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2FEATURES OF THE CLINICAL COURSE OF NONSTE-ACS WITH ASSESSMENT OF PSYCHOSOMATIC STATUS
Abdulloeva Maftuna Dilshodovna
Assistant of the Department of Internal Medicine and Cardiology No. 2, Samarkand State Medical University, Samarkand, Uzbekistan Yusra Rasheed,Kehkasha Students of the Samarkand State Medical University, Samarkand, Uzbekistan https://doi.org/10.5281/zenodo.14054152
ABSTRACT
Currently, cardiovascular diseases play a decisive role in the evolution of overall mortality worldwide. Coronary heart disease accounts for 26.6% of all cardiovascular diseases. Among the various forms of coronary heart disease, angina pectoris occupies a leading place. The increased risk caused by these psychosomatic factors is similar to more common risk factors for coronary heart disease, such as smoking, dyslipidemia, insulin resistance, and hypertension. The identified psychosomatic risk factors should be taken into account when assessing and managing the risks of individual coronary heart disease and have implications for public health policy and research
Introduction. Currently, cardiovascular diseases play a decisive role in the evolution of overall mortality worldwide. Coronary heart disease accounts for 26.6% of all cardiovascular diseases. Among the various forms of coronary heart disease, angina pectoris occupies a leading place. The increased risk caused by these psychosomatic factors is similar to more common risk factors for coronary heart disease, such as smoking, dyslipidemia, insulin resistance, and hypertension. The identified psychosomatic risk factors should be taken into account when assessing and managing the risks of individual coronary heart disease and have implications for public health policy and research.
The aim of the work. To identify etiopathogenetic risk factors for the development of neurovegetative disorders in patients with ACS without ST segment elevation .
Materials and methods. A total of 114 patients diagnosed with acute coronary syndrome without ST segment elevation ( ACS NSTE) were examined at the Samarkand Regional Branch of the Republican Specialized Scientific and Practical Medical Center of Cardiology and the Samarkand Branch of the Republican Scientific Center for Emergency Medical Care ( SF RSCEMC ) from 2021 to 2024. The average age of patients with ACS NSTE was 62.85±10.06 years. Of these, 55 (48.2%) patients had ACS without ST segment elevation and without neurovegetative disorders and 59 (51.2%) patients had ACS without ST segment elevation with neurovegetative disorders and 30 patients with stable angina who made up a comparable group. All patients gave their written informed consent for inclusion in the study.
ihiîs:Mit 5H1
Central Asian Journal of
Academic Research
ARTICLE INFO
Qabul qilindi: 01- Noyabr 2024 yil Ma'qullandi: 05- Noyabr 2024 yil Nashr qilindi: 07- Noyabr 2024 yil
KEYWORDS
To identify etiopathogenetic risk factors for the development of neurovegetative disorders in patients with ACS without ST segment elevation
Results and discussion. A total of 114 patients with ACS were observed. Among them, 54 were women and 60 were men; the average age was 62.85±10.06 years (Fig. 1).
Patients with ACS
male ■ female
A
47.36% 52.64% ^^^^^
Fig. 1. Distribution of patients with ACS by gender.
Among these patients, arterial hypertension was found in 86 patients (78.01%), diabetes mellitus - in 24 patients (21.05%), 52 patients (45.61%) had previously suffered a myocardial infarction, rhythm disturbance was noted in 39 (34.21%), anemia - 32 (16.4%), previous stroke - 5 (4.38%), COPD - 9 (7.89%), obesity - 78 (68.4%), other diseases 13 (11%) (Fig. 2).
other diseases 11,4
Fig. 2. Distribution of patients depending on the frequency of occurrence of concomitant conditions.
In our study, 21 (9.26%) patients had paroxysmal dyspnea as an equivalent of angina. 27 (12.68%) patients with NSTE -ACS had an atypical nature of the pain syndrome. To solve general clinical problems, patients, thanks to two scales (Beck scale and GAD -7 scale), were conditionally divided into 2 groups: Group 1 - patients in comorbidity with neurovegetative disorders (n = 59) and Group 2 - patients without neurovegetative disorders (n = 55). The indicators of biochemical studies between patients with NSTE- ACS with and without NVI, as well as between a comparable group of patients with CVS are statistically insignificant, but it is necessary to emphasize the fact that among patients with NVI, the UA level was 110.5 [imol / l higher than in patients without NVI.
CENTRAL ASIAN JOURNAL OF ACADEMIC RESEARCH IF = 5.441 ,
After identifying elevated UA levels in the blood of patients with NSTE -ACS with NVI, we decided to study the characteristics of the blood lipid profile in patients with unstable angina, as well as the relationship between UA levels and NVI.
The biochemical test results between patients with NSTE -ACS with and without NIH, as well as between a comparable group of patients with CVS, are statistically insignificant, but it is necessary to emphasize the fact that among patients with NIH, the UA level was 74.5 [imol /l higher than in patients without NIH.
Conclusion. The analysis of the results of the studies showed that among patients with NSTE-ACS and NIH, the TC and LDL-C indicators were statistically significantly higher in comparison with patients with NSTE -ACS and without NIH, as well as patients with SS. The coefficient atherogenicity coefficient was statistically increased in all groups of patients, while the optimal value is considered to be when CA is equal to 2-3. But among patients with NSTE -ACS and NVI, these values were significantly higher. In addition, the UA level also statistically differed among these groups, which shows the relationship of hyperuricemia with dyslipidemia. The period of ACS destabilization is accompanied by changes in: lipid profile ( atherogenicity coefficient ), asymptomatic hyperuricemia , the number of coronary artery lesions, the severity of which is higher depending on the degree of situational and personal anxiety. The identified disorders in patients with NSTE -ACS with NVI are confirmed by the correlation relationships between the sum of the parameters of the questionnaires used (Beck and GAD -7) and the UA level ( R 2 = 0.7894).
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