Incidence and regulation of cardiovascular risk factors in patients after surgical myocardial revascularization

Ciljevi istraživanja: Glavni cilj istraživanja jest prikazati utjecaj i učestalost kardiovaskularnih čimbenika rizika na nastanak incidenata kod kardioloških bolesnika, odnosno utvrditi u kojoj mjeri su bili prisutni rizični čimbenici prije nastanka incidenta i u kojoj su mjeri prisutni nakon incidenta te kako su regulirani, ovisno o vrsti revaskularizacije miokarda (premosnica ili stent). Ispitanici i metode: Provedena je presječna case-control studija u koju je uključeno 100 bolesnika koji su se nalazili na stacionarnoj rehabilitaciji u Specijalnoj bolnici za medicinsku rehabilitaciju Krapinske Toplice na Odjelu za medicinsku rehabilitaciju kardioloških bolesnika u razdoblju od 01. ožujka do 10. srpnja 2020. godine. Od toga je 50 bolesnika s ugrađenom premosnicom i 50 bolesnika s ugrađenim stentom (usporedna skupina). Podatci su uzimani iz medicinske dokumentacije. Kriterij uključivanja bolesnika bila je koronarna bolest – preboljeli infarkt miokarda (STEMI/NSTEMI) i angina pektoris (stabilna/nestabilna). Osim sociodemografskih, prikupljeni su i podatci o rizičnim čimbenicima i njihovoj regulaciji prije i nakon kardiovaskularnog incidenta. U istraživanju su korišteni podatci 20 bolesnica i 80 bolesnika. Utvrđeno je da ih je najviše u dobi između 50 i 69 godina (68%) i dolazi iz središnje Hrvatske (53%). Rezultati: Istraživanjem je utvrđeno da je postojao značajno veći udio otkrivene i regulirane hipertenzije kod bolesnika s ugrađenom premosnicom (66%) te značajno manji udio kod iste skupine s otkrivenom, a nereguliranom hipertenzijom (4%). U usporednoj skupini taj omjer iznosi 40%, odnosno čak 26%. Također je pronađena statistički značajna razlika nakon reguliranja masnoća između dvije skupine. Postoji statistički značajno veći udio lošeg kolesterola kod bolesnika s ugrađenom premosnicom (80%). Nisu pronađene statistički značajne razlike između skupina prema drugim parametrima. Uspoređujući podatke o pušenju, konzumaciji alkohola i tjelesnoj aktivnosti prije i nakon kardiovaskularnog incidenta, dobivena je statistički značajna razlika u sva tri čimbenika. Utvrđeno je i da su bolesnici kojima je ugrađen stent imali više rizičnih čimbenika od bolesnika kojima je ugrađena premosnica. Zaključak: Analizom rezultata istraživanja možemo zaključiti da se bolesnici u velikoj mjeri pridržavaju uputa medicinskog osoblja o načinu života nakon preboljelog koronarnog incidenta, što je zapravo vrlo pohvalno i bolesnicima daje poticaj da se nastave pridržavati dobivenih uputa. Međutim, postoje i dva rizična čimbenika koji još uvijek nisu zadovoljavajući, a to su prekomjerna tjelesna masa/pretilost i velik udio bolesnika sa povišenom razinom lošeg kolesterola. Upravo ovakva istraživanja su važna jer nam ukazuju na čemu trebamo dodatno poraditi u prevenciji kardiovaskularnih bolesti, koje su vodeći uzrok smrtnosti.The targets of the research: The main goal of the study is to show the impact and frequency of cardiovascular risk factors to the occurrence of the incident in cardiac patients, to determine the extent to which risk factors were present before the occurrence of incidents and in the extent present after the incident and and how they are regulated, depending on the type of myocardial revascularisation (bypass or stent). Subjects and methods: A cross-examination case-control study involving 100 patients who were in stationary rehabilitation at the Krapinske Toplice Special Hospital for Medical Rehabilitation was conducted in the Department of Medical Rehabilitation of Cardiac Patients between 01 March and July 10, 2020. Of these, 50 are patients with a built-in bypass and 50 patients with a built-in stent (comparison group). The data was taken from medical records. The patient's inclusion criterion was coronary disease – myocardial infarction (STEMI/NSTEMI) and angina pectoris (stable/unstable). In addition to sociodemographics, data on risk factors and their regulation were collected before and after the cardiovascular incident. Data from 20 patients and 80 patients were used in the study. Most were found to be between 50 and 69 years of age (68%) and comes from central Croatia (53%). Results: The study found that there was a significantly higher proportion of detected and regulated hypertension in patients with implanted bypass (66%) significantly lower proportion in the same group with detected and unregulated hypertension (4%). In the comparison group, this ratio is 40% and even 26%, respectively. A statistically significant difference was also found after fat regulation between the two groups. There is a statistically significantly higher proportion of bad cholesterol in patients with embedded bypass (80%). No statistically significant differences were found between the groups according to other parameters. Comparing data on smoking, alcohol consumption and physical activity before and after a cardiovascular incident, a statistically significant difference was obtained across all three factors. Patients with a stent were also found to have had more risk factors than patients with a bypass. Conclusion: By analysing the results of the study, we can conclude that patients largely follow the instructions of the medical staff on the way of life after a major coronary incident, which is actually highly commendable and gives patients an incentive to continue to follow the instructions obtained. However, there are also two risk factors that have not yet overweight/obese and a high proportion of patients with elevated levels of bad cholesterol. This kind of research is important because it shows us what we need to work on in the prevention of cardiovascular disease, which is the leading cause of mortality