СОСТОЯНИЕ КОРОНАРНЫХ АРТЕРИЙ У МУЖЧИН МОЛОЖЕ 60 ЛЕТ ПРИ ИНФАРКТЕ МИОКАРДА, ОСЛОЖНЕННОМ ОСТРЫМ ПОВРЕЖДЕНИЕМ ПОЧЕК

Abstract

Relevance. The role of the coronary arteries angiographic changes severity in myocardial infarction complicated by acute kidney injury is assessed in different ways. Aim. To evaluate the features of the coronary arteries state in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 168 patients. A comparative assessment of coronary angiography indicators, also acute kidney injury and heart failure development risk analysis (ANOVA) were performed. Results. There were no differences in the compared groups in angiographic data, localization, depth of the lesion, and the frequency of the complicated course of the disease. The study group were characterized by akinesia in the middle anterior (in the studied% 100; control: 15.6%; p =0.02) and antero-septal (100 and 17.7%; respectively; p=0.04) segments , as well as the frequency of registration of chronic heart failure (72.0 and 43.2%; p=0.005) by the eighth week of myocardial infarction. Bypass surgery (absolute risk: 46.2%; relative - 4.37; p=0.0002) and unstable angina (absolute risk: 19.8%; relative - 2,46; p=0.02) in the medical history, as well as the presence of peripheral angiopathies (absolute risk: 18.9%; relative - 3.21; p=0.0008). Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction were not differ in the number and extent of large coronary artery lesions from the general group. They are characterized by large in area and severity of dysfunction lesions of the anterior middle segments of the left ventricle with a higher frequency of chronic heart failure than in the general group. The anamnestic data listed above associated with coronary arteries is advisable to use in the formation of groups at high risk for the acute kidney injury development formation, as well as prognostic modeling.