CORONARY CIRCULATION CHANGES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: ANGIOGRAPHY DATA

The aim of the study was to investigate coronary arteries damage during ST-elevation myocardial infarction (STEMI) manifestation in patients with chronic obstructive pulmonary disease (COPD). The protocols of coronary angiography of 90 patients who suffered STEMI were analyzed. The patients were divided into two groups depending on the presence of COPD. The first group (50 people) was formed from the patients who had ST elevation myocardial infarction (STEMI) and COPD. The second group (40 people) had STEMI and no COPD. It was found that in case of COPD and STEMI comorbidity the number of coronary stenosis is bigger than in case of mono AMI patients. In the group of patients with COPD and STEMI the angiographic picture of atherosclerosis damage of coronary arteries demonstrates the prevalence of medium and distal stenosis of major branches and coronary arteries of the second order unlike the group with isolated STEMI. The number of extended stenosis in the group with the comorbid pathology is also higher. The patients with STEMI have the same number of hemodynamically important stenosis as the other group. The correlation between the change of the vessel channel and smoking anamnesis, the level of the systematic inflammation marker (CRP) and the level of lipids in patients with COPD and STEMI was studied. The severity of coronary atherosclerosis directly correlates with CRP level, smoking anamnesis, level of cholesterol, LDLP. The number of distal stenosis, including those that are hemodynamically important, has reverse correlation with the level of HDLP.