Structure of risk factors, comorbid conditions and emotional disorders in patients with myocardial infarction with atrial fibrillation
https://doi.org/10.21518/2079-701X-2020-11-26-31
Abstract
Introduction: the majority of patients with cardiovascular diseases in real medical practice are characterized by a combination of two or more diseases and conditions, that is, comorbidity. This places additional demands on the observation and treatment of this category of patients.
Objective: to assess risk factors, the structure of comorbid conditions and the severity of psychoemotional disorders in patients with myocardial infarction with various forms of atrial fibrillation.
Materials and methods: 138 patients (63 men, 75 women) who were hospitalized in the cardiology department of the City Clinical Hospital No. 7 GBUZ with a diagnosis of myocardial infarction with atrial fibrillation were examined. Depending on the form of atrial fibrillation, the patients were divided into 2 groups: the 1st consisted of 83 (60,1%) patients with a paroxysmal form, the 2nd group – 55 (39,9%) with a constant form. The examination was carried out in the first three days of hospitalization of patients.
Results: in patients with myocardial infarction with a paroxysmal form of atrial fibrillation, the structure of risk factors is dominated by an average degree of nicotine addiction, dangerous alcohol consumption, high salt intake and excess body weight, and with a constant form of atrial fibrillation, a mostly weak and high degree of nicotine addiction, harmful alcohol consumption and obesity.
Conclusion: in patients with myocardial infarction with a paroxysmal form of atrial fibrillation, the predominant risk factors are: dangerous alcohol consumption, high salt intake and overweight combined with depressive disorders in the form of subclinical and clinical depression, and with a constant form of atrial fibrillation, a high degree of nicotinic dependence and mild anxiety disorders: subclinically and clinically severe anxiety, which must be taken into account when carrying out preventive, rehabilitation measures and the solution of expert issues.
About the Authors
N. N. NeobutovRussian Federation
Nikolay N. Neobutov, cardiologist
76/1, Peterburgskoe Shosse, Tver, 170036
S. V. Kolbasnikov
Russian Federation
Sergey V. Kolbasnikov, Dr. of Sci. (Med), Professor, Head of the Department of General Medical Practice (Family Medicine)
4, Sovetskaya St., Tver, 170100
References
1. Shalnova S.A., Kontsevaya A.M. Monitoring of risk factors for chronic noncommunicable diseases in health care practice. Moscow; 2012. 27 р. (In Russ.)
2. Piepoli M.F., Hoes A.W., Agewall S., Albus C., Brotons C., Catapano A.L. et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37(29):2315–2381. doi: 10.1093/eurheartj/ehw106.
3. DuGoff E.H., Canudas-Romo V., Buttorff C., Leff B., Anderson G.F. Multiple chronic conditions and life expectancy: a life table analysis. Med Care. 2014;52(8):688–694. doi: 10.1097/MLR.0000000000000166.
4. Oganov R.G., Denisov I.N., Simanenkov V.I., Bakulin I.G., Bakulina N.V., Boldueva S.A. еt al. Comorbidities in practice. Clinical guidelines. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2017;16(6):5–56. (In Russ.) doi: 10.15829/1728-8800-2017-6-5-56.
5. Lazebnik L.B., Vertkin A.L., Konev Yu.V., Li E.D., Skotnikov A.S. Aging: professional medical approach (National leadership). Moscow: Eksmo; 2014. 320 р. (In Russ.)
6. Lazebnik L.B., Konev Yu.V. Historical features and semantic difficulties of using the terms denoting multiplicity of diseases in one patient. Ehksperimental’naya i klinicheskaya gastroehnterologiya = Experimental & Clinical Gastroenterology. 2018;(6):4–9. (In Russ.) Available at: https://www.nogr.org/jour/article/view/629#.
7. Tilling L., Clapp B. Atrial fibrillation in myocardial infarction: predictors and prognosis. Int J Clin Pract. 2009;63(5):712–721. doi: 10.1111/j.1742-1241.2009.02061.x.
8. Neobutov N.N., Kolbasnikov S.V. The state of the myocardium, the vascular wall and the severity of anxiety-depressive disorders in patients with myocardial infarction and atrial fibrillation. Archiv Euromedica. 2019;9(1):109–112. doi: 10.35630/2199-885X/2019/9/1/109.
