Archive \ Volume.13 2022 Issue 4

Q-myocardial Infarction on the Background of Undifferentiated Connective Tissue Dysplasia: Pathogenetic “Paradoxes” and “Crossovers”

Mariia Chernykh, Olena Solyeyko, Larysa Soleyko, Yevhenii Mironov, Olena Terekhovska, Arthur Berezovskiy, Oleg Fedorchenko, Lena Davtian
Abstract

Acute myocardial infarction (MI) is an important public health problem. Modern cardiology studies the role of such a premorbid background as undifferentiated connective tissue dysplasia (UCTD) in the pathogenesis of coronary heart disease (CHD) and MI in particular. Despite a large number of studies, the biochemical pathogenetic links of MI development against the background of UCTD remain unexplored. That is why our study aimed to analyze the stigmas of dysembryogenesis, coagulogram parameters, and platelet and uric acid (UA) levels as the most expected factors in the pathogenesis of MI with UCTD. The level of platelets in the peripheral blood of patients with UCTD (182.0 [161.0–265.0] x 109/l) did not differ reliably (but it was still significantly lower) from that in patients without UCTD [230.0 [206.0–309.0] x 109/l) (p>0.05). In particular, in 26 patients (57.8%) with UCTD, it was below the reference value. In those patients, who also have a large number of UCTD markers (10 or more), the stigma of “easy hematoma formation with insignificant damage” was most common. The level of UA in patients with Q-IM with UCTD was higher than normal and reliably higher than in the group without dysplasia (383.60 ± 33.82 vs. 292.11 ± 28.56, p<0.05). Increasing the level of UA provokes the activation of inflammatory processes in the coronary arteries, and leukocyte-lymphocytic infiltration of their tunica media, which, even at a low platelet level, leads to a cascade of mutually aggravating pathological changes that converge at the level of multivector endothelial damage.



How to cite:
Vancouver
Chernykh M, Solyeyko O, Soleyko L, Mironov Y, Terekhovska O, Berezovskiy A, et al. Q-myocardial Infarction on the Background of Undifferentiated Connective Tissue Dysplasia: Pathogenetic “Paradoxes” and “Crossovers”. Arch Pharm Pract. 2022;13(4):40-4. https://doi.org/10.51847/hdCqPRLP8u
APA
Chernykh, M., Solyeyko, O., Soleyko, L., Mironov, Y., Terekhovska, O., Berezovskiy, A., Fedorchenko, O., & Davtian, L. (2022). Q-myocardial Infarction on the Background of Undifferentiated Connective Tissue Dysplasia: Pathogenetic “Paradoxes” and “Crossovers”. Archives of Pharmacy Practice, 13(4), 40-44. https://doi.org/10.51847/hdCqPRLP8u

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References

1.        Conclusions from the study of the global burden of disease in 2019. Cardiovascular diseases - the main cause of death of Ukrainians [Internet]. Public Health Center of the Ministry of Health of Ukraine; 2021 [cited 2021 Jan 04]. [In Ukrainian]. Available from: https://phc.org.ua/news/sercevo-sudinni-zakhvoryuvannya-golovna-prichina-smerti-ukrainciv-visnovki-z-doslidzhennya

2.        Chiu IM, Barbayannis G, Cabrera J, Cosgrove NM, Kostis JB, Sargsyan D, et al. Myocardial Infarction Data Acquisition System (MIDAS 43) Study Group. Relation of Socioeconomic Status to 1-Year Readmission and Mortality in Patients with Acute Myocardial Infarction. Am J Cardiol. 2022;175:19-25. doi:10.1016/j.amjcard.2022.03.044

3.        Rak N. Features of the clinical course of arterial hypertension combined with connective tissue dysplasia. Ph.D. thesis, Danylo Halytsky Lviv National Medical University. Danylo Halytsky Lviv National Medical University, Lviv. 2021. [In Ukrainian]

4.        Chernykh MO. Coronary artery disease on the background of non-differentiated dysplasia of connective tissue: course peculiarities, aspects of diagnosis and prognosis. (Dys. kand. med. nauk). DVNZ Ivano-Frankiv. nats. med. un-t., Ivano-Frankivsk. 2016. [In Ukrainian]

5.        Chernykh MO, Berezovskyi AM, Shamrai VA, Postolovskyi LYu. Clinical and morphological changes of the cardiovascular system in patients with cardioneurosis (neurocirculatory dystonia). Rep Vinnytsia Natl Med Univ. 2019;3(23):515-21. [In Ukrainian]

6.        Lindahl B, Baron T, Albertucci M, Prati F. Myocardial infarction with non-obstructive coronary artery disease. EuroIntervention. 2021;17(11):e875-87. doi:10.4244/EIJ-D-21-00426. Erratum in: EuroIntervention. 2022 Apr 01;17(17):e1366.

