Сhanges in the quality of life of patients undergoing coronary stenting and with concomitant pathology

Abstract

Goal — was to assess the quality of life of patients with coronary heart disease, concomitant type II diabetes mellitus and arterial hypertension at 2 years after coronary stenting. Material and methods. The study included 103 patients aged 44 to 67 years. Clinical and laboratory results were assessed after stenting of the coronary arteries, 2 years later in an outpatient setting. The patients were divided into two groups: the 1st group included 54 patients with ischemic heart disease, angina pectoris III–IV f.c. in combination with arterial hypertension; in the 2nd group — 49 patients with ischemic heart disease, angina pectoris III–IV f.k. in combination with arterial hypertension and type II diabetes mellitus. The study was carried out in accordance with Good Clinical Practice and Declaration of Helsinki principles. The study protocol was approved by the Ethics Committees of all participating clinical centers. Written informed consent was obtained from all participants prior to enrollment.Results. In our study, 103 patients with ischemic heart disease and angina pectoris III–IV f.c. Within 2 years after coronary artery stenting, 33 cases of myocardial infarction (32.0%) were registered. The quality of life improved to stable exertional angina pectoris I–II f.k. 34 patients (33.0%). At the same time, 39.8% did not change their quality of life. Myocardial infarction in the group with angina pectoris III–IV f.k. and arterial hypertension, developed in 12 (22.2%) patients, and in the group with angina pectoris III–IV f.c. and arterial hypertension + type II diabetes mellitus were registered in 21 (42.8%) patients, which is almost twice as high as in group 1, the same for improving the quality of life. That is, despite the stenting of the coronary arteries, the high incidence of complications in the form of myocardial infarction can be explained by a combination of concomitant diseases, in the form of arterial hypertension + type II diabetes mellitus. We are confident that type II diabetes mellitus has a greater impact on the quality of life and complications in patients who have undergone coronary stenting. At the same time, the risk of complications decreases with adequate control of arterial hypertension and type II diabetes mellitus — the transition of angina pectoris III–IV to I–II f.c. characterized by a significant improvement at p-0.0034; odds ratio 0.50; the confidence interval is 0.31–0.80. Conclusion. The improvement in the quality of life in patients with coronary heart disease and arterial hypertension after stenting of the coronary arteries in the long-term period is twice as good as in patients with coronary heart disease and arterial hypertension + type II diabetes mellitus. Arterial hypertension is a serious but manageable risk factor for the development of macrovascular and microvascular complications. The study demonstrated the effectiveness of correcting only arterial hypertension in terms of preventing cardiovascular and microvascular complications than the combination of arterial hypertension and type II diabetes mellitus, which significantly worsen the prognosis of the disease in patients with coronary artery disease after coronary artery stenting. This is reflected in the recommendations for stratification of the risk of arterial hypertension and type II diabetes mellitus.