СРАВНИТЕЛЬНОЕ ИЗУЧЕНИЕ ВЛИЯНИЯ ИНСУЛИНОЗАВИСИМОГО САХАРНОГО ДИАБЕТА 2-ГО ТИПА, ОТЯГОЩЕННОЙ НАСЛЕДСТВЕННОСТИ И КУРЕНИЯ НА ТЯЖЕСТЬ ИШЕМИЧЕСКОЙ БОЛЕЗНИ СЕРДЦА

Abstract

Introduction. The presence of high-risk factors such as hereditary burdening, tobacco smoking, and diabetes mellitus significantly worsen the prognosis in potentially healthy individuals by increasing the incidence of coronary heart disease. Aim. To study the separate influence of insulin-dependent diabetes mellitus type 2, heredity and smoking on the severity and course of coronary heart disease. Material and methods. One hundred patients with coronary heart disease were enrolled in the study. The patients were divided according to the presence of the following high-risk factors: heredity, tobacco smoking, and insulin-dependent type 2 diabetes mellitus. The patients were examined at the beginning and 1 year after treatment. The results of echocardiography and electrocardiography were analyzed at the beginning of follow-up and one year later. The severity of coronary artery lesions was assessed using SYNTAX score analysis of coronarography protocols. The number of Q and QS waves on electrocardiogram, increased size and decreased left ventricular ejection fraction were also considered as criteria of coronary heart disease severity. The obtained data were processed using IBM Statistics SPSS-26 program. The differences were considered statistically significant at p<0,05. Results and discussion. Patients with diabetes mellitus were more susceptible to aortocoronary bypass grafting, whereas coronary angioplasty was performed more frequently in patients with heredity (p<0,05). Coronary vessels were more affected in diabetic patients and in tobacco smokers compared with patients with a burdened heredity [(20,4±2,7) points (21,9±1,39) and (12,9±1,8) points, respectively]. Severe heart failure prevailed among patients with concomitant diabetes mellitus. After one year, all patients had a reduction of clinical symptoms of angina and heart failure. The efficacy of medical treatment of angina in patients with heredity was lower compared to other groups. Conclusion. In patients with a history of diabetes mellitus development of coronary heart disease is manifested by severe myocardial and coronary lesions, which increases the risk of coronary artery bypass grafting. Despite this, patients with diabetes mellitus lend themselves well to drug treatment. The tobacco smoking group is not inferior to the diabetes mellitus group by the severity of heart and coronary artery lesions and is well amenable to drug therapy. The last place in the severity of coronary heart disease is occupied by patients with a hereditary burden, although they are more prone to acute coronary syndrome.