Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.

THE AIM. Investigation of cardiovascular diseases (CVD) risk factors prevalence in men under 60 years old with myocardial infarction (MI) and renal dysfunction depending on a year season for enhanced prevention and treatment management of aforementioned target population.PATIENTS AND METHODS. In-patient treatment results analyses of 412 men in total under 60 y.o. with MI for the period of 2000-2015 indicated that within primary 48 hours from the MI onset 61 patients were having 30-59 mL/min/1,73 m2 estimated glomerular filtration rate (CKD-EPI 2009, modification 2011) and 351 patients were having more than 60 mL/min/1,73 m2 respectively. Collection of supplemental information about MI promotive conditions and disease triggers was done with their manifestation rate comparison in groups of patients with renal dysfunction (RD) and normal CKDEPI. Seasonal differences evaluation was performed with separation of events by climatic time intervals based on mean daily air temperature changes in St. Petersburg, Russia.RESULTS. RD was observed in 14.8% of the examined cases. The frequency of its detection prevailed in the spring and winter (22% each) seasons. Arterial hypertension (AH), mild obesity, hypertensive crisis events, frequent colds occurrences were noted to be detected more frequently in patients with the RD. Moderate obesity along with Ischemic Heart Disease (IHD) manifestations depending from a year season were noted less frequently. In first hours from a MI onset, RD patients demonstrated expressed dyslipidemia evidences due to hypertriglyceridemia and elevated levels of very low density lipoproteins (VLDL).CONCLUSIONS. AH was noted to be the main cause of DP in men under 60 years old in their initial hours from the IM onset. Its presence in combination with frequent colds predisposition, regardless of diabetes and obesity presence in spring and winter attributes RD development risk in MI acute period. Dyslipidemia is indicative for this type of patients, and that brings the need to assess triglyceride and VLDL blood levels.

Аннотация. Актуальность. Механизмы сезонных изменений состояния коронарных артерий при инфаркте миокарда (ИМ) и их значимость недостаточно изучены. С учетом известных географических и сезонных закономерностей смертности от сердечно-сосудистых заболеваний (ССЗ) предполагается возможность их использования для профилактики. Цель. Оценка клинической значимости сезонных изменений состояния коронарных артерий у мужчин моложе 60 лет с ИМ в Санкт-Петербурге. Материалы и методы. Изучено распределение результатов коронарографии у 57 мужчин моложе 60 лет с ИМ в зависимости от климатических сезонов Санкт-Петербурга, локализации, глубины поражения, числа ИМ в анамнезе, осложнений и прогноза заболевания. Результаты. Протяженные и многососудистые (три и более) поражения артерий сердца выявляются у половины мужчин в возрасте до 60 лет при ИМ. Более выраженные изменения артерий сердца характерны для ИМ с зубцом Q, осложненных, рецидивирующих поражений и для группы умерших. Также выявляются сезонные закономерности. Заключение. Менее благоприятными для прогноза ИМ оказались весенний и зимний периоды, а более благоприятным-летний. Сезонные изменения имели меньшее значение, чем клинические особенности, а уровни атерогенных фракций липидного обмена играли противоположную роль для прогноза в разные сезоны года. Ключевые слова: инфаркт миокарда, сезонная изменчивость, возрастные особенности, клиническое течение, состояние коронарных артерий, сердечная недостаточность. Annotation. Relevance. The nature of coronary atherosclerosis seasonal changes in myocardial infarction (MI) and its significance is not explored sufficiently. The known geographical and seasonal patterns of cardiovascular diseases (CVD) mortality suggest their importance for CVD prevention. Aim. Investigation of the clinical significance of coronary arteries seasonal changes in men with MI in St. Petersburg, Russia. Materials and methods. The distribution of coronarography results in 57 men under 60 years old with MI was explored focusing on the impact of the annual seasons in St. Petersburg, Russia, localization, depth of a injury, the number of MIs in the medical history, complications and prognosis of the disease. Results. Extended lesions in multiple (three or more) coronary arteries simultaneously have been detected in half of men under the age of 60 with MI. Myocardial Infarction with a Q wave having exacerbated, recurrent injuries, as well as the lethal cases are characterized with more expressed changes of coronary arteries. There were seasonal patterns detected as well. Conclusions. The spring and winter periods were noted to have less favorable prognosis for the MI, whereas the summer period had a more favorable one. Seasonal changes were noted to be less important compared to the influence of clinical features. Atherogenic lipid fractions levels had reversed relevance for prognosis in different seasons of a year.

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