Clinical-functional peculiarities of stable angina of different functional classes considering myocardial infarction in an anamnesis

Authors

  • V. K. Tashchuk Higher State Educational Establishment of Ukraine “Bukovinіan State Medical University”, Chernivtsi, https://orcid.org/0000-0002-7988-5256
  • Al Salama Muhamed Vasek Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi,
  • T. М. Amelina Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi, https://orcid.org/0000-0002-5295-8371
  • I. O. Makoviichuk Regional Clinical Cardiology Center, Chernivtsi, Ukraine,
  • O. P. Dinova Regional Clinical Cardiology Center, Chernivtsi, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2020.6.218300

Keywords:

stable angina pectoris, Q-myocardial infarction, nonQ-myocardial infarction, echocardiography, bicycle ergometry, coronary angiography, amino-terminal propeptide of natriuretic peptide, C-reactive protein, uric acid, testosterone

Abstract

 

Aim. To study clinical-functional peculiarities of stable angina pectoris (SAP) of different functional classes (FC) with post-infarction and diffuse cardiosclerosis.

Materials and methods. In total, 120 patients with SAP involved in the study, and a written informed consent was obtained from all of them. The patients were distributed into the groups according to angina severity, experienced Q-myocardial infarction (Q-MI) in the anamnesis, nonQ-myocardial infarction (nonQ-MI) and diffuse cardiosclerosis.

Results. Q-MI in the anamnesis was found to promote the development of more severe SAP (Р < 0.01), unlike nonQ-MI. Coronary angiography findings were indicative of the hemodynamically significant damage of the coronary arteries among the patients with FC III SAP. Higher FC SAP was associated with a considerable increase in total cholesterol (Р < 0.05) rather than increase in triglyceride levels (Р > 0.05), irrespective of experienced MI in the anamnesis. The levels of amino-terminal propeptide of natriuretic peptide and C-reactive protein were higher in FC III SAP (Р < 0.01 and Р < 0.001, respectively) regardless of MI in the anamnesis. An increased level of uric acid caused more severe SAP (Р < 0.001) among patients who had experienced myocardial infarction Q-MI (Р < 0.01).

According to the echocardiography findings, patients with FC III SAP presented larger size of the left ventricle (Р < 0.05), irrespective of experienced MI in the anamnesis. The bicycle ergometry results revealed lower indices of the threshold load and tolerance to physical exercise (in both cases Р < 0.001) and more pronounced test-induced ischemia (Р < 0.001) due to FC III SAP.

Conclusions. Higher FC SAP is caused by more hemodynamically significant damage of the coronary arteries with increased levels of amino-terminal propeptide of natriuretic peptide and C-reactive protein, irrespective of experienced Q-MI and nonQ-MI in the anamnesis.