9. Schotten U., Verheule S., Kirchhof P., Goette A. Pathophysiological mechanisms of atrial fibrillation: a translational appraisal. Physiol Rev. 2011;91(1):265–325. doi: 10.1152/physrev.00031.2009.
10. Kirchhof P., Benussi S., Kotecha D., Ahlsson A., Atar D., Casadei B. et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–2962. doi: 10.1093/eurheartj/ehw210.
11. Pogosova N., Saner H., Pedersen S.S., Cupples M.E., McGee H., Höfer S. et al. Psychosocial aspects in cardiac rehabilitation: from theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Eur J Prev Cardiol. 2015;22(10):1290–1306. doi: 10.1177/2047487314543075.
12. Lichtman J.H., Froelicher E.S., Blumenthal J.A., Carney R.M., Doering L.V., Frasure-Smith N. et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350–1369. doi: 10.1161/CIR.0000000000000019.
13. Vinokur V.A., Grinevich V.B., Ilyashevich I.G., Kurpatov V.I., Ledovaya A.V., Oganezova I.A. et al.; Simanenkov V.I. (ed.). Psychosomatic disorders in the practice of the therapist. St Petersburg: SpecLit; 2008. 335 p. (In Russ.)
14. Garganeeva N.P., Petrova M.M., Evsyukov A.A., Kaskaeva D.S. The influence of depression on the course of coronary heart disease and quality of life. Klinicheskaya meditsina = Clinical Medicine. 2014;92(12):30–37. (In Russ.) Available at: http://www.medlit.ru/journalsview/clinicalmedicine/view/journal/2014/issue-12/743-vliyanie-depressii-na-techenie-ishemicheskoybolezni-serdca-i-kachestvo-zhizni-pacientov.
15. Zigmond A.S., Snaith R.P. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x.
16. Saunders J.B., Aasland O.G., Babor T.F., de la Fuente J.R., Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption II. Addiction. 1993;88(6):791–804. doi: 10.1111/j.1360-0443.1993.tb02093.x.
17. Nadezhdin A.V., Tetenova E. Ju., Sharova E.V. Nicotine Dependence: Diagnosis and Treatment. Meditsina = Medicine. 2016;(3):164–189. (In Russ.) Available at: https://stom.tilimen.org/jurnal-medicina-3-2016-164-164-zavisimoste-ot-nikotina-diagnos.html.
18. Heatherton T.F., Kozlowski L.T., Frecker R.C., Fagerström K.O. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991;86(9):1119–1127. doi: 10.1111/j.1360-0443.1991.tb01879.x.
19. Romanova N.P. Restriction of table salt consumption with food as the main method of arterial hypertension prevention. Gubernskie meditsinskie vesti = Provincial Medical News. 2000;3(5):6–8. (In Russ.)
20. Weinberger M.H. Salt sensitivity as a predictor of hypertension. Am J Hypertens. 1999;(4):615–616.
21. Ametov A.S. Demidova T.Yu., Tselikovskaya A.L. Obesity and cardiovascular diseases. Terapevticheskiy arkhiv = Therapeutic Archive. 2001;(8):69–72.
22. Nedogoda S.V., Barykina I.N., Brel U.A., Butrina L.V., Chalyabi T.A. Obesity and arterial hypertension. Part I: weight reduction and blood pressure normalisation. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2008;7(5):105–115. (In Russ.) Available at: https://cardiovascular.elpub.ru/jour/article/view/1266.
23. Panchenko E.P. Cardiovascular risk factors and their control in early XXI century (REACH registry data). Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2006;5(6):91–94. (In Russ.) Available at: https://elibrary.ru/item.asp?id=9956604.
24. Ivashkin V.T., Drapkina O.M., Korneeva O.N. Clinical options of the metabolic syndrome. Moscow: MIA; 2011. 208 p. (In Russ.) Available at: https://elibrary.ru/item.asp?id=19559614.
Review
For citations:
Neobutov NN, Kolbasnikov SV. Structure of risk factors, comorbid conditions and emotional disorders in patients with myocardial infarction with atrial fibrillation. Meditsinskiy sovet = Medical Council. 2020;(11):26-31. (In Russ.) https://doi.org/10.21518/2079-701X-2020-11-26-31