• Home
  • NEW DAY MEDICINE
  • 5 (43) 2022
  • 5 -5 (43) 2022 — Alyavi A.L., Aminov A.I., — PREINFARCTION ANGINA PECTORIS AS PROTECTION AGAINST REPERFUSION INJURY OF THE MYOCARDIUM IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-ELEVATION

5 -5 (43) 2022 — Alyavi A.L., Aminov A.I., — PREINFARCTION ANGINA PECTORIS AS PROTECTION AGAINST REPERFUSION INJURY OF THE MYOCARDIUM IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-ELEVATION

PREINFARCTION ANGINA PECTORIS AS PROTECTION AGAINST REPERFUSION INJURY OF THE MYOCARDIUM IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-ELEVATION

Alyavi A.L., Republican Scientific Center emergency medical care Tashkent Medical Academy Bukhara State Medical Institute

Aminov A.I., Republican Scientific Center emergency medical care Tashkent Medical Academy Bukhara State Medical Institute

Koyirov A.K., Republican Scientific Center emergency medical care Tashkent Medical Academy Bukhara State Medical Institute

Kenjayev S.R., Republican Scientific Center emergency medical care Tashkent Medical Academy Bukhara State Medical Institute

Boltayev E.B. Republican Scientific Center emergency medical care Tashkent Medical Academy Bukhara State Medical Institute

Resume

To evaluate the effect of pre-infarction angina (PIА) on myocardial reperfusion injury and the clinical course of acute ST-segment elevation myocardial infarction (STSEMI) in patients receiving thrombolytic therapy. 102 patients aged 25 to 70 years were hospitalized within the first 6 hours after the development of symptoms of ST-segment acute coronary syndrome (ACS). All patients received basic therapy, including antiplatelet agents, anticoagulants, β-blockers, ACE inhibitors, nitrates and statins. Thrombolytic therapy (TLT) was performed by intravenous infusion of 1.5 million units of streptokinase for 40 minutes. Random sampling was used to form two groups of patients without initial clinical and anamnestic data and statistically significant differences in the main therapy used: group 1 (main) – 48 patients with angina pectoris (pre-infarction angina pectoris) in the last 24-48 hours before the development of MI; group 2 – (control) – 54 patients with sudden onset of MI without angina pectoris.

Thus, the study of the protective effect of short-term episodes of pre-infarction angina pectoris in patients receiving reperfusion therapy (TLT) with STSEMI showed a positive effect on the clinical course of AMI. Our results show that the presence of PIA (in the main group of patients) contributed to a decrease in ischemic/reperfusion myocardial damage, limited the development of myocardial necrosis, as well as a decrease in the incidence of life-threatening reperfusion ventricular arrhythmias, which, in turn, led to an improvement in the results of reperfusion in STSEMI.

The presence of pre-infarction angina in patients with STSEMI has a positive effect on the effectiveness of reperfusion therapy by accelerating the “symptom-reperfusion” time.

Keywords: ST-segment elevation acute coronary syndrome, myocardial reperfusion injury, pre-infarction angina, ischemic preconditioning.

First page

23

Last page

30

For citation: Alyavi A.L., Aminov A.I., Koyirov A.K., Kenjayev S.R., Boltayev E.B. PREINFARCTION ANGINA PECTORIS AS PROTECTION AGAINST REPERFUSION INJURY OF THE MYOCARDIUM IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-ELEVATION //New Day in Medicine 5(43)2022 23-30 https://clck.ru/hEiz2

LIST OF REFERENCES:

