СРАВНИТЕЛЬНЫЙ АНАЛИЗ 9-ЛЕТНЕЙ ДИНАМИКИ ПАРАМЕТРОВ СЕРДЕЧНО-СОСУДИСТОГО СТАТУСА ЖИТЕЛЕЙ АРКТИЧЕСКИХ И ЮЖНЫХ ТЕРРИТОРИЙ ТЮМЕНСКОЙ ОБЛАСТИ

Abstract

Introduction. Studies show that coronary atherosclerosis and coronary artery disease in the Arctic and Subarctic regions have their own characteristics and need to be further studied. Aim. To conduct a comparative prospective analysis of clinical, laboratory, echocardiographic and coronary angiography data in middle-aged residents of the Arctic regions compared with residents of the south of Tyumen region. Material and methods. From the Coronary Angiography Registry we selected 229 patients of mean age 45-59 years who underwent coronary angiography more than once between 2000 and 2021. The average interval between the 1st and 2nd survey points was 9.0±3.4 years. Patients who underwent coronary angiography to verify the diagnosis, patients with stable coronary artery disease and old myocardial infarction were included. Individuals with acute coronary syndrome were not included. Patients were divided into 2 groups: 85 residents of Tyumen and the south of Tyumen region and 144 residents of the Yamal-Nenets Autonomous Okrug. Differences between groups and dynamics of the studied parameters were assessed using the application package IBM SPSS Statistics 21. Results and discussion. The groups were comparable in demographic characteristics. Initially, cardiovascular status was more severe in Yamal-Nenets Autonomous Okrug group of patients: more severe (II and III) functional classes of exertional angina and a history of myocardial infarction, hemodynamically significant coronary lesions, including coronary artery occlusion, were more common. In Yamal-Nenets Autonomous Okrug group, the level of high-density lipoprotein cholesterol was initially lower. During the follow-up period, obesity and echo-signs of post-infarction changes were detected in patients of Yamal-Nenets Autonomous Okrug more often, higher asynergy index and triglyceride levels were recorded. Intergroup differences in the incidence of myocardial infarction and occlusive lesions and high-density lipoprotein cholesterol levels persisted. Conclusion. During 9-year follow-up, middle-aged patients who underwent elective coronary angiography and lived in the Arctic zone had more severe baseline indicators of cardiovascular status, as well as their more significant negative dynamics compared to patients lived in the south of Tyumen region.