Терапевтический архив (Sep 2012)
Trends in the risk factors and signs of subclinical atherosclerosis in subjects at low and moderate risk according to the SCORE scale in different medical management tactics: Two-year follow-up results
Abstract
Aim. To comparatively analyze the following parameters of the subclinical manifestations of atherosclerosis: carotid intima-media thickness (IMT), the presence and number of carotid atherosclerotic plaques (ASP), ankle brachial pulse wave velocity (ABPWV) in patients from 2 (active and conventional observation) groups at low and moderate risks according to the SCORE scale in two-year outpatient practice. Subjects and methods. A screening could select 600 able-bodied persons (445 women and 155 men) aged 30 to 65 years at low and moderate risks (according to the SCORE scale without atherosclerosis-associated diseases who were divided into 2 groups: A) active observation (n=400) and B) conventional medical management tactics (n=200). Five hundred and seven (85%) persons (339 in Group A and 168 in Group B) completed the study following 2 years. Carotid duplex scanning, computed sphygmography, and biochemical tests for blood lipid composition were performed. The delta index (%) calculated by the special formula, by subtracting the results during the first visit from those obtained 2 years later, was used to statistically analyze the time course of changes in the parameters under study. Results. Delta IMT (%) statistically significantly increased in Group B men as compared to that in Group A men (p=0.042). The delta parameter of total carotid stenosis, which reflected the percentage of the latter, proved to be high in both Group B women and men (p=0.0001) and the persons with a larger number of ASP were statistically significantly more in Group B (p=0.035). Delta ABPWV (%) was also greater in Group B (p=0.001). Conclusion. Just after 2 years, the active medical observation tactics in patients at low and moderate risks (according to the SCORE scale) can result in a reduction in the rate of subclinical atherosclerosis progression in the carotid artery.
