THE EFFICIENCY OF CARDIAC REHABILITATION TREATMENT OF PATIENTS WHO HAVE SUFFERED FROM ACUTE CORONARY SYNDROME DEPENDING ON SMOKING HABITS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11597Keywords:
acute coronary syndrome, smoking, cardiac rehabilitation, metabolic profile, NYHAAbstract
This article provides the results of the research of the metabolic profile and NYHA of the patients, who have suffered from acute coronary syndrome (ACS), on the stage of health-resort cardiac rehabilitation depending on smoking habits.
The aim – to investigate the trends in indicators relating to metabolic status and NYHA of patient`s condition, who have suffered from acute coronary syndrome (ACS), on the stage of health-resort cardiac rehabilitation depending on smoking habits.
Material and Methods. A total of 62 patients aged 42–78 years (mean age (56.61± 1.4) who have gone through the program of cardiac rehabilitation were examined. The patients were divided into 2 groups: group I – smokers (n=34, mean age (54.94±1.6), and group II – people with ACS who do not have any smoking habits (n=28, mean age (58.64±1.4). The performance of lipid and carbon dioxide exchange and systemic inflammation, as well as physical activity with the help of 6 minute walk test in the first day of cardiac rehabilitation was identified. The program of health-resort treatment included limited therapeutic walk, physical activities (PA), laser therapy on cubital vein along with optimal pharmacological therapy (OPT).
Results. At the beginning of rehabilitation program patients in group 1 had significantly bigger average level of total cholesterol, compared to group 2 (5.88±1.17) mmol/L (I) vs. (5.29±0.95) mmol/L (II)), low density lipoprotein cholesterol (LDL-C) (3.95±0.96) (I) vs. (3.64±0.93) mmol/L (II)), level of triglycerides (TG) (3.08±0.51) (I) to (2.67±0.56) mmol/L (II)), atherogenic index of plasma (AIP)) (4.65±1.51) (I) vs. (3.87±1.01)), C-reactive protein (CRP) (5.36±0.55) (I) vs. (4.95±0.43) mg/mL (II)), fibrinogen (FGN) (3.61±0.53) (I) vs. (3.54±0.44) g/L (II)), glycosylated hemoglobin (HbA1c) (6.10±0.36) (I) vs. (5.74±0.30) % (II)), and lower level of high density lipoprotein cholesterol (HDL-C) (1.08±0.22) (I) vs (1.15±0.17) mmol/L (II)).The analysis of indicators that was carried after the program of rehabilitation showed positive dynamic in both groups: the level of total cholesterol was reduced by 18.1 % (I) and 17.3 % (II), LDL-C – by 22.1 % (I) and 20.1 % (II) (р<0.05), TG – by 32.8 % (I) and 19.9 % (II) (р>0.05), AIP – by 36.8 % (I) vs. 34.2 % (II) (р<0.05), HbA1c – by 4.1 % (I) and 5.8 % (II) (р>0.05), CRP – by 15 % (I) (р<0.05) and 14 % (II) (р>0.05), FGN – by 24.1 % (I) and 18.4 % (II) (р<0.05), and increasing of HDL-C – by 16.6 % (I) and 12.1 % (II), (р<0.05). After carrying the program of rehabilitation, NYHA I prevails in group of smokers who have suffered from ACS by 58.8 % (р<0.05), NYHA II prevails in group of non-smokers by 57.1 % (р<0.05), while rehabilitation patients who have smoking habits remain in NYHA III by – 11.8 % (р<0.05) vs. 0 % (р<0.05) in non-smokers.
Conclusions. Smokers, who suffered from ACS, had more significant disorders of lipid exchange with atherogenic nature, carbon dioxide exchange and systemic inflammation. After carrying the program of cardiac rehabilitation, there was recorded a positive dynamic in metabolic profile in both groups of patients, however a group of smokers had more detectable positive dynamic. At the end of the rehabilitation program among the patients with smoking habits NYHA I occurred more often in comparison with non-smoking patients. However, in the group of smokers who had emerging NYHA III there was no positive changes recorded, while among the non-smokers there was no NYHA III cases registered.
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