PSI - Issue 65

Mironov V.A. et al. / Procedia Structural Integrity 65 (2024) 152–157 Author name / Structural Integrity Procedia 00 (2024) 000–000

156

5

4. Results

The repeated episodes of a significant decrease in the overall variability of all heart rhythm waves were detected in group I. These episodes are ischemic in nature, probably, since they were accompanied by ischemic changes during ECG monitoring – Mironov et al. (2022). In group II, a high-frequency wave periodicity with a peak spectral density power in the range of 0.15-0.25 Hz in intoxication syndromes were registered by the features of intersystolic intervals number, in addition to episodes of reduced variability of all rhythm waves – Tyurin (2005), Kalmykova (2007), Marchenko (2008), Sadyrin (2008), Solovyova (2011), Milashchenko et al. (2018). Group III the predominant clinical manifestations of SAP, shortness of breath of a mixed nature was characterized, and the main instrumental sign of HT-RCG was a decrease in total HRV of less than 10 ms, regardless of the orientation of vegetative stress tests. Prospective follow-up in the research groups was carried out three years after PCI. To determine the relationship between the researched groups, the Odds Ratio (OR) was determined. The confidence interval (CI) for OR was 95%. The results of the study are shown in Table 1.

Table 1. Intermediate and end points of prospective three-year follow-up of patients after PCI in the research groups

Death from cardiovascular complications

Research Group

Number of people in the research

Number of responde nts

Recurrence of SAP

The development of myocardial infarction

The development of stroke

Repeated PCI

n %

n % 5 10.4

n % 2 4.2

n % 2 4.2

n % 8 16.7

n % 2 4.2

I (SAP)

53

48 90.5

4.533* (1.332-15.561)

8.474* (1.611-44.562)

OR I, III groups (CI 95%) II (SAP and CIF) OR II, III groups (CI 95%) III (SAP and ACNP) OR I, II groups (CI 95%)

3.000 (0.468-19.231)

2.647 (0.874 -8.021)

5.476 (0.981- 30.557)

57

52 91.2

5 9.6

2 3.8

2 3.8

8 15.4

2 3.8

4.976* (1.461-16.956)

9.211* (1.755-48.339)

5.952* (1.069 - 33.149)

3.261 (0.510-20.866)

2.912 (0.965 - 8.789)

28

26 92.8

9 34.6

7 26.9

3 11,5

9 34.6

5 19.2

1.093 (0,296-4,038)

1.087 (0.147-8.035)

1.087 (0.147-8.035)

1.100 (0.378 - 3.205)

1.087 (0.147- 8.035)

138

126 91.3

19 15.0

11 8.7

7 5.6

25 19.8

9 7.1

*- groups in which the OR indicator has statistical significance

5. Discussion

3 years after coronary artery stenting, SAP occurred 4.5 times more often, and myocardial infarction was recorded 8.4 times more often in patients of the SAP and ACNP group than in patients of the SAP group. This indicates a more unfavorable course of SAP against the background of vegetative denervation. In the SAP and CIF group, the differences under consideration were more pronounced than in the SAP group in the form of a 4.9-fold increase in cases of recurrent SAP compared with group III. There are 9.2 times more cases of myocardial infarction. There were also 5.9 times more cases of cardiac death in group III compared to the corresponding indicator of group II. There were no differences between groups I and II. Consequently, coronary events in the group of patients with CAP and ACNP increased significantly 3 years after PCI compared with group II (SAP and CIF).