Zeynalov R.V., Isaev E.I., Abbasov E.F., Samadov F.M., Aliyev F.V.

THE CONDITION OF CORONARY ARTERIES AND ENDOVASCULAR TREATMENT OUTCOMES IN YOUNG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

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About the author:	Zeynalov R.V., Isaev E.I., Abbasov E.F., Samadov F.M., Aliyev F.V.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The urgency of the problem of acute myocardial infarction and coronary atherosclerosis in young age to date is confirmed by the increased mortality and disability in young people with coronary heart disease and the incidence of atherosclerotic process among them (77%). According to the epidemiological data, major risk factors for coronary heart disease are family history (50%), nephrotic syndrome, familial hypercholesterolemia, smoking, hyperlipidemia, diabetes, hypertension, hyperhomocysteinemia, antiphospholipid syndrome, which suggests a genetic predisposition. As a rule, the heart attack at young people is preceded for the first time with the cardiac angina (24%), less than a week, with the defeat of the lower wall of the left ventricle (43%) and the development of acute cardiac insufficiency (41%). Cases of supraventricular arrhythmias were observed in 11%, atrial fibrillation in 5%, ventricular tachycardia in 30% of young patients. Analysis of laboratory data revealed a significant increase in the level of creatine phosphokinase (CPK), leukocytes, troponin. The single vessel disease or absence of vascular lesions is being diagnosed more often by coronary angiography. The frequency of two-vessel disease was the same as in the elderly, and the presence of three-vessel disease less than it was in a young group. Revascularization was successful (93%) had a favorable forecast and a little complications. The aortocoronary bypass surgery needed only in 5% of cases after endovascular procedures. The survival rate was 92%. The use of thrombolytic medication is recognized as an effective treatment for young patients as thrombosis of the coronary arteries are detected more frequently than older people. Administration of beta adrenergic blockers should be postponed in young patients, as it is in spasm of the coronary arteries helps to promote alpha adrenoceptor. Administration of nitrate is also compulsory in young patients undergoing myocardial infarction.
Tags	atherosclerosis, acute myocardial infarction, young age, coronary angiography
Bibliography	Borisov I. A. Osobennosti klinicheskogo techeniya bolnyih IBS molodogo vozrasta / I. A. Borisov, I. G. Berezovets / Byulleten NTsSSH im. A.N. Bakuleva RAMN, - 2002, Tom 3, No. 11, S. 74-76. Dobordzhginidze L. M. Dislipidemii: Lipidyi i lipoproteinyi, metabolizm i uchastie v aterogeneze (Tsentr ateroskleroza NII fiziko-himicheskoy meditsinyi Minzdrava RF) / L.M. Dobordzhginidze, N.A. Gratsianskiy // Referativnyiy Meditsinskiy Zhurnal, Moskva, - 2000, t. 8, No. 7, S. 15-18. Nazarenko G. I. Diagnostika antifosfolipidnogo sindroma. / G.I. Nazarenko, A.K. Kishkun, V.P. Mikolauskas [i dr.] // - Moskva, izd-vo: Meditsinskiy tsentr Banka Rossii, - 2003, S. 32-41. Popkova T. V. Lipoprotein pri sistemnoy krasnoy volchanke. T. V. Popkova, S. N. Pokrovskiy, 3. S. Alekberova // Klinicheskaya meditsina, - 1998, No. 1, S. 12-15. Reshetnyak T. M. Kardiologicheskie aspektyi antifosfolipidnogo sindroma. Chast I. Klapannyie porazheniya serdtsa pri pervichnom i vtorichnom antifosfolipidnom sindrome i sistemnoy krasnoy volchanke / T.M. Reshetnyak, G. P. Kotelnikova, O. A. Fomicheva // Kardiologiya,- 2002, No. 7, S. 38 - 43. Suslina Z.A. // Mezhdunarodnyiy Zhurnal nevrologii, - 2006, No. 2, C. 6 - 8. Аsherson R.A. Myocardial infarction and antiphospholipidantibodies in SLE and related disorders Quart / R. A. Аsherson, M.A. Khamashta, E.I. Baguley // J Med, - 1989, Vol. 73, P. 1103 - 1115. Berenson G. S. