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Каротидный атеросклероз и уровень дегидроэпиандростерона сульфата у мужчин молодого и среднего возраста с ишемической болезнью сердца

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В исследование вошли 78 мужчин в возрасте от 28 до 50 лет, в том числе 49 больных ИБС с верифицированным посредством коронарографии стенозирующим атеросклерозом коронарных артерий и 29 пациентов (контрольная группа), не имевших клинических проявлений атеросклероза. Среди больных ИБС показатель толщины комплекса интима–медиа общих сонных артерий составил 0,88 ± 0,23 мм (против 0,76 ± 0,18 мм в контрольной группе) (р = 0,01). Атеросклеротические бляшки в общих сонных артериях присутствовали у 92% больных ИБС и 28% пациентов контрольной группы (р 0,001), при этом множественное поражение наблюдалось в 80 и 14% случаев соответственно (p 0,001). Достоверных различий средних значений уровня дегидроэпиандростерона сульфата у пациентов обеих групп не выявлено. Увеличение у мужчин молодого и среднего возраста показателя толщины комплекса интима–медиа и наличие множественных атеросклеротических бляшек в общих сонных артериях сопряжены с повышенным риском развития ИБС. Уровень дегидроэпиандростерона сульфата в крови мужчин молодого и среднего возраста не влияет на возникновение коронарного атеросклероза.

Ключевые слова:
ультразвуковая диагностика, атеросклероз, толщина комплекса интима–медиа, сонная артерия, ишемическая болезнь сердца, молодой возраст.

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Carotid Atherosclerosis and Dehydroepiandrosterone Sulfate Level in Young and Middle-aged Men with Coronary Artery Disease

The aim of the study was to assess relationships between carotid atherosclerosis and serum dehydroepiandrosterone sulfate (DHEA-S) concentration, and incidence of coronary artery disease (CAD) in young and middle-aged men. Ultrasound assessments of intima-media thickness (IMT) and plaques in the carotid arteries, and serum DHEA-S level were evaluated in 78 patients with a mean age of 43 ± 6 years. Carotid IMT was determined by high-resolution ultrasound. The study group was divided into a CAD group (n = 49), and a non-CAD group (n = 29). IMT was significantly greater in patients with CAD than in patients without CAD (0.88 ± 0.23 mm vs. 0.76 ± 0.18 mm, p = 0.01). 92% patients of the CAD group and 28% patients of non-CAD group had atherosclerotic plaques in the carotid arteries (p 0.001). Patients with CAD more often had multiple plaques. DHEA+S level did not differ between patients with or without CAD. In conclusion, a high carotid IMT values and plaques in the carotid arteries are reliable markers of CAD higher risk among young and middle+aged men. Serum DHEA+S concentration in young and middle-aged men is not associated with incidence of coronary atherosclerosis.

Keywords:
ultrasound diagnostics, atherosclerosis, intima-media thickness, carotid artery, coronary artery disease, young-aged men.