Character of coronary vasculature lesions in patients with non-Q myocardial infarction in gender and age aspects

Abstract

Aim. Evaluation of the character of the coronary lesion in non-Q myocardial infarction, depending on the gender and age differences, and determination of correlations between these disorders and other clinical and instrumental parameters. Material and Methods. Forty patients (62.5% of men) with non-Q myocardial infarction from 52 to 79 (average 67.1±1.4) over the period of 2011-2016 were examined. In all patients in 1 to 70 (on average 19.4±3.0) hours from the time of admission to the hospital, coronary angiography was performed on the device SIEMENS Axiom Artis (Germany). Patients were screened in accordance with the protocol, which complies with the recommendations of the Association of Cardiologists of Ukraine for diagnosis and treatment of acute myocardial infarction (2016), with ] definition of the generally accepted clinical and laboratory and instrumental indicators. The statistical processing of the results of the study was carried out using non-parametric methods of variation statistics. The reliability of the difference between the quantitative indicators was calculated according to Mann-Whitney U test, and qualitative - by criterion 2. The relationship between the indicators was determined by the Spearman Rank Order Correlation . Results and Discussion. The analysis of coronarography data indicated rather significant structural change in coronary arteries in patients with non-Q-myocardial infarction in the absence of significant gender differences in the nature of anatomical lesions of coronary arteries. In the group of patients older than 70 years, unlike younger patients, there was a significant increase in the incidence of occlusion registrations in the left coronary artery, the mean length of certain stenoses, and an increase in the incidence of cases with stenoses >10 mm. On the other hand, in the analysis of the anatomical features of the lesion of the right coronary artery, the revealed patterns have reversed radically; namely, the more severe degree of stenosis was recorded precisely in the group of younger patients. The analysis of cases of two and three vascular lesions showed that anatomical lesions of two coronary arteries were recorded equally frequently, while the lesions of the three coronary arteries were slightly more frequent in patients older than 70 years. Thus, the analysis of the data of the coronary angiography indicated certain fundamental features of anatomical coronary lesions in patients with non-Q myocardial infarction of different age. Conclusions. The absence of significant gender differences in the character of anatomical lesions of coronary arteries has been proved. More severe anatomical lesions were observed in patients with non-Q-infarction of the myocardium aged over 70 years. Compared to younger patients, this was characterized by a significant increase in the frequency of occlusion registrations in the left coronary artery basin and the mean length of stenoses, as well as an increase in the incidence of cases with stenosis >10 mm. On the other hand, it was shown that the more severe degree of stenosis of the right coronary artery was characteristic of younger patients.

Keywords

• non-q myocardial infarction, coronary angiography, gender-specific features