  1. Аляви А.Л., Кенжаев М.Л., Рахимова Р.А., Кенжаев С.Р. Реперфузионное повреждение миокарда при остром коронарном синдроме и современные способы кардиопротекции (пре- и посткондиционирование миокарда). //Кардиология Узбекистана 2015; 4: 74-82.
  2. Аронов Д.М., Лупанов В.П. Функциональные пробы в кардиологии. /М Медпресс-Информ 2007: 212213.
  3. Иванов А.П., Горностаева Т.С., Эльгардт И.А. Роль предшествующей инфаркту миокарда стенокардии и феномена ишемического прекондиционирования в сохранности коронарного резерва в раннем постинфарктном периоде. //Кардиоваскулярная терапия и профилактика 2006; 5 (1): 71-75.
  4. Лупанов В.П., Максименко А.В. Протективная ишемия в кардиологии. Формы кондиционирования миокарда. //Кардиоваскулярная терапия и проф 2011; 10 (1): 96-103.
  5. Кенжаев М.Л., Ризаева М.Ж. (2020). Клиническое течение фибрилляции предсердий у больных ишемической болезнью сердца. //In Наука и инновации-современные концепции (pp. 103-109).
  6. Kenzhaev M.L., Rizaeva M.Zh., Identification of atrial fibrillation predictors in patients with coronary heart disease//New Day in Medicine 2(30)2020 398-401. https://cutt.ly/QvIQm5R
  7. Маслов Л.Н. Новые подходы к профилактике и терапии ишемических и реперфузионных повреждений сердца при остром инфаркте миокарда // Сиб. мед. журн. — 2010. — Т. 25. — № 2. — Вып. 1. — С.17–24
  8. Писаренко О.И. Ишемическое прекондиционирование: от теории к практике. //Кардиология 2005; 9: 62-72.
  9. Шляхто Е.В., Галагудзе М.М., Нифонтов Е.М., Щербак Н.С. Острое ишемическое повреждение и защита миокарда. Руководство по атеросклерозу и ишемической болезни сердца. Под ред. акад. Е.И. Чазова  и др. /М Медиа Медика 2007: 552-573.
  10. Rizaeva M.Zh. Efficiency and safety of electric cardioversion in persistent form of atrial fibrillation//New Day in Medicine 4(32)2020 322-325 https://cutt.ly/KzwHHR6
  11. Турдиев У.М., Болтаев Э.Б., Кодиров М.Д. Показатели цитокинов у больных с острым коронарным синдромом в зависимомти от вида антитромботическиой терапии. //Высшая школа: научные исследования, 2020, р. 93-97.
  12. Duan Q, et al. Role of phosphoinositide 3-kinase IA (PI3K-IA) activation in cardioprotection induced by ouabain preconditioning. j Mol Cell Cardiol. 2015;80:114-125.
  13. Qoyirov A.Q., Kenjaev S.R., Xaitov S.SH. Egamova N.T., Boltaev E.B., The role of delirium in patients with myocardial infarction of complicated acute heart failure //New Day in Medicine 3(31)2020 68-71 https://cutt.ly/PxvS3SO
  14. Granfeld A., Lefer D.J., Vinten-Johansen J. Protective ischemia in patients: preconditioning and postconditioning. //Cadiovasc Res 2009; 83 (2): 234-46.
  15. Hausenloy D.J., Ong S.B., Yellon D.M. The mitochondrial permeability transition pore as a target for preconditioning and postconditioning. Basic Res Cardiol 2009; 104 (2): 189-202.
  16. Kloner R.A., Jennings R.B. Consequences of brief ischemia: stunning, preconditioning, and their clinical implications: Part 1. Circulation 2001; 104 (24):
  17. Lønborg J., Kelbæk H., Vejlstrup N., et al. Influence of pre-infarction angina, collateral flow, and pre-procedural TIMI flow on myocardial salvage index by cardiac magnetic resonance in patients with ST-segment elevation myocardial infarction. //Eur Heart J Cardiovasc Imaging 2012; 13 (5): 433–43
  18. Myrry C., Jennings R., Reimer K. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. // Circulation 1986; 74: 1124-36. 17
  19. Koyirov A.K., Boltayev E.B.,Shirinov D.K., Rakhimov M.M., Jalilov A.A Non-invasive lung ventilation in acute respiratory failure caused by new coronavirus infection covid-19 //New Day in Medicine 1(33)2021 107-114 https://cutt.ly/nzlySdM
  20. Perrelli M.G., Pagliaro P., Penna C. Ischemia/reperfusion injury and cardioprotective mechanisms: Role of mitochondria and reactive oxygen species. World J Cardiol 2011; 3 (6): 186–200

file

download