Buksińska-Lisik Małgorzata, Kwasiborski Przemysław Jerzy, Ryczek Robert, Lisik Wojciech, Mamcarz Artur
3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 2 Bursztynowa St., 04-749 Warsaw, Poland.
Department of Cardiology and Internal Medicine, Multidisciplinary Hospital Warsaw Miedzylesie, 2 Bursztynowa St., 04-749 Warsaw, Poland.
Diagnostics (Basel). 2023 Aug 22;13(17):2724. doi: 10.3390/diagnostics13172724.
Having the appropriate tools to identify pancreas recipients most susceptible to coronary artery disease (CAD) is crucial for pretransplant cardiological assessment. The aim of this study is to evaluate the association between blood pressure (BP) indices provided by ambulatory blood pressure monitoring (ABPM) and the prevalence of CAD in pancreas transplant candidates with type 1 diabetes (T1D). This prospective cross-sectional study included adult T1D patients referred for pretransplant cardiological assessment in our center. The study population included 86 participants with a median age of 40 (35-46) years. In multivariate logistic regression analyses, after adjusting for potential confounding factors, higher 24 h BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.063, 95% CI 1.023-1.105, = 0.002/OR = 1.075, 95% CI 1.003-1.153, = 0.042/OR = 1.091, 95 CI 1.037-1.147, = 0.001, respectively) and higher daytime BP (systolic BP/diastolic BP/pulse pressure) (OR = 1.069, 95% CI 1.027-1.113, = 0.001/OR = 1.077, 95% CI 1.002-1.157, = 0.043/OR = 1.11, 95% CI 1.051-1.172, = 0.0002, respectively) were independently and significantly associated with the prevalence of CAD. Daytime pulse pressure was the strongest indicator of the prevalence of CAD among all analyzed ABPM parameters. ABPM can be used as a valuable tool to identify pancreas recipients who are most susceptible to CAD. We suggest the inclusion of ABPM in pretransplant cardiac screening in type 1 diabetes patients eligible for pancreas transplantation.
拥有合适的工具来识别最易患冠状动脉疾病（CAD）的胰腺移植受者对于移植前的心脏评估至关重要。本研究的目的是评估动态血压监测（ABPM）提供的血压（BP）指标与1型糖尿病（T1D）胰腺移植候选者CAD患病率之间的关联。这项前瞻性横断面研究纳入了在我们中心接受移植前心脏评估的成年T1D患者。研究人群包括86名参与者，中位年龄为40（35 - 46）岁。在多因素逻辑回归分析中，在调整潜在混杂因素后，较高的24小时血压（收缩压/舒张压/脉压）（OR = 1.063，95%CI 1.023 - 1.105，P = 0.002/OR = 1.075，95%CI 1.003 - 1.153，P = 0.042/OR = 1.091，95%CI 1.037 - 1.147，P = 0.001，分别）和较高的日间血压（收缩压/舒张压/脉压）（OR = 1.069，95%CI 1.027 - 1.113，P = 0.001/OR = 1.077，95%CI 1.002 - 1.157，P = 0.043/OR = 1.11，95%CI 1.051 - 1.172，P = 0.0002，分别）与CAD患病率独立且显著相关。在所有分析的ABPM参数中，日间脉压是CAD患病率的最强指标。ABPM可作为识别最易患CAD的胰腺移植受者的有价值工具。我们建议在符合胰腺移植条件的1型糖尿病患者的移植前心脏筛查中纳入ABPM。
