Diagnostic value of clinical, instrumental and hematological data in detecting a specific clinical-functional state in patients with acute myocardial infarction due to the impact of wartime factors
Article Sidebar
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Main Article Content
https://orcid.org/0000-0002-1427-2344
Abstract
The aim – to establish markers of clinical and functional state development in patients with acute myocardial infarction inherent in wartime.
Materials and methods. A cohort of 133 STEMI patients was examined (77.4 % men, 61.7±0.9 years). Part of the patients (group 1) was hospitalized from February to May 2019 (n=87), while the other part of them (group 2) was hospitalized in the period from February 24, 2022 to May 2023 (n=46) within the first 24 hours from the development of symptoms (average time of admission 5.2±0.4 hours). In order to eliminate discrepancies in indicators, which with a low probability are related to the action of wartime factors, comparable samples were made from groups 1 and 2 (52 patients and 17 patients, respectively). Comparison of groups was carried out based on clinical and anamnestic and laboratory parameters of the first day.
Results and discussion. At the admission to the hospital, markers of a specific clinical and functional state in patients with STEMI due to the influence of wartime factors are: level of leukocytes > 13.0 · 109/L, monocytes > 0.5 · 109/L, lymphocytes > 1.2 . 109/L, triglycerides > 1.63 mmol/L, heart rate > 76 beats/min, as well as criteria made up of these indicators (in particular, products of the level of monocytes or lymphocytes, the level of triglycerides and heart rate, as well as the 7-component scale, which takes into account heart rate, ESR, glucose and triglyceride levels, as well as the number of monocytes, lymphocytes and platelets). Moreover, the increase in the number of monocytes is not associated with hospital complications in these patients. Instead, the level of triglycerides, the number of lymphocytes and platelets are directly related both to the influence of wartime factors and to the complicated hospital course of STEMI.
Conclusions. The influence of wartime factors in patients with STEMI is combined with the response to myocardial damage. It leads to an increase in the risk of a complicated course of the hospital stage, as well as to specific clinical and laboratory changes. These changes make it possible to recognize the impact of wartime factors and patients at high risk of hospital course of myocardial infarction.
Article Details
Keywords:
References
Anni NS, Jung SJ, Shim JS, Jeon YW, Lee GB, Kim HC. Stressful life events and serum triglyceride levels: the Cardiovascular and Metabolic Diseases Etiology Research Center cohort in Korea. Epidemiol Health. 2021;43:e2021042. https://doi.org/10.4178/epih.e2021042.
Bains JS, Sharkey KA. Stress and immunity – the circuit makes the difference. Nat Immunol. 2022;23:1137-9. https://doi.org/10.1038/s41590-022-01276-1.
Cesari F, Marcucci R, Gori AM, Caporale R, Fanelli A, Casola G, Balzi D, Barchielli A, Valente S, Giglioli C, Gensini GF, Abbate R. Reticulated platelets predict cardiovascular death in acute coronary syndrome patients. Insights from the AMI-Florence 2 Study. Thromb Haemost. 2013 May;109(5):846-53. https://doi.org/10.1160/TH12-09-0709.
Garcia M, Moazzami K, Almuwaqqat Z, Young A, Okoh A, Shah AJ, Sullivan S, Lewis TT, Elon L, Ko YA, Hu Y, Daaboul O, Haddad G, Pearce BD, Bremner JD, Sun YV, Razavi AC, Raggi P, Quyyumi AA, Vaccarino V. Psychological Distress and the Risk of Adverse Cardiovascular Outcomes in Patients With Coronary Heart Disease. JACC Adv. 2024;3(2):100794. https://doi.org/10.1016/j.jacadv.2023.100794.
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, Caforio ALP, Crea F, Goudevenos JA, Halvorsen S, Hindricks G, Kastrati A, Lenzen MJ, Prescott E, Roffi M, Valgimigli M, Varenhorst C, Vranckx P, Widimský P; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77. https://doi.org/10.1093/eurheartj/ehx393.
