Faculty of Medicine

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    Subclinical hypothyroidism and risk to carotid atherosclerosis
    (FapUNIFESP (SciELO), 2011-10)
    Valentina, Velkoska Nakova
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    Chedo, Dimitrovski
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    OBJECTIVE: The aim of this study was to assess whether subclinical hypothyroidism (SCH) is associated with carotid atherosclerosis, as well as dyslipidemia, and arterial hypertension. SUBJECTS AND METHODS: The study included 69 consecutive patients with newly diagnosed SCH, and 30 matched healthy controls. Body mass index (BMI), TSH, fT4, antibodies to thyroid peroxidase (TPOabs), lipids, blood pressure, mean and maximum carotid intima-media thickness (CIMT) were determined in all participants. RESULTS: Mean values of CIMT, triglycerides, and total cholesterol/HDL-C ratio were significantly different in SCH patients versus matched controls. Linear multiple regression analysis demonstrated that TSH, diastolic blood pressure and triglycerides were independent predictors of mean CIMT, fT4 for maximum CIMT; and that TSH, fT4, age, and total cholesterol/HDL-C ratio were independent predictors of the presence of carotid plaques. CONCLUSION: Our data revealed that SCH is associated with increase in CIMT and presence of carotid plaques, independent of classical risk factors for atherosclerosis.
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    Arterial hypertension in patients with coronary artery disease treated with surgical myocardial revascularization
    (AEP Press, 2007-07)
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    Borozanov, V
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    Taneva, B
    Objectives: To evaluate the incidence and prognostic power of arterial hypertension in patients with coronary artery disease treated with surgical myocardial revascularisation, before and after the operation. Background: Arterial hypertension is one of the leading modifiable risk factors in CAD patients who underwent CABG surgery with the major impact on clinical outcome in these patients. Methods: 749 patients with mean age of 55 +/- 8 years, (639 male/119 female) were analyzed for their preoperative: demographic, clinical, left ventricular morphologic and functional and angiographic, perioperative: type of operation, type and number of applied conduits, in-hospital morbidity and mortality, and post-operative: demographic, clinical, left ventricular morphologic and functional and angiographic characteristics. Mean postoperative follow-up period was 5.97 +/- 4.27 years. Results: Hypertension was found in 52.7% of patients before the operation, and it was the most frequent risk factor, without any differences between different age groups, but significantly more often in females (p = 0.0001), diabetics (p = 0.0001), and patients with preserved LV function (p = 0.011). Although significantly correlated with in-hospital morbidity (r = 0.085 and p = 0.023), HTA was not identified as independent predictor. The most predictable was the occurrence of early neurological complications. HTA was also found to be a predictor of long life prognosis in CABG patients, but not as independent prognostic factor. Significant reduction in incidence was found in post-CABG patients (30.1%), which is most likely a result of applied pharmacologic treatment. ACE-inhibitors, Ca-antagonists and B-blockers were applied in 39.44%, 30.1% and 33.6% of patients respectively, with significant positive correlations found for all of them as follows: r = 0.221, p = 0.0001, r = 0.316, p = 000.1 and r = 0.093, p = 0.031. Conclusion: Hypertension is the most powerful risk factor in CAD patients who undergo CABG surgery in our country, and a powerful prognostic factor of early and late clinical outcome. There is a trend toward decreasing the incidence of HTA in post-CABG patients, as a result of improved pharmacologic treatment after the operation (Tab. 5, Fig. 1, Ref. 13). Full Text (Free, PDF) www.bmj.sk.