Влияние женского пола и сахарного диабета 2 типа на госпитальную смертность пациентов с острым коронарным синдромом: ретроспективное когортное исследование в период 2015-2022

Цель. Оценить влияние женского пола и сахарного диабета (СД) 2 типа на госпитальную смертность среди пациентов с острым коронарным синдромом (ОКС) в отделениях неотложной помощи в период 2015-2022, а также изучить связь соответствующих лабораторных факторов.

Материал и методы. Было проведено наблюдательное, аналитическое, ретроспективное когортное исследование, в котором основное внимание уделялось пациентам с острым коронарным синдромом, у которых измерялся уровень липопротеинов высокой плотности (ЛВП). В исследование были включены в общей сложности 196 пациентов, разделенных на 2 группы по 98 пациентов с наличием и отсутствием СД 2 типа.

Результаты. Из 196 пациентов с острым коронарным синдромом 181 выжил, а 15 скончались до выписки из стационара. Статистически значимые связи были выявлены между женским полом (относительный риск (RR): 3,52, 95% доверительный интервал (ДИ): 1,25-9,92, р=0,017) и СД 2 типа (RR: 4,05, 95% ДИ: 1,51-10,85, р=0,005) и повышенным риском летального исхода у пациентов с ОКС. Примечательно, что высокие значения ЛВП не имели статистической значимости (RR: 0,88, 95% ДИ: 0,33-2,33, p=0,789). Последующий многомерный анализ подтвердил 20% увеличение риска летального исхода у пациентов с СД 2 типа и ОКС (RR: 1,2, 95% ДИ: 0,15-2,25, p=0,025).

Заключение. Исследование показало, что, хотя повышенные уровни ЛВП не связаны с увеличением госпитальной смертности у пациентов с ОКС, СД 2 типа заслуживает внимание как фактор, оказывающий статистически значимое влияние на смертность.

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