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa heart study / G.S. Berenson, S.R. Srinivasan, W. Bao // N Engl J Med, - 1998, Vol. 338, P. 1650–1656. Chen L. Clinical factors and angiographic features associated with premature coronary artery disease / L. Chen, M. Chester, J.C. Kaski // Chest, - 1995, Vol. 108, P. 364 - 366. Cattaneo M. Hiperhomocysteinemia, atherosclerosis and thrombosis / M. Cattaneo // Thrombos, hemostas, - 1999, Vol. 81, P. 165 - 176. Egred M. Impending paradoxical embolism / M. Egred, J.C. Patel, S. Walton // Circulation, - 2001, Vol. 103, P. 113 - 114. Egred M. Management of paradoxical coronary embolism / M. Egred, J.C. Patel, S. Walton // Circulation, - 2001, Vol. 104, P. 153 - 156. Egred M. Myocardial infarction in young adults / M. Egred // Postgrad Med J,- 2005, Vol. 81, P. 741-745. Hoit E.A. Myocardial infarction in young patients: an analysis by age subsets / E.A. Hoit, H. Gilpin, A.A. Henning [et al.] // BD Circulation, - 1986, Vol. 74, P. 712 - 721. Hasnie A.M. Diastolic dysfunction is a feature of the antiphospholipid syndrome / A.M. Hasnie, M.F. Stoddard, C.B. Gleason // Am Heart J, - 1995, Vol. 129, P. 1009 - 1113. Hamamichi Y. Anomalous origin of the main stem of the left coronary artery from the non-facing sinus of valsalva associated with sudden death in a young athlete / Y. Hamamichi, E. Okada, F. Ichida // Cardiol Young, - 2000, Vol. 10, P. 147 - 149. Kannel W.B. Incidence and prognosis of unrecognized myocardial infarction. An update on the Framingham study / W. B. Kannel, R. D. Abbott // N Engl J Med, - 1984, Vol. 311, P.1144-1147. Lamm G. The Epidimiology of Acute myocardial Infarction / G. Lamm // Myocardial Infarction at Young Age editted by Roskmann. Springer, - 1981, 227 p. Louis Bezold M.D. Myocardial infarction in childhood / M.D. Louis Bezold // JEM, - 2014, P. 23-25. Myong – Ki Hong. Acute Myocardial Infarction in the young adults / Myong – Ki Hong, Seung – Yun. // Yonsei Medical Journal, - 1994, Vol. 35/2, P. 567-569. Mc Gill H.C. Jr. Association of coronary heart disease risk factors with microscopic qualities of coronary atherosclerosis in youth / H.C. Mc Gill Jr, C.A. Mc Mahan, A.W. Zieske // Circulation, - 2000, Vol. 102, P. 374 - 376. Milonig G. Early inflammatory and immunological lesions in juvenile atherosclerosis from the pathological determinants of atherosclerosis in youth (PDAY) study / G. Milonig, G.T. Malcolm, G. Wick // Atherosclerosis, - 2002, Vol. 160, P. 444 - 448. Mohlenkamp S. Update on myocardial bridging / S. Mohlenkamp, W. Hort, J. Ge // Circulation, - 2006, Vol. 106, P. 2616 - 2619. Roskmann H. Myocardial Infarction at young age / H. Roskmann // Springer-Verlag Berlin Heidelberg. New –York, - 1981, P. 237-241. Simonson E. Myocardial infarction in young people / E. Simonson, R. Berman // Am Heart J, - 1972, Vol. 84, P. 814 - 816. Vale P.R. Coronary artery stenting for spontaneous coronary artery dissection: a case report and review of the literature / P. R. Vale, D. W. Baron // Cathet Cardiovasc Diagn - 1998, Vol. 45, P. 280 - 286. Yater W.M. Comparison of clinical and pathologic aspects of coronary artery disease in men of various age groups / W.M. Yater, P.P. Welsh //Ann. Intern. Med., 1951, Vol. 4, P. 352 - 354. Zimmerman F. H. Myocardial Infarction in Young Adults: Angiographic Characterization, Risk Factors and Prognosis (Coronary Artery Surgery Study Registry) / F.H. Zimmerman, A Cameron, L.D. Fisher [et al.] // J Am Coll Cardiol, - 1995, Sep., Vol. 26(3), P. 654 - 661.
Publication of the article	«World of Medicine and Biology» №1(55), 2016 year, 039-044 pages, index UDK 616