THE INFLUENCE OF RISK FACTORS OF ISCHEMIC HEART DISEASE ON THE DEVELOPMENT OF ACUTE CORONARY SYNDROME

Kyyak Y. H., Halkevych M. P., Labinska O. Y.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

According to INTERHEART STUDY there are 9 major modified cardiovascular risk factors (RF) for ischemic heart disease (IHD) in men and women: arterial hypertension, smoking, dyslipidemia, type 2 diabetes, abdominal obesity, hypodynamia, overweight, psychosocial factors, excessive alcohol consumption. The purpose of the study is to evaluate the impact of different cardiovascular RF on the occurrence of acute coronary syndrome (ACS). Object and methods. 186 patients with admitting diagnosis of ACS were observed (81 with ST-elevation myocardial infarction (STEMI) (average age of 61.67±1.13 years) and 86 with non ST-segment myocardial infarction (NSTEMI) (average age of 61,80±1,13 years). Particular attention was paid to the impact on the occurrence of IHD not only of the classical RF, but also of the occupational hazards. Results. The most common RF for IHD in patients with ACS are hypertension, dyslipidemia and smoking. A prevalence analysis of the combination of RF revealed that most patients had 3-4 RF of IHD at once (56,79±5,50 % (I) і 55,81±5,36 % (II), p>0,05).It was found that the relative risk of ACS in the presence of type 2 diabetes is 24% higher in patients with STEMI (I) than in patients with NSTEMI (II) (RR=1,24±0,22 [0,15-2,34]). Smoking has been found to increase the risk of IHD in patients from group I by 20% in comparison with patients from group II (RR=1,20±0,16 [0,15-2,26]). It was found that the relative risk of ACS in the presence of dyslipidemia is 56% higher in patients from group II in comparison with patients from group I (RR=1,56±0,17 [0,40-2,72]). The history of patients with prolonged exposure to occupational hazards increases the risk of ACS in group II by 53%, compared with group I (RR=1,53±0,19 [0,35- 2,70]). Conclusion. Indeed, hypertension, dyslipidemia, and smoking have been found to be the most common RF for IHD in patients with ACS; however, most people have a combination of 3-4 factors at once. It was established that type 2 diabetes and smoking mostly predetermine the occurrence of STEMI, which is caused, apparently, by the activation of the coagulation system and coronary artery thrombosis in the presence of coronary sclerosis. Dyslipidemia and occupational hazards mainly contribute to the development of NSTEMI and coronary sclerosis, but without the activation of the blood coagulation system.

acute coronary syndrome, ischemic heart disease, risk factors.

1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52.
2. Kotseva K. Lessons from EUROASPIRE I, II, and III surveys. Heart Metab. 2011;50:32-5.
3. Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U. EUROASPIRE III: A survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from twenty two European countries. Europ J Cardiovasc Prev Rehabilitation. 2009;16:121-37.
4. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-200.
5. Skybchyk VA, Babliak SD, Matviienko YuO. Prohnostychna tsinnist faktoriv ryzyku sertsevo-sudynykh zakhvoriuvan dlia vyznachennia tryvalosti zhyttia 50-richnykh zhinok. Ukrainskyi medychnyi chasopys. 2012;1:130-2. [in Ukrainian].
6. Chernyshov VA. Vplyv nemodyfikovanykh klasychnykh chynnykiv ryzyku na zminy pokaznykiv lipidnoho obminu u khvorykh na ishemichnu khvorobu sertsia. Ukrainskyi kardiolohichnyi zhurnal. 2005;1:11-5. [in Ukrainian]. 6. Giugliano RP, Cannon CP, Blazing MA, Nicolau JC, Corbalán R, Špinar J, et al. Benefit of adding ezetimibe to statin therapy on cardiovascular outcomes and safety in patients with versus without diabetes mellitus: results from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). Circulation. 2018;137(15):1571-82.
7. Solomenchuk TM, Skybchyk VA. Aterohenna dyslipidemiia chy ksenobiotyky: shcho nasampered vyznachaie kardiovaskuliarnyi ryzyk osib vikom do 50 rokiv? Ukrainskyi medychnyi chasopys. 2006;3(53):84-9. [in Ukrainian].
8. Sakhanda IV, Nehoda TS, Siatynia ML. Faktory ryzyku vynyknennia, struktura i dynamika rozvytku sertsevo-sudynnoi zakhvoriuvanosti naselennia Ukrainy. Liky Ukrainy. 2015;4:116-8. [in Ukrainian].
9. Svitlyk HV. Vplyv ksenobiotykiv na perebih hostroho infarktu miokarda. Svit medytsyny ta biolohii. 2018;1(63):69-74. [in Ukrainian].
10. Sikora VZ, Yarmolenko OS. Vikovi osoblyvosti morfofunktsionalnykh peretvoren miokarda v normi ta v umovakh vplyvu ushkodzhuvalnykh chynnykiv (ohliad literatury). Zhurnal klinichnykh ta eksperymentalnykh medychnykh doslidzhen. 2013;1(3):263-74. [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 4 Part 1 (153), 2019 year, 94-97 pages, index UDK 616.12-005.4-06:616.132.2-005.8]-038

10.29254/2077-4214-2019-4-1-153-94-97