References

  1. Katz, D., & Gavin, M. C. (2019). Stable Ischemic Heart Disease. Annals of Internal Medicine, 171(3), ITC17-ITC32. https://doi.org/10.7326/AITC201908060
  2. Mansoor, H. Jo A., Beau De Rochars, V. M., Pepine, C. J., & Mainous, A. G. (2019). Novel Self-Report Tool for Cardiovascular Risk Assessment. Journal of the American Heart Association, 8(24), Article e014123. https://doi.org/10.1161/JAHA.119.014123
  3. Adabag, S., & Langsetmo, L. (2020). Sudden cardiac death risk prediction in heart failure with preserved ejection fraction. Heart Rhythm, 17(3), 358-364. https://doi.org/10.1016/j.hrthm.2019.12.009
  4. Frydland, M., Møller, J. E., Lindholm, M. G., Hansen, R., Wiberg, S., Lerche Helgestad, O. K., Thomsen, J. H., Goetze, J. P., Engstrøm, T., Frikke-Schmidt, R., Ravn, H. B., Holmvang, L., Jensen, L. O., Kjaergaard, J., & Hassager, C. (2020). Biomarkers predictive of late cardiogenic shock development in patients with suspected ST-elevation myocardial infarction. European Heart Journal: Acute Cardiovascular Care, Article 2048872619896063. https://doi.org/10.1177/2048872619896063
  5. Jang, J. J., Bhapkar, M., Coles, A., Vemulapalli, S., Fordyce, C. B., Lee, K. L., Udelson, J. E., Hoffmann, U., Tardif, J. C., Jones, W. S., Mark, D. B., Sorrell, V. L., Espinoza, A., Douglas, P. S., Patel, M. R., & PROMISE Investigators. (2019). Predictive Model for High-Risk Coronary Artery Disease. Circulation: Cardiovascular Imaging, 12(2), Article e007940. https://doi.org/10.1161/CIRCIMAGING.118.007940
  6. Ye, F., Winchester, D., Jansen, M., Lee, A., Silverstein, B., Stalvey, C., Khuddus, M., Mazza, J., & Yale, S. (2019). Assessing Prognosis of Acute Coronary Syndrome in Recent Clinical Trials: A Systematic Review. Clinical Medicine & Research, 17(1-2), 11-19. https://doi.org/10.3121/cmr.2019.1433
  7. Zagidullin, N., Motloch, L. J., Gareeva, D., Hamitova, A., Lakman, I., Krioni, I., Popov, D., Zulkarneev, R., Paar, V., Kopp, K., Jirak, P., Ishmetov, V., Hoppe, U. C., Tulbaev, E., & Pavlov, V. (2020). Combining Novel Biomarkers for Risk Stratification of Two-Year Cardiovascular Mortality in Patients with ST-Elevation Myocardial Infarction. Journal of Clinical Medicine, 9(2), Article 550. https://doi.org/10.3390/jcm9020550
  8. Nikorowitsch, J., Ojeda, F., Lackner, K. J., Schnabel, R. B., Blankenberg, S., Zeller, T., & Karakas, M. (2020). Head-to-Head Comparison of the Incremental Predictive Value of The Three Established Risk Markers, Hs-troponin I, C-Reactive Protein, and NT-proBNP, in Coronary Artery Disease. Biomolecules, 10(3), Article 394. https://doi.org/10.3390/biom10030394
  9. Ferencik, M., Mayrhofer, T., Bittner, D. O., Emami, H., Puchner, S. B., Lu, M. T., Meyersohn, N. M., Ivanov, A. V., Adami, E. C., Patel, M. R., Mark, D. B., Udelson, J. E., Lee, K. L., Douglas, P. S., & Hoffmann, U. (2018). Use of High-Risk Coronary Atherosclerotic Plaque Detection for Risk Stratification of Patients With Stable Chest Pain: A Secondary Analysis of the PROMISE Randomized Clinical Trial. JAMA Cardiology, 3(2), 144-152. https://doi.org/10.1001/jamacardio.2017.4973
  10. Mani, P., Puri, R., Schwartz, G. G., Nissen, S. E., Shao, M., Kastelein, J., Menon, V., Lincoff, A. M., & Nicholls, S. J. (2019). Association of Initial and Serial C-Reactive Protein Levels With Adverse Cardiovascular Events and Death After Acute Coronary Syndrome: A Secondary Analysis of the VISTA-16 Trial. JAMA Cardiology, 4(4), 314-320. https://doi.org/10.1001/jamacardio.2019.0179
  11. Kotecha, D., Flather, M. D., Atar, D., Collins, P., Pepper, J., Jenkins, E., Reid, C. M., Eccleston, D., & Alternative Risk Markers in Coronary Artery Disease (ARM-CAD) Study. (2019). B-type natriuretic peptide trumps other prognostic markers in patients assessed for coronary disease. BMC Medicine, 17(1), Article 72. https://doi.org/10.1186/s12916-019-1306-9
  12. Mandurino-Mirizzi, A., Crimi, G., Raineri, C., Pica, S., Ruffinazzi, M., Gianni, U., Repetto, A., Ferlini, M., Marinoni, B., Leonardi, S., De Servi, S., Oltrona Visconti, L., De Ferrari, G. M., & Ferrario, M. (2018). Elevated serum uric acid affects myocardial reperfusion and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Journal of Cardiovascular Medicine, 19(5), 240-246. https://doi.org/10.2459/JCM.0000000000000634
  13. Hirji, S. A., Stevens, S. R., Shaw, L. K., Campbell, E. C., Granger, C. B., Patel, M. R., Sketch, M. H., Jr, Wang, T. Y., Ohman, E. M., Peterson, E. D., & Brennan, J. M. (2017). Predicting risk of cardiac events among ST-segment elevation myocardial infarction patients with conservatively managed non-infarct-related artery coronary artery disease: An analysis of the Duke Databank for Cardiovascular Disease. American Heart Journal, 194, 116-124. https://doi.org/10.1016/j.ahj.2017.08.023

Downloads

How to Cite

1.
Tashchuk VK, Muhamed Vasek AS, Amelina TМ, Makoviichuk IO, Dinova OP. Clinical-functional peculiarities of stable angina of different functional classes considering myocardial infarction in an anamnesis. Zaporozhye Medical Journal [Internet]. 2020Dec.9 [cited 2026May11];22(6). Available from: https://zmj.zsmu.edu.ua/article/view/218300

Issue

Vol. 22 No. 6 (2020)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons