A.A. GILMANOV, S.D. MAYANSKAYA, A.F. USMANOVA, I.R. ISKANDAROV

 Kazan State Medical University, Kazan

 Contact details:

Mayanskaya S.D. — MD, Professor of the Department of Hospital Therapy

Address: 49 Butlerov St., 420012 Kazan, Russian Federation, tel.: +7-905-316-99-66, e-mail: Smayanskaya@mail.ru

 The purpose — to evaluate the impact of various risk factors (RF) for cardiovascular diseases on the survival rate of patients with ST-segment elevation myocardial infarction (STEMI) and comorbid pathology.

Material and methods. From 250 analyzed case histories of patients with STEMI, three groups were selected: group 1 — 58 patients with type II diabetes mellitus (DM), arterial hypertension (H) and chronic kidney disease (CKD) (C3a–C5), group 2 — 24 patients with type II DM in combination with H, and group 3 — 26 patients with H only. Statistical analysis was performed using the StatTech v. 4.2.7 software (developer — StatTech LLC, Russia). Differences were considered statistically significant at p < 0.05.

Results. The comparative study of RF showed combined statistically significant differences in the groups by age, hypertriglyceridemia (HTG) level (> 1.7 mmol / l), and obesity and anemia. In group 1, hemodynamically significant stenosis of peripheral and coronary arteries was detected significantly more often, which was accompanied by arrhythmias and a decrease in the left ventricular ejection fraction (p < 0.005). The data were confirmed using the TIMI scale.

Conclusions. Based on the results obtained, age, HTG, anemia and obesity had the greatest impact on the survival of patients with STEMI and CKD + D + H.

Key words: STEMI, chronic kidney disease, diabetes mellitus, arterial hypertension, cardiovascular risk factors, hypertriglyceridemia, multivessel arterial stenosis, survival rate.

REFERENCES

1. Littnerova S., Kala P., Jarkovsky J. et al. GRACE Score among six risk scoring systems (CADILLAC, PAMI, TIMI, Dynamic TIMI, Zwolle) demonstrated the best predictive value for prediction of long-term mortality in patients with ST-elevation myocardial infarction. PLoS One, 2015, vol.10, pp. 2137–2148.
2. D’Ascenzo F., Biondi-Zoccai G., Moretti C. et al. TIMI, GRACE and alternative risk scores in Acute Coronary Syndromes: a meta-analysis of 40 derivation studies on 216,552 patients and of 42 validation studies on 31,625 patients. Contemp. Clin. Trials, 2012, vol. 33, rr. 507–514.
3. Homorodean C., Iancu A.C., Dregoesc I.M. et al. renal failure impact on the outcomes of ST-segment elevation myocardial infarction patients due to a left main coronary culprit lesion treated using a primary percutaneous coronary intervention. J. Clin. Med, 2019, vol. 8 (4), p. 565.
4. Sott J., Bidulka P., Taylor D.M. et al. Management and outcomes of myocardial infarction in people with impaired kidney function in England. BMC Nephrol, 2023, vol. 24, p. 325.
5. Rzhevskaya O.N., Moiseeva A.Yu., Esaulenko A.N. et al. Chronic kidney disease and myocardial infarction. Zhurnal im. N.V. Sklifosovskogo Neotlozhnaya meditsinskaya pomoshch’, 2022, vol. 11, no. 1, pp. 104–118 (in Russ.).
6. Charytan D., Kuntz R.E. The exclusion of patients with chronic kidney disease from clinical trials in coronary artery disease. Kidney Int, 2006, vol. 70 (11), pp. 2021–2030.
7. Fox C.S., Matsushita K., Woodward M. et al. Chronic Kidney Disease Prognosis Consortium. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet, 2012, vol. 380 (9854), pp. 1662–1673.
8. Ibanez B. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur. Heart J, 2018, vol. 39 (2), pp. 119–177.
9. Lattuca B., Kerneis M., Zeitouni M. et al. Elderly patients with ST-segment elevation myocardial infarction: a patient-centered approach. Drugs Aging, 2019, vol. 36 (6), pp. 531–539.
10. Madhavan M.V., Gersh B.J., Alexander K.P. et al. Coronary artery disease in patients ≥80 years of age. J. Am. Coll. Cardiol, 2018, vol. 71, pp. 2015–2040.
11. Murkamilov I.T., Sabirov I.S., Fomin V.V. et al. Relationship between hypertriglyceridemia and types of left ventricular remodeling in patients with chronic kidney disease. Terapevticheskiy arkhiv, 2019, vol. 91, no. 6, pp. 93–99 (in Russ.).
12. Colombo M.G., Kirchberger I., Amann U. et al. Association between admission anemia and long-term mortality in patients with acute myocardial infarction: results from the MONICA/KORA myocardial infarction registry. BMC Cardiovasc. Disord, 2018, vol. 18 (1), p. 50.
13. Mamas M.A., Kwok C.S., Kontopantelis E. et al. Relationship between anemia and mortality outcomes in a national acute coronary syndrome cohort: Insights from the UK myocardial ischemia national audit project registry. J. Am. Heart Assoc, 2016, vol. 5 (11), pp. 1–12.
14. Bucholz E.M., Rathore S.S., Reid K.J. et al. Body mass index and mortality in acute myocardial infarction patients. Am. J. Med, 2012, vol. 125 (8), pp. 796‒803.
15. Sameer T.A., David A.M., Braunwald E. et al. Dynamic TIMI Risk Score for STEMI. J. Am. Heart Assoc, 2013, vol. 2, pp. 1–10.