Effect of Chronic Obstructive Pulmonary Disease on In-Hospital Mortality and Clinical Outcomes After ST-Segment Elevation Myocardial Infarction

Objective: To study the levels of heat shock protein 70 (HSP70) and annexin V-dependent apoptosis of cells in myocardial infarction (MI) with a different course of the disease and in the setting of chronic obstructive pulmonary disease (COPD).Materials and Methods: Sixty-five patients with MI were examined; 37 of them developed MI in the setting of COPD, and 28 patient had MI without COPD. The subjects were divided into subgroups depending on the presence of ST segment elevation. The control group included 30 somatically healthy individuals.Results: In all examined patients with MI and in patients with MI with COPD, the number of annexin V-associated apoptotic cells and the level of HSP70 was statistically significantly higher than in healthy individuals. The value of the studied biomarkers was statistically significantly higher than in patients without COPD. In patients with MI with ST segment elevation, the values of the studied biomarkers were statistically significantly higher in patients without ST segment elevation in all the examined patients.Conclusions: Higher values of the studied biomarkers in the group of comorbid patients compared with those with MI without COPD may be associated with intensified apoptosis in the setting of chronic systemic inflammation, which worsens the clinical course of both diseases. The greater significance of the levels of HSP70 and annexin V-dependent cell apoptosis in patients with MI with ST segment elevation compared with patients without ST segment elevation is due to the volume of myocardial lesion.

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CORONARY CIRCULATION CHANGES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: ANGIOGRAPHY DATA

Bulletin physiology and pathology of respiration ◽

10.12737/article_5b1896e7cb8e08.22551994 ◽

2018 ◽

Vol 1 (68) ◽

pp. 34-39

Author(s):

Евгения Димова ◽

Evgeniya Dimova

Keyword(s):

Myocardial Infarction ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Coronary Arteries ◽

St Elevation Myocardial Infarction ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

St Segment Elevation ◽

St Segment ◽

St Elevation

The aim of the study was to investigate coronary arteries damage during ST-elevation myocardial infarction (STEMI) manifestation in patients with chronic obstructive pulmonary disease (COPD). The protocols of coronary angiography of 90 patients who suffered STEMI were analyzed. The patients were divided into two groups depending on the presence of COPD. The first group (50 people) was formed from the patients who had ST elevation myocardial infarction (STEMI) and COPD. The second group (40 people) had STEMI and no COPD. It was found that in case of COPD and STEMI comorbidity the number of coronary stenosis is bigger than in case of mono AMI patients. In the group of patients with COPD and STEMI the angiographic picture of atherosclerosis damage of coronary arteries demonstrates the prevalence of medium and distal stenosis of major branches and coronary arteries of the second order unlike the group with isolated STEMI. The number of extended stenosis in the group with the comorbid pathology is also higher. The patients with STEMI have the same number of hemodynamically important stenosis as the other group. The correlation between the change of the vessel channel and smoking anamnesis, the level of the systematic inflammation marker (CRP) and the level of lipids in patients with COPD and STEMI was studied. The severity of coronary atherosclerosis directly correlates with CRP level, smoking anamnesis, level of cholesterol, LDLP. The number of distal stenosis, including those that are hemodynamically important, has reverse correlation with the level of HDLP.

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