Kang M, Ragan BG, Park JH. Issues in outcomes research: an overview of randomization techniques for clinical trials. J Athl Train. 2008;43(2):215-21. https://doi.org/10.4085/1062-6050-43.2.215.
Kovnick MO, Young Y, Tran N, Teerawichitchainan B, Tran TK, Korinek K. The Impact of Early Life War Exposure on Mental Health among Older Adults in Northern and Central Vietnam. J Health Soc Behav. 2021;62(4):526-44. https://doi.org/10.1177/00221465211039239.
Ley S, Weigert A, Brüne B. Neuromediators in inflammation--a macrophage/nerve connection. Immunobiology. 2010 Sep-Oct;215(9-10):674-84. https://doi.org/10.1016/j.imbio.2010.05.027.
Mantel N, Haenszel W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22(4):719-48. https://doi.org/10.1093/jnci/22.4.719.
Meng G, Wang L, Wang X, Chi VTQ, Zhang Q, Liu L, Yao Z, Wu H, Bao X, Gu Y, Zhang S, Sun S, Zhou M, Jia Q, Song K, Sun Z, Wu Y, Niu K. Association between neutrophil to lymphocyte ratio and depressive symptoms among Chinese adults: A population study from the TCLSIH cohort study. Psychoneuroendocrinology. 2019;103:76-82. https://doi.org/10.1016/j.psyneuen.2019.01.007. Epub 2019 Jan 9. PMID: 30658341.
Metz CE. Basic principles of ROC analysis. Semin Nucl Med. 1978;8(4):283-98. https://doi.org/10.1016/s0001-2998(78)80014-2. PMID: 112681.
Peng X, Wu H. Inflammatory Links Between Hypertriglyceridemia and Atherogenesis. Curr Atheroscler Rep. 2022;24(5):297-306. https://doi.org/10.1007/s11883-022-01006-w.
Roohafza H, Talaei M, Sadeghi M, Mackie M, Sarafzadegan N. Association between acute and chronic life events on acute coronary syndrome: a case-control study. J Cardiovasc Nurs. 2010;25(5):E1-7. https://doi.org/10.1097/JCN.0b013e3181d81799.
Rosenbaum PR, Rubin DB. Constructing a Control Group Using Multivariate Matched Sampling Methods That Incorporate the Propensity Score. The American Statistician, 1985;39(1):33-8. https://doi.org/10.1080/00031305.1985.10479383.
Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, Blackett KN, Sitthi-amorn C, Sato H, Yusuf S; INTERHEART investigators. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):953-62. https://doi.org/10.1016/S0140-6736(04)17019-0.
Schneider M, Kraemmer MM, Weber B, Schwerdtfeger AR. Life events are associated with elevated heart rate and reduced heart complexity to acute psychological stress. Biol Psychol. 2021 Jul;163:108116. https://doi.org/10.1016/j.biopsycho.2021.108116.
White AG, Elias E, Orozco A, Robinson SA, Manners MT. Chronic Stress-Induced Neuroinflammation: Relevance of Rodent Models to Human Disease. Internation J Mol Scie. 2024;25(10):5085. https://doi.org/10.3390/ijms25105085.
Wu Q, Yang Z, Qiu R, Cheng S, Zhu X, Han Z, Xiao W. The military occupational stress response scale: Development, reliability, and validity. Front Psychol. 2023;14:1032876. https://doi.org/10.3389/fpsyg.2023.1032876.
Yang L, Guo J, Chen M, Wang Y, Li J, Zhang J. Pan-Immune-Inflammatory Value is Superior to Other Inflammatory Indicators in Predicting Inpatient Major Adverse Cardiovascular Events and Severe Coronary Artery Stenosis after Percutaneous Coronary Intervention in STEMI Patients. Rev Cardiovasc Med. 2024;25(8):294. https://doi.org/10.31083/j.rcm2508294.
Yao BC, Meng LB, Hao ML, Zhang YM, Gong T, Guo ZG. Chronic stress: a critical risk factor for atherosclerosis. J Int Med Res. 2019;47(4):1429-40. https://doi.org/10.1177/0300060519826820.