7.        Vershinina MV, Nechaeva GI, Gudilin VA. Relative cardiovascular risk in young patients with connective tissue dysplasia. Therapy. 2020;6:40-4. [In Russian]. doi:10.18565/therapy.2020.6.40-44

8.        Hu M, Lu Y, Wan S, Li B, Gao X, Yang J, et al. Long-term outcomes in inferior ST-segment elevation myocardial infarction patients with right ventricular myocardial infarction. Int J Cardiol. 2022;351:1-7. doi:10.1016/j.ijcard.2022.01.003

9.        Solyeyko OV, Rykalo NA, Osypenko IP, Soleyko LP. Syndrome of undifferentiated connective tissue dysplasia: from the concept of pathogenesis to treatment strategy. Tutorial. Vinnytsia, Ukraine: Nova Knyha; 2014. 168 p. [In Ukrainian]

10.      Oleksandrivna CM, Vitaliivna SO, Petrivna SL, Borisivna YO, Prystupiuk M, Prystupiuk L, et al. Markers of Undifferentiated Connective Tissue Dysplasia in Female Patients with Acute Q-myocardial Infarction. Arch Pharm Pract. 2021;12(2):80-5. doi:10.51847/yMuzdZlE7y

11.      Arsent'ev V, Pshenichnaya K, Suvorova A, Shabalov N. Clinical and pathogenetic aspects of disorders in the hemostasis system with connective tissue dysplasia in children. Pediatr- Zh G. N. Speranskogo. 2009;87(4):134-9. [In Russian]

12.      Unified clinical protocol of emergency, primary, secondary (specialized), and tertiary (highly specialized) medical care and medical rehabilitation "Acute coronary syndrome with ST-segment elevation". Order of the Ministry of Health of Ukraine; 2014. Pub. L. No. 445. [In Ukrainian]

13.      Nechaeva GI, Yakovlev VM, Konev VP, Druk IV, Morozov SL. Connective tissue dysplasia: main clinical syndromes, diagnosis formulation, treatment. Lechashchij vrach. 2008;2:22-5. [In Russian]

14.      Shaparenko PF. Mathematical morphology - the way to objectify research. Principles of proportion, symmetry, structural harmony and mathematical modeling in morphology. Proceedings of the international symposium. Vinnytsia, Ukraine; 1997. p. 3-6. [In Russian]

15.      Katerenchuk IP. Clinical interpretation and diagnostic value of laboratory parameters in general practice: a textbook. 4th ed. Kyiv: Medknyha; 2018. 228 p. [In Ukrainian]

16.      Zaremba YeH, Rak NO, Zaremba OV, Zaremba-Fedchyshyn OV, Virna MM, Odnorih LO. Diagnostic criteria for undifferentiated connective tissue dysplasia in patients with arterial hypertension. Achv Clin Exp Med. 2020;2:49-54. doi:10.11603/1811-2471.2020.v.i2.1130

17.      Lutsyk O, Chaikovskyi Yu. Histology. Cytology. Embryology: a textbook for students. Vinnytsia, Ukraine: Nova Knyha; 2020. 496 p. [In Ukrainian]

18.      Xu Q, Wang LN, Zhao JY, Xiao YH, Du C. Effects of paeonol on proliferation and collagen synthesis of rat cardiac fibroblasts induced by aldosterone. Bangladesh J Pharmacol. 2021;16(2):42-8. Available from: https://www.banglajol.info/index.php/BJP/article/view/51605

19.      Zaremba YeH, Zaremba OV, Rak NO, Prokosa MI, Chekh SR. Effect of quercetin on blood lipid spectrum, acute phase reactions, and uric acid levels in patients with hypertension combined with undifferentiated connective tissue dysplasia. Fitoterapiia. Naukovo-praktychnyi chasopys. 2018;3:26-30.

20.      Casiglia E, Tikhonoff V, Virdis A, Masi S, Barbagallo C, Bombelli M, et al. Serum uric acid and fatal myocardial infarction: detection of prognostic cut-off values: The URRAH (Uric Acid Right for Heart Health) study. J Hypertens. 2020;38(3):412-9. doi:10.1097/HJH.0000000000002287

21.      Borghi C, Bentivenga C, Cosentino ER. Uric acid and risk of myocardial infarction. A dynamic duo. Int J Cardiol. 2020;320:23-4. doi:10.1016/j.ijcard.2020.06.006

22.      Abd El-Azeem NE, Elhefny M, Elzohri MH, Taher SM. Possibility of association of hypertension and ischemic heart disease with primary hyperuricemia. Curr Med Res Pract. 2020;5(1):109-14.

23.      Lopez-Pineda A, Cordero A, Carratala-Munuera C, Orozco-Beltran D, Quesada JA, Bertomeu-Gonzalez V, et al. Association analysis between hyperuricemia and long term mortality after acute coronary syndrome in three subgroups of patients. Data Br. 2018;17:885-9. doi:10.1016/j.dib.2018.01.101

24.      Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol. 2019;234(10):16812-23. doi:10.1002/jcp.28350

25.      Tian X, Zuo Y, Chen S, Wang A, Li H, He Y, et al. Associations between changes in serum uric acid and the risk of myocardial infarction. Int J Cardiol. 2020;314:25-31. doi:10.1016/j.ijcard.2020.03.083

26.      Ösken A, Hacı R, Dinç Asarcıklı L, Arıkan ME, Onuk T, Ünal Dayı Ş, et al. Mean platelet volume/platelet count ratio as a predictor of stent thrombosis in patients with ST-segment–elevation myocardial infarction. Ir J Med Sci. 2021;190(3):1095-102. doi:10.1007/s11845-021-02626-y