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

Abstract

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.

Keywords

• acute coronary syndrome
• ischemic heart disease
• risk factors.