Nephrolithiasis and the risk of myocardial infarction and stroke.

Abstract

Introduction. The article discusses the results of studies and meta-analyses that have studied the risks of coronary heart disease (CHD), myocardial infarction (MI) and stroke in patients with urinary stone disease (USD). The purpose of this review is to critically analyze the available studies on the association of USD with CHD and stroke, as well as to evaluate USD among other cardiovascular disease (CVD) risk factors and to assess the role of USD metaphylaxis in reducing this risk. Materials and methods. The authors conducted a search in international and domestic specialized databases of scientific publications, 657 publications were found. For this review, 75 articles were selected that were published no later than April 1, 2021. Results. Despite conflicting research results and high statistical heterogeneity, all meta-analyses have shown that patients with USD have an increased risk of coronary artery disease, MI, and stroke by about 20-40%. In comparison with other risk factors for CVD, USD represents a moderate risk, which dictates not only the need to identify and correct «high» risk factors in patients with USD, but also the need for effective metaphylaxis. There are no studies to support the efficacy of USD metaphylaxis in reducing the risk of CVD. However, it can be assumed that effective metaphylaxis, especially in young patients, using remote technologies, will not only reduce the risk of urolithiasis recurrence, but also help correct metabolic disorders that trigger pathophysiological processes common with CVD. The possibility that simple and inexpensive interventions that reduce the risk of recurrent urolithiasis may also reduce the risk of MI and stroke, the most common cause of death and disability, warrants further study. Conclusions. To increase the effectiveness of USD metaphylaxis, it is possible to use remote monitoring with automatic data processing and regular feedback.