TO THE QUESTION OF THE MYOCARDIAL INFARCTION CLINICAL COURSE FEATURES IN MEN UNDER 60 YEARS OLD WITH ULCER DISEASE
Patients with myocardial infarction and peptic ulcer disease have a worse prognosis than patients without digestive diseases due to limitations in vital therapy. Aim. To evaluate the features of risk factors for cardiovascular diseases, the clinical course in men under 60 years old with MI and peptic ulcer disease to improve preventive measures. Material and methods. The study includes men 19-60 years old with type I myocardial infarction. Patients were divided into two groups: I - the studied, with peptic ulcer disease - 109patients (mean age 51,8 ± 5,1 years); II - without concomitant diseases of the digestive system - 358 patients (mean age 50,8 ± 6,7years; р=0,567) as a control group. A comparative assessment of the frequency of identification of cardiovascular risk factors, the course of myocardial infarction and its complications were performed. Results. The incidence of peptic ulcer disease among the entire group of examined was 19.2%. In patients with peptic ulcer disease among the previous myocardial infarction risk factors prevails: unstable angina (58.7% in the study and 47.5% in the control; p < 0.05), inpatient treatment (53.2 and 42.2%, respectively; p < 0.05), coronary angiography (22.0 and 10.4%; р<0.01) in the medical history and less frequently observed peripheral angiopathies (53.7 and 65.5%; р<0.01). The course of the disease in the study group less favorable in the total number of complications (71.6 and 56.1%; p < 0.01), the frequency of thrombosis (23.1 and 13.7%; p<0.05), gastric bleeding and intestinal paresis (4.6 and 0, 6%; p<0.01), supraventricular tachycardia (4.0 and 0.6%; p<0.05) and incomplete atrioventricular block (8.0 and 3.4%; p<0.05). Conclusions. The presence in the medical history: peptic ulcer disease, inpatient treatment, coronarography, a history of unstable angina in combination with cardiac arrhythmias and conduction with signs of heart failure in the first hours of myocardial infarction indicates a high risk of side effects of standard hypo- coagulation therapy against microcirculation disorders, which must be taken into account when treatment of such patients.