UČESTALOST I KARAKTERISTIKE DISPEPSIJE U BOLESNIKA S KORONARNOM BOLEŠĆU SRCA

Damir Fabijanić, Ksenija Slaviček, Duško Kardum, Marko Banić, Željko Sutlić, Branimir Anić, Igor Rudež, Damir Bonacin, Dobrila Karlica, Miroslav Šimunić

Sažetak. Cilj istraživanja bio je u bolesnika sa stabilnom koronarnom bolešću procijeniti učestalost dispeptičnih tegoba, učestalost funkcionalne i organske dispepsije i moguće pretkazatelje organske dispepsije. U istraživanje je uključeno 150 bolesnika (109 muškaraca; prosječna dob 62,61±10,23 god.) sa stabilnom pektoralnom anginom koji su zbog signifikantne koronarne bolesti upućeni na operaciju aorto-koronarnog premoštenja. Dispepsija je zabilježena temeljem anamnestičkih podataka o postojanju: boli u žličici, napuhanosti, mučnine i povraćanja. Dispepsija praćena endoskopskim oštećenjima sluznice definirana je kao organska, a uz normalan endoskopski nalaz kao funkcionalna. Nezavisna korelacija niza kliničko-demografskih varijabla i organske dispepsije (zavisna varijabla) procijenjena je multivarijantnom analizom (logistička regresija). Sto trideset pet (90%) bolesnika imalo je barem jedan simptom dispepsije. U 85 (63 %) bolesnika zabilježena je organska dispepsija, a u 50 (37%) bolesnika funkcionalna dispepsija (P<0,001). Bolesnici s organskom dispepsijom imali su veći broj simptoma dispepsije od bolesnika s funkcionalnom dispepsijom (1,92 ± 0,88 prema 1,38 ± 0,87, P<0,001). Veći broj simptoma dispepsije (> 3) korelirao je s težim oblicima gastroduodenalnih oštećenja (r=0,267, P<0,0001). Multivarijantnom analizom opažena je nezavisna povezanost primjene niskih doza acetilsalicilne kiseline (b=11,701, P=0,004), šećerne bolesti (b=2,921, P=0,027), pušenja (b=2,910, P=0,037) i mučnine (b =3,620, P=0,015) s organskom dispepsijom. Istraživanje je pokazalo visoku učestalost dispepsije u bolesnika s koronarnom bolešću. Tri i više simptoma dispepsije, kronična primjena niskih doza acetilsalicilne kiseline, pušenje, šećerna bolest i mučnina povećavaju vjerojatnost organske dispepsije, pa prisutnost navedenih parametara sugerira potrebu upućivanja bolesnika na ezofagogastroduodenoskopiju.

Summary. The aim of the study was to determine the frequency of functional and organic dyspepsia and possible predictors for organic dyspepsia in coronary artery disease (CAD) patients. The 150 patients (109 men; mean age 62.61±10.23 yr) undergoing coronary artery by-pass grafting because of stable pectoral angina due to significant CAD were enrolled in the study. Dyspepsia was determined by the existence of epigastralgy, heartburn, nausea and vomiting. Dyspepsia with endoscopic lesions was defined as organic, and dyspepsia with normal endoscopy was defined as functional. Multivariate analysis (logistic regression) was used to estimate predictive values of some independent clinical and demographic variables in relation to organic dyspepsia (dependent variable). One hundred thirty-five (90%) patients had at least one symptom of dyspepsia. Eighty five patients (63%) had organic dyspepsia, and 50 (37%) patients had functional dyspepsia (P<0.001). Patients with organic dyspepsia had more dyspeptic symptoms than patients with functional dyspepsia (1.92 ± 0.88 vs. 1.38 ± 0.87, P<0.001). More dyspeptic symptoms correlated with heavy GD lesions (r=0.267; P<0.0001). Multivariate analysis revealed independent correlation of consuming low-dose aspirin (standardized coefficient b=11.701, P=0.004), diabetes (b=2.921, P=0.027), cigarette smoking (b=2.910, P=0.037) and nausea (b=3.620, P=0.015) with organic dyspepsia. The study showed high frequency of dyspepsia, especially organic dyspepsia, in CAD patients. Three or more dyspeptic symptoms, low-dose aspirin, cigarette smoking, diabetes and nausea, increased the probability of organic dyspepsia. Therefore, for patients with combination of dyspeptic symptoms and present risk factors the endoscopic examination should be considered.