Keywords
How to Cite
Abstract
The aim of the study was to examine the features of changes in the coronary blood flow during coronary angiography (CAG) in patients with ST-elevation myocardial infarction (STEMI) in the presence of overweight and obesity. Material and methods. 158 patients with STEMI age from 32 to 86 years were examined. All patients were divided into 3 groups: the first group consisted of 52 patients with MI with normal body weight (body mass index (BMI) — 18.5-24.9 kg/m2), the second group — 51 patients with MI with overweight (BMI — 25.0-29.9 kg/m2), the third group — 55 people with MI and obesity of I-III stages (BMI ≥ 30.0 kg/m2). Results. When evaluating the results of CAG, it was found that the prevalence of the left type of coronary blood supply of the heart was recorded in 48.08±6.93% of patients with STEMI who had normal body weight (group I), in 41.18±6.89% of patients with STEMI and overweight (group II) and in 41.82±6.65% of patients with STEMI and obesity (group III) (p>0.05). The right type of blood supply was detected in 48.08±6.93% of patients of the I group, 43.14±6.94% of the patients of the II group, and in 38.18±6.55% of the patients of the III group (p>0.05). A balanced type of coronary circulation was observed only in 3.85±1.67% of patients of group I, 15.69±5.09% of patients of group II, and in persons of group III — in 20±5.39% of cases (p1-2=0.042, p1-3=0.011). Multivessel lesions of coronary arteries (CA) in the I group were found in 28.85±6.28% of persons, but in persons with overweight and obesity, such cases were significantly more — 39.22±6.84% (II group) (р1-2<0.05) and 41.82±6.65% (III group) (р1-3<0.05), respectively. Conclusions. According to the results of CAG, reliably higher proportion of persons with a balanced type of the myocardium blood supply among patients with obesity was detected. Multi-vessel CA lesions occur significantly more often in patients with overweight and obesity. Obese patients were characterized by the localization of hemodynamically significant changes in the medial segment of the anterior interventricular branch of the left CA (р<0.05), and they also had a tendency to more frequent chronic occlusions (p=0.08).
References
2. Hebebrand J, Holm JC, Woodward E, Baker JL, Blaak E, Durrer Schutz D, et al. A Proposal of the European Association for the Study of Obesity to Improve the ICD-11 Diagnostic Criteria for Obesity Based on the Three Dimensions Etiology, Degree of Adiposity and Health Risk. Obes Facts. 2017;10(4):284-307.
3. Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2014;383(9921):999-1008. doi:10.1016/S0140-6736(13)61752-3.
4. Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et. al. INTERHEART Study Investigators. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005 Nov 5;366(9497):1640-9. doi: 10.1016/S0140-6736(05)67663-5. PMID: 16271645.
5. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N EnglJ Med. 2008;359(20):2105-20.
6. Folsom AR, Kushi LH, Anderson KE, Mink PJ, Olson JE, Hong CP, et al. Associations of general and abdominal obesity with multiple health outcomes in older women: the Iowa Women’s Health Study. Arch Intern Med. 2000;160(14):2117-28.
7. Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, et. al. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med 2015;163:827-835.
8. Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation 2008;117:1658–1667.
9. Chen GC, Arthur R, Iyengar NM, Kamensky V, Xue X, Wassertheil-Smoller S, et. al. Association between regional body fat and cardiovascular disease risk among postmenopausal women with normal body mass index. Eur Heart J. 2019 Sep 7;40(34):2849-2855. doi: 10.1093/eurheartj/ehz391. PMID: 31256194; PMCID: PMC6933870.
10. Karpe F, Pinnick KE. Biology of upper-body and lower-body adipose tissue—link to whole-body phenotypes. Nat Rev Endocrinol 2015;11:90–100.
11. Stefan N, Schick F, Haring HU. Causes, characteristics, and consequences of metabolically unhealthy normal weight in humans. Cell Metab 2017;26:292–300.
12. Tchkonia T, Thomou T, Zhu Y, Karagiannides I, Pothoulakis C, Jensen MD, Kirkland JL. Mechanisms and metabolic implications of regional differences among fat depots. Cell Metab 2013;17:644–656.
13. Lakka HM, Lakka TA, Tuomilehto J, Salonen JT. Abdominal obesity is associated with increased risk of acute coronary events in men. Eur Heart J. 2002 May;23(9):706-13. doi: 10.1053/euhj.2001.2889. PMID: 11977996.
14. Никоненко АС, Наконечный СЮ, Молодан АВ, Осауленко ВВ, Матерухин АН. Сравнительная характеристика результатов коронарографии, структурно-геометрических и функциональных показателей левого желудочка у больных ишемической болезнью сердца без и с Q-инфарктом миокарда в анамнезе с показаниями до реваскуляризации миокарда. Сучасні медичні технології. 2011;3-4:278-80.
15. Barbarawi M, Kheiri B, Zayed Y, Barbarawi O, Chahine A, Haykal T, Kanugula AK, Bachuwa G, Alkotob ML, Bhatt DL. Meta-analysis of optimal timing of coronary intervention in non-ST-elevation acute coronary syndrome. Catheter Cardiovasc Interv. 2020 Feb;95(2):185-193. doi: 10.1002/ccd.28280. Epub 2019 May 21. PMID: 31111670.