COMPARATIVE CLINICAL AND ANAMNEST CHARACTERISTICS OF RISK FACTORS OF NON ST ELEVATION ACUTE CORONARY SYNDROME IN PRE- AND POSTMENOPAUSAL WOMEN

Abstract

Over the past decades, the attention of the scientific community in the field of cardiology has been concentrated mainly on a group of male patients, despite the existence of significant gender differences in the pathophysiological mechanisms of development of cardiovascular diseases on the basis of atherosclerosis, their risk factors, clinical features, characteristic hagiographical changes, approaches to treatment, prognosis and higher mortality in women.

The aim of the study – to conduct a comparative analysis of the high cardiovascular (CV) risk factors in women with non ST elevation acute coronary syndrome (non-STEM I) and almost healthy women depending on the gormonal status.

Materials and Methods. We examined 157 women aged 35–72 years old (average age (56.54±0.87) years). 112 patients with nonSTEM I females (Group I) aged 39 to 72 years (average age (58.52±0.99) years). The comparison group (Group II) concluded pf 45 women aged 35 to 71 years (average age (52.58±1.58) years) of almost healthy women. The level of female sex hormones was determined. The main factors of high CV risk were studied. Depending on the type of hormonal status, women of Groups I and II were divided into subgroup IA – 64 patients with non-STEM I 39–72 years old (average age (60.77±1.16)), ІІА – 26 practically healthy women 42–71 years (average age – (58.64±2.18) years) with hormonal signs of post menopause: level estradiol <80 pmol /l (21.79 pg / ml) and the ratio of LH / FSH <1. In the IB subgroup 48 women with non-STEM I were at the age of 35 to 65 years old (average age (52.29±1.63)), ІІB – 19 practically healthy women 35–58 years old (average age – (49.84±1.84) years) with estradiol levels> 80 pmol / l (21.79 pg / ml) and a ratio of LH / FSH > 1.

Results and Discussion. In patients with postmenopausal type of hormonal status (IA), the following traditional factors of CV-risk such as hypertension (82.81±4.72) %, dyslipidemia, hypercholesterolemia, hypertriglyceridemia are significantly more common. The incidence of hypercholesterolemia among them in 1.3 times significantly exceeded that of patients in the subgroup IB ((95.31±2.64) % (IA) vs (75.00±6.25) % (IB)). The mean HDL cholesterol level in patients IB subgroup is significantly lower in comparison with IA subgroup ((1.04±0.03) mmol / l (IB) vs (1.16±0.05) mmol/l (IA)). Visceral obesity index (VO I) is the highest in the subgroup IA (4.74±0.51 unit (IA) versus 3.75±0.33 units (IB). Diabetes (31.25±5.15) %, smoking (54.16±7.19) % and occupationally harmful work (89.58±4.41) % were more common in the IB subgroup. Among them a significantly higher proportion of people with elevated levels of CRP is significantly higher than approximately 20 % had a mean value compared to subgroups of women IA ((6.40±0.53) mg/l (IB) versus (5.17±0.44) mg/l (IA)).

Conclusions. Regardless of the hormonal status, in women with non-STEM I, the prevalence and severity of the underlying of high CV risk factors in comparison with healthy persons is shown. Estrogen deficiency in postmenopausal women with non-STEM I leads to a higher prevalence of hypertension, severe lipid and fat metabolism disorders, which leads to the development of acute coronary syndrome. The cause of non-STEM I in women with relatively preserved hormonal status is the increased prevalence of smoking and exposure to xenobiotics due to prolonged occupationally damaged labor, diabetes mellitus, along with the traditional factors of high CV risk.