DETERMINANT FACTORS OF ATHEROSCLEROTIC LESIONS OF CORONARY ARTERIES IN ACUTE MYOCARDIAL INFARCTION
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i3.13288Keywords:
lesions of coronary vessels, myocardial infarction, comorbidityAbstract
SUMMARY. The frequency and features of the combination of atherosclerotic lesions of coronary vessels during myocardial infarction with comorbid pathology on the severity of the course of the disease and the consequences of treatment are studied.
The aim – to study comorbid conditions that are combined with acute myocardial infarction and to evaluate their influence on the course of the disease.
Material and Methods. The results of the clinical examination of 250 patients with acute coronary syndrome with ST elevation and without ST elevation with subsequent infarct-related coronary artery revascularization were analyzed.
Results. The main diagnosis of ACS with ST segment elevation (STEMI) was in 228 (91.2 %) cases and without ST segment elevation (NSTEMI) in 22 (8.8 %) cases. STEMI of the front wall of the left ventricle – 111 (44.4 %), STEMI of the lower (or back wall) – 66 (26.4 %), NSTEMI– 22 (8.8 %). Recurrent MI was diagnosed in 51 (20.4 %) patients. The mass of necrosis in the studied cohort was (15.57±1.03) %. In the vast majority of the examined (212, 84.8 %) concomitant pathology was detected. Arterial hypertension was diagnosed in 195 (78.4 %), diabetes – in 59 (23.7 %). 150 (60.0 %) were overweight or obese, 81 (32.4 %) were smokers with a smoking index (23.73±2.00) pack-years. Hypercholesterolemia was detected in 95 subjects (38.0 %), and an LDL increase was detected in 84 (33.6 %). 52 patients (20.8 %) had COPD. Gastroenterological pathology was confirmed in 65 patients, which was 26.0 %. Heart rhythm disturbances (102, 40.8 %), of which life-threatening ventricular arrhythmias were observed in 3.6 % of cases.
Conclusions. In the vast majority of patients with ACS who referred for urgent coronary intervention, a comorbid pathology affected the nature and prevalence of atherosclerotic lesions of the coronary vessels, significantly burdened the course of MI and required a differential approach in the process of performing the procedure of coronary angiography, angioplasty and stenting.
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