EFFECT IMBALANCE AQUEOUS BODY FLUIDS, AND RENAL DYSFUNCTION, CARDIOVASCULAR SURVIVAL IN PATIENTS AFTER AN ACUTE CORONARY SYNDROME, MYOCARDIAL REVASCULARIZATION

Objective. Analysis imbalance aqueous body fluids on the prognosis of cardiovascular events in the late period after an acute coronary syndrome (ACS) and myocardial revascularization based on indicators of renal function.Materials and methods. The study included 120 patients with ACS, including unstable angina was diagnosed in 68 patients, 52 patients — acute myocardial infarction. All patients underwent myocardial revascularization. To register the presence of albuminuria in the range of 30-300 mg/l, and glomerular filtration rate (GFR). It makes calculations indicators aqueous body fluids — the total volume of water (TVW), the total fluid, intracellular fluid (IF), extracellular fluid. The endpoint of the study was the presence of cardiovascular complications within 6 months after ACS.Results. It is found that the presence and magnitude of albuminuria was significantly increase the risk of the end point of the study. In patients with GFR less than 60 mL/min/1,73m2 studied the risk is higher by 17.1%, compared with patients with a GFR above this limit. Analysis of the distribution of the water body fluids showed a significant increase in the average TVW and IF. Through statistical analysis of survival found an increased risk of cardiovascular complications in the late period after ACS in patients who have an increase IF on the stage of development of coronary catastrophe.Conclusion. The study demonstrated the predictive value to stratify cardiovascular disease risk, not only the presence of albuminuria, but its level and value of GFR less than 60 mL/min/1,73m2. Redistribution of aqueous body fluids in the form of increased IF is a marker of adverse cardiovascular events in the late period after ACS. These data indicate the need for a comprehensive and integrated analysis of existing pathogenetic changes occurring in ACS, as well as the status of the patients premorbid factor for improving risk stratification of cardiovascular complications in the long term after a cardiovascular accident

ANALYSIS OF THE DISTRIBUTION OF BODY FLUIDS VOLUMES IN PATIENTS WITH ACUTE CORONARY PATHOLOGY WITH REGARD TO REMODELING OF THE LEFT VENTRICLE MYOCARDIUM

Purpose: estimation  of the dynamics of distribution of the organism water environment in patients with acute coronary syndrome (ACS) taking into account the presence of myocardial hypertrophy of left ventricle, at different stages of hospitalization. Materials and methods: we have examined 120 patients  with ACS undergoing restoration of coronary blood flow. The assessment was made traditional and renal risk factors (albuminuria 30-300 mg/l, the value of eGFR), and produced the aqueous environments  of the body. All examined patients  were divided into two groups. The first group includes patients  with left ventricular hypertrophy, the second group included patients  without hypertrophy of the LV myocardium. Results: for both studied groups were characterized  by the increase in the total  water volume (TWV), the total  liquid volume (TLV), the intracellular fluid volume (IFV) at all stages of the study. Summary: in patients with ACS and the presence of LV hypertrophy found a significant increase of the average content  of TWV,  TLV, IFV at all stages of hospitalization. Also in the group of patients  with LV remodeling and hyperhydratation was observed a decrease in GFR, and the presence of albuminuria

Risk of Cardiovascular Death in the Remote Period after Myocardial Revascularization and in Association with Renal Dysfunction

The aim of the present study was to assess the effectiveness of standard medical therapy in lowering the risk of cardiovascular death (rCVD) in the remote period after myocardial revascularization (MR), taking into account the presence of renal dysfunction (RD). Material and Methods: The study included 90 patients with coronary heart disease (CHD) and indications for revascularization. We evaluated a drug therapy obtained at different stages of revascularization, as well as the severity of patients’ condition and the prevalence of RD. Results: In the remote period after MR (5.8±0.05 years), 71/78.9% patients participated in the study; death occurred in 10/12.3% patients. The duration of therapy for chronic myocardial ischemia before MR (P=0.005), as well as compliance with prescribed therapy during 6 months (P=0.008) after this procedure, affected CVD in the remote period after MR. Using statins before MR reduced rCVD by 17.2% (P=0.01), beta-blockers -14.95% (P=0.04), and ACE inhibitors (ACEIs) - 15.75% (P=0.03). The lack of regular use of acetylsalicylic acid (ASA) for 6 months after RM was associated with an increase in rCVD up to 36.2% (P=0.005). Statins and ACEIs are drugs that reduce rCVD in the presence of RD (P<0.05). Conclusion: An efficient drug regimen for patients after MR is important in reducing a long-term prognosis of CVD and for an efficient correction of coronary artery patency