenia metabolizmu glukozy wykryte w doustnym teście obciążenia glukozą u chorych z zawałem serca: znaczenie kliniczne, epidemiologia, przebieg naturalny i problemy terapeutyczne
 
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Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
 
 
Autor do korespondencji
Paweł Francuz   

Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
 
 
Ann. Acad. Med. Siles. 2018;72:33-44
 
SŁOWA KLUCZOWE
DZIEDZINY
STRESZCZENIE
W porównaniu z glikemią na czczo, wartość glikemii po dwóch godzinach (2h-PG) uzyskana w doustnym teście obciążenia glukozą (OGTT) jest parametrem lepiej korelującym z przyszłymi niekorzystnymi zdarzeniami sercowo-naczyniowymi, a jej związek z zapadalnością na chorobę wieńcową oraz ze śmiertelnością jest stopniowy i niezależny. Nieprawidłowy wynik 2h-PG w większości publikowanych prac definiuje się jako ≥ 7,8 mmol/l (140 mg/dl). U chorych z zawałem serca, u których stwierdza się nieprawidłowy wynik 2h-PG, w porównaniu z chorymi z pra-widłowym 2h-PG, rokowanie jest gorsze. Charakteryzują się również częstszym występowaniem chorób towarzyszących. Są to pacjenci, których śmiertelność odległa jest znamiennie wyższa, jednak dotychczas nie wykazano jednoznacznie, aby byli to chorzy, u których częściej występuje ponowny zawał serca, rewaskularyzacja wieńcowa czy udar mózgu. Wskazuje się również na fakt, iż u części chorych stan glukometaboliczny zmienia się po ostrej fazie choroby, co ma wpływ na śmiertelność. W prezentowanej pracy przedstawiono znaczenie zaburzeń metabolizmu glukozy, ich epidemiologię, przebieg naturalny oraz poruszono problem leczenia hipoglikemizującego.
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