Abstract
Aim . To study the factors associated with the development of acute coronary syndrome in young adults. Methods . 299 patients with acute coronary syndrome (ACS) aged 25 to 44 years admitted to the Cardiology Department at the Regional Government Budgetary Healthcare Institution “Altai Regional Cardiology Dispensary” were enrolled in the study. The mean age of patients was 40.3±0.2 years. The control group included 53 healthy subjects without cardiovascular diseases aged 25 to 44 years (the mean age of 39.9±0.79 years). Traditional risk factors were assessed in all patients. CBC and blood biochemistry were performed in all patients to determine lipid profile and fasting glucose levels. Additionally, height and weight were measured with the subsequent calculation of the body mass index. Patients with ACS underwent electrocardiography, echocardiography, coronary angiography. Gene polymorphisms FII G20210A, FV G1691A, MThFr C677T were evaluated by polymerase chain reaction in 116 young adults present with ACS and 53 healthy volunteers. Results . Based on the comprehensive assessment of the clinical and demographic data, traditional risk factors and hemostatic and folate metabolism gene polymorphisms assessment in young adults, the most significant risk factors associated with the development of ACS in young patients included smoking, elevated low-density lipoprotein cholesterol with the presence of FV G1691A heterozygous polymorphism. The obtained findings could be effectively used in clinical practice to determine patients at high risk of cardiovascular diseases. Conclusion . Thus, screening for high risk of cardiovascular diseases among young adults should include genetic testing of FV G1691A and MTHFR C677T gene polymorphisms along with traditional risk factors to introduce additional examinations and employ novel preventive strategies.
Highlights
В исследование было включено 299 пациентов молодого возраста с острого коронарного синдрома (ОКС), находившихся на лечении в кардиологическом отделении для лечения больных острым инфарктом миокарда КГБУЗ «Алтайский краевой кардиологический диспансер»
В результате проведенной комплексной оценки клинико-анамнестических показателей, традиционных факторов риска и полиморфизмов генов факторов системы гемостаза и ферментов фолатного метаболизма у пациентов с ОКС молодого возраста определено, что наиболее значимыми факторами риска, ассоциированными с развитием ОКС у молодых пaциeнтов, являются сочетание курения, повышение уровня холестерина липопротеинов низкой плотности с наличием гетерозиготного полиморфизма 1691 GA гена FV, что может эффективно использоваться в клинической практике для формирования группы высокого сердечно-сосудистого риска
To study the factors associated with the development of acute coronary syndrome in young adults
Summary
В исследование было включено 299 пациентов молодого возраста с ОКС (от 25 до 44 лет, ВОЗ 2017 г.), находившихся на лечении в кардиологическом отделении для лечения больных острым инфарктом миокарда КГБУЗ «Алтайский краевой кардиологический диспансер». На следующем этапе части из обследованных молодых пациентов с ОКС (n = 116) и группы контроля (n = 53) проведен молекулярно-генетический анализ протромботических полиморфизмов генов системы гемостаза (FII (G20210A), FV (G1691A) и гена фермента фолатного метаболизма MTHFR (C677T)).
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