Elaboration of New Medical Technology for Predicting the Risk of Ischemic Heart Disease in the Workers of the Coal Industry

Abstract

Background. Ischemic heart disease is the leading cause of death in the majority of developed countries, including Russia. It determines the importance of elaboration of individual risk prediction of ischemic heart disease for primary prevention.Aim: to develop a strategy for predicting the ischemic heart disease in coal industry workers.Materials and methods. Ischemic heart disease incidence and its risk factors were studied in 196 coalmine workers (sinkers, stope miners). Rose Questionnaire, daily ECG monitoring and bicycle ergometry were used to detect angina. The indices of lipid metabolism, hemostatic system, the level of homocysteine, uric acid, C-reactive protein, constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems were studied.When elaborating the prognostic system, we used the Bayes method. A prognostic coefficient was calculated for each factor. Prediction of ischemic heart disease was carried out according to the sum of prognostic coefficients.Results. Ischemic heart disease was detected in 18 (9.2 %) miners. According to the above mentioned indices, a medical technology was elaborated to predict the ischemic heart disease, based on the determination of the most significant risk markers: age, work experience in harmful working conditions, type A behavior, arterial hypertension, fasting hyperglycemia, metabolic syndrome, hypercholesterolemia, decrease in the level of high density lipoprotein cholesterol, increase in the value of low density lipoprotein cholesterol, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increase in the level of soluble fibrin monomer complexes and C-reactive protein, abdominal obesity, hypersthenic constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems.Conclusion. Based on the most significant markers, a personalized strategy for ischemic heart disease prediction in miners was elaborated, which allowed timely undertaking therapeutic and preventive measures.