PECULIARITIES OF THE CLINICAL COURSE OF MYOCARDIAL INFARCTION IN COMBINATION WITH ULCER DISEASE IN MEN OF YOUNG AND MIDDLE AGES

Abstract

Background. Patients with myocardial infarction and peptic ulcer disease (PUD) are difficult to curate due to significant limitations in therapy. PUD negatively affects the prognosis of MI. Purposes and tasks. To study the characteristics of risk factors for cardiovascular diseases, the clinical course in men under 60 years old with MI and PUD to improve preventive measures. Materials and methods. The study includes men 19-60 years old with type I IM. Patients were divided into two groups: I - the studied, with PUD - 109 patients (mean age 51,8±5,1 years); II - without concomitant diseases of the digestive system - 358 patients (mean age 50,8±6,7 years; p=0,567) as a control group. A comparative assessment of the frequency of identification of cardiovascular risk factors, the course of MI and its complications were performed. The results. The incidence of PUD among the entire group of examined was 19.2%. In patients with PUD among the previous MI risk factors, unstable angina pectoris prevails (58.7% in the study and 47.5% in the control; p<0.05), inpatient treatment (53.2 and 42.2%, respectively; p<0.05), coronary angiography (22.0 and 10.4%; p<0.01) in the medical history and less frequently observed peripheral angiopathies (53.7 and 65.5%; p<0.01) The course of the disease in the study group less favorable in the total number of complications (71.6 and 56.1%; p<0.01), the frequency of thrombosis (23.1 and 13.7%; p<0.05), bleeding (4.6 and 0, 6%; p<0.01), supraventricular tachycardia (4.0 and 0.6%; p<0.05) and incomplete atrioventricular block (8.0 and 3.4%; p<0.05). Conclusions. The presence in the medical history: PUD, inpatient treatment, coronarography, unstable angina in combination with cardiac arrhythmias and conduction disturbances with signs of heart failure in the first hours of MI indicates an increased risk of microcirculatory disorders in the digestive organs and a high likelihood of side effects of standard hypocoagulation therapy, what needs to be considered when treating of such patients.