International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Plenary session

The aim of this study was to test the hypothesis about more severe coronary artery disease (CAD) in patients leaving in circumpolar area compare to south area in Tyumen region of Western Siberia. A total of 5936 symptomatic consecutive subjects underwent clinical investigation, echocardiography and coronary angiography. 2227 patients with coronary angiographic atherosclerosis (>50% of lumen) or having history of myocardial infarction were selected: 1261 from south and 966 from circumpolar north areas of Tyumen region. Groups were matched for age and sex.

Results: Higher rates of smoking (67,9 vs 48,9%, р<0,001), obesity (51,7 vs 39,4%, р<0,001), diabetes mellitus (12,8 vs 7,9%, р<0,001), hypertension (76,3 vs 70,2%, р=0,004), alcohol drinking (36,4 vs 23,0%, р<0,001), history of myocardial infarction (74,5 vs 64,6%, р<0,001), thyroid disorders (26,6 vs 14,2%, р<0,001) were found among north than south patients as well as higher level of blood glucose (5,34+/-0,056 vs 5,30+/-0,059 mmol/l, р=0,045). No difference between north and south was observed for severity of heart failure. The prevalence of angina pectoris was higher in south (94,7 vs 86,9%, р<0,001) as well as the rate of III-IV class of angina (62,8 vs 53,3%, р<0,001). According to echocardiographic measurement south patients had higher left atrial dimension (42,6+/-0,18 vs 41,7+/-0,18 mm, р<0,001), lower left ventricular ejection fraction (54,4+/-0,26 vs 55,6+/-0,26%, р=0,001), higher extent of left ventricular wall motion abnormalities (16,2+/-0,47 vs 14,4+/-0,50%, р=0,014). There was higher rate of patients with low left ventricular function in the south (21,8 vs 17,8%, р=0,026). North patients had higher aortic and right ventricle diameters (35,0+/-0,01 vs 34,1+/-0,10 mm, р<0,001; 25,5+/-0,11 vs 24,6+/-0,08 mm, р<0,001,) as well as higher prevalence of atherosclerotic pattern of aorta and left ventricular thrombus (81,8 vs 74,1%, р<0,001; 3,2% vs 1,3%, р=0,002, respectively).

Conclusion: Despite more severe risk-factor profile and higher prevalence of prior myocardial infarction in north ischemic patients we revealed more severe angina and left ventricular disorders in the south.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)