Abstract

*Nagaeva G. A., Zhuraliev M. Zh., Olimov Kh. A. and Li V. N.

ABSTRACT

Purpose: analysis of lesions of the gastroduodenal zone in relation to angiographic and clinical laboratory parameters in patients with coronary artery disease (CAD). Material and methods: In the period from 03/01/2021 to 09/01/2021, 298 patients with CAD were examined, who underwent coronary angiography (CAG) and percutaneous coronary intervention (PCI) with stenting. In addition to general clinical laboratory and functional research methods, esophagogastroduodenoscopy (EGDS) was carried out in order to assess the localization and nature of lesions of the gastroduodenal zone (GDZ). Results: Among patients with CAD in 36.6% of cases there is some form of GDZ lesion, while the proportion of patients with stable CAD accounts for 71.6% of cases, and 28.4% - for acute forms of CAD. The documented (visually confirmed on EGDS) presence of GDZ lesions was detected in 25.8% of cases, of which 67.5% were asymptomatic. At the same time, the presence of gastralgic symptoms (without a picture of EGDS lesion) was observed in 10.7% of cases among all patients with CAD. The acute form of CAD most often (34.4%) occurred among persons who had only gastralgic symptoms, without a picture of EGDS lesion, which should always remind doctors (therapists, cardiologists, gastroenterologists and surgeons) about atypical variants of the course of CAD. The latter in our study was 1.7% of cases. Among individuals with asymptomatic GDZ lesions, an acute form of CAD was observed in 28.8% of cases, and among patients with positive symptoms and EGDS-picture - in 20.0% of cases. The angiographic features of patients with CAD & with combined lesions of the GDZ turned out to be, comparatively, a lower incidence of complex (type "B" and "C") stenosis, according to the ACC / ANA classification (all p> 0.05). However, patients with asymptomatic GDZ lesions were characterized by a more frequent occurrence of lesions of the basins of the left coronary and anterior descending arteries, which once again emphasizes the mandatory nature of the EGDS study before performing interventional operations in patients with CAD. Among patients with gastralgic lesions (n = 107), a decrease in Hb level occurred in 27.1% of cases, of which 9.8% were associated with asymptomatic GDZ lesions. Conclusion: In order to timely diagnose and prevent dangerous complications of GDZ diseases, it is advisable for all patients with CAD to conduct an EGDS study.