DOI: https://doi.org/10.22263/2312-4156.2023.1.48
V.P. Podpalov1, J.N. Surunovich1, O.V. Podpalova2, A.D. Deev3, O.N. Zhurova1, A.I. Schastlivenko1, A.D. Kozlova1
The influence of risk factors and comorbid pathology on the development of MACE (according to the 5-year and 13-year prospective randomized studies)
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Republican Scientific and Practical Centre «Cardiology», Minsk, Republic of Belarus
3Federal State Budgetary Institution “National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russian Federation”, Moscow, Russian Federation
Vestnik VGMU. 2023;22(1):48-56.
Abstract.
Objectives. To assess the influence of classical and new risk factors, as well as comorbid pathology on the development of MACE (major adverse cardiac events) in urban unorganized population.
Material and methods. In 2007/2008 – 2020/2021 the 5-year and 13-year prospective randomized studies of 3,500 people of the urban unorganized population of Vitebsk were conducted. Four screenings were carried out: in 2007/2008, 2010/2011, 2012/2013 and 2020/2021. During the survey, the socio-demographic data were recorded, all subjects were examined with the WHO questionnaires, the anthropometry data were taken into account, instrumental and laboratory examination methods were used.
Results. According to the 5-year prospective study the development of MACE was connected with the age (p<0.001), gender (p<0.001), the level of systolic (p<0.001) and diastolic blood pressure (p<0.001), hypertension (p<0.001), family history of myocardial infarction (p<0.001) and stroke (p<0.01), chronic heart failure (p<0.001), hereditary burden of premature cardiovascular diseases (p<0.01), body-mass index (p<0.001), smoking at present and in the past (p<0.001), alcohol abuse (p<0.001), creatinine level (p<0.05), cholesterol level (p<0.1). According to the 13-year prospective study the development of MACE was connected with the age (p<0.001), gender (p<0.001), chronic heart failure (p<0.001), the level of systolic blood pressure (p<0.001), HDL-cholesterol level (p<0.001), hypertension (p<0.01), chronic obstructive pulmonary disease (p<0.01), angina pectoris (p<0.01), the level of diastolic blood pressure (p<0.05), and also with the new risk factors such as uric acid level (p<0.01) in the blood serum and the amount of ECG peaks SV1+RV5-RV6 (p<0.001). At the same time there was a tendency to direct connection with diabetes mellitus (p<0.1) and education (p<0.1).
Conclusions. According to the 5-year and 13-year prospective randomized studies high frequency of MACE development in Belarusian unorganized population has been established, it being reliably higher in men compared to women. The most significant risk factors and comorbid conditions in the MACE development in accordance with the results of the conducted studies in addition to classical ones were newly identified risk factors and comorbid pathology, such as chronic obstructive pulmonary disease, the serum uric acid level and the amount of ECG peaks SV1+RV5-RV6.
Keywords: MACE, death from CVD, myocardial infarction, stroke, risk factor, comorbid pathology.
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Information about authors:
V.P. Podpalov – Doctor of Medical Sciences, professor, head of the Chair of Hospital Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Vladislav P. Podpalov;
J.N. Surunovich – senior lecturer of the Chair of Hospital Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
O.V. Podpalova – Candidate of Medical Sciences, research officer, Republican Scientific and Practical Centre of Cardiology;`
A.D. Deev – head of the Biostatistics Laboratory, Federal State Budgetary Institution “National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russian Federation”;
O.N. Zhurova – Candidate of Medical Sciences, associate professor of the Chair of Hospital Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
A.D. Kozlova – teacher-trainee of the Chair of Hospital Therapy and Cardiology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
A.I. Schastlivenko – Candidate of Medical Sciences, associate professor of the Chair of General Medical Practice, Vitebsk State Order of Peoples’ Friendship Medical University.
