Improvement of quality of life indicators in patients with metabolic syndrome after correction of hemodynamically significant coronary stenoses and dyslipidemia

Abstract

It is known that metabolic syndrome is currently the leading cause of the development of cardiovascular pathology, which occupies a leading position in the structure of mortality not only in the Russian population, but also in the world. The prevalence of MS is growing, which is associated with stressful professions, eating disorders. The presence of MS is associated with arterial hypertension and atherosclerosis of the arteries of any localization. In this regard, the purpose of our study was to study the quality of life in patients with MS, depending on the severity of coronary atherosclerosis. Materials and methods: The study included 239 patients (142 men, 97 women) with MS with atherosclerosis of the coronary and carotid arteries. The number of subjects in group 1 (n=141), of which 101 were men and 40 were women. The second group consisted of 84 male and 14 female patients (n=98). The control group consisted of 70 people (27 men, 43 women) with grade 1-3 hypertension. The age of the subjects was 31-56 years. All patients underwent: collection of complaints and anamnesis, assessment of body mass index (BMI); determination of the lipid spectrum, blood glucose, glycated hemoglobin. Microalbuminuria and glomerular filtration rate were determined. Instrumental studies were carried out: ultrasound examination of brachiocephalic vessels with determination of the thickness of the intima-media complex and the percentage of carotid artery stenosis; coronary angiography on the General Electric Innova 3100 angiographic complex. Based on the results of coronary angiography, the patients were divided into two subgroups: group 1 - with coronary artery stenosis of less than 50% (n=141), group 2 - with stenosis of 50% or more (n=98), group 3 (control) without stenotic lesions of the coronary arteries. A non-specific questionnaire “SF-36 Health Status Survey” was used to assess the quality of life. Results: assessing physical functioning and mental health, there was a significant decrease in these indicators in patients of group 2, in whom, according to coronary angiography, hemodynamically significant coronary artery stenoses were diagnosed, a strong correlation (r=0.730; p=0.005) was revealed between deterioration in quality of life and hemodynamically significant stenosis of the carotid and coronary arteries. Restriction of physical activity and reduction of daily activities were more significant in group 2 compared to groups 1 and 3. The feeling of uncertainty with restless expectation and fears, as well as a feeling of depression prevailed in men. However, patients after percutaneous coronary intervention, as well as with lipidogram correction, assessed the quality of life with some restriction of physical activity, but with significant social functioning. Conclusions: hemodynamically significant atherosclerosis of the carotid and coronary arteries is a predictor of deterioration in the quality of life, especially in men. The use of the international questionnaire “SF-36 Health Status Survey” is appropriate for assessing the health and vital activity in patients with MS and hypertension, with signs of atherosclerosis. The interaction of a cardiologist, an endocrinologist and a psychotherapist are justified for the most optimal management of patients with comorbid pathology.