Assessment of Quality of Life, Stratification of Risk Factors and Optimization of Prevention in Patients with Unstable Angina Pectoris

Abstract

Unstable angina pectoris (NS) has remained one of the most pressing problems of cardiology in recent years (N.A. Graziansky, 2000; St. Shalaev, 2002; E. Braunwald, 1999; CHamm et al, 2000). NS is the most frequent manifestation of acute coronary syndrome (ACS) and accounts for about 75-80% of all episodes of acute coronary insufficiency (Yu.V.Nikiforov et al., 2004). The course of NS is associated with a high risk of sudden death, acute myocardial infarction leading to heart remodeling and heart failure (B.C. Moiseev et al., 2000; J.A.Ambrose et al., 2000). Therefore, the study of this multifaceted and complex problem is aimed at finding approaches that would reduce the risk of these complications. In recent years, this approach has been risk stratification. The European recommendations for the treatment of ACS (M.E. Bertrandetal, 2002), as well as the Russian version of these recommendations (VNOK, 2004) use the TIMI scale, which stratifies the risk of adverse outcomes in seven main positions. At the same time, it is known that behavioral risk factors (FR) such as smoking, BMI, NFA, as well as biological risk factors such as hypertension, DM, HHS, ECG changes significantly affect the course of coronary heart disease, stable angina pectoris and myocardial infarction. There is little data in the literature on the effect of these factors on the course of NS depending on the gender of patients, severity, depending on the FC of NS. EJBraunwald et Definition of unstable angina pectoris. Ischemic (coronary) heart disease is clinically manifested by stable angina pectoris, pain-free myocardial ischemia, unstable angina pectoris (NS), acute myocardial infarction (AMI), heart failure (HF) and sudden death (M.E.Bertrand et al., 2000). NS, OIM is usually attributed to ACS (N.A.Graziansky, 2000; S.V.Shalaev, 2001; P.Theroux et al., 1998). One of the forms of ACS - NS is a combination of acute ischemic episodes. This condition was previously called preinfarction angina pectoris, preinfarction condition, preinfarction syndrome, as well as a condition threatening THEM, acute coronary insufficiency, mild coronary attack or intermediate coronary syndrome (R.D.Bahr et al., 2000). Currently, NS is considered to be an acute process of myocardial ischemia, the severity and duration of which are insufficient for the development of myocardial necrosis. Usually, there are no ST segment elevations on the ECG. There is no release into the bloodstream of biomarkers of myocardial necrosis in quantities sufficient for the diagnosis of MI (N.A.Graziansky, 2000; E.Braunwald et al., 2000). NS is a severe exacerbation of coronary heart disease, which indicates a high risk of developing MI both during hospitalization and during further monitoring of patients (N.A.Graziansky, 2000; VNOK, 2001, 2004; M.E.Bertrand et al., 2000; al., 2000).