Research Article
Volume 9 Issue 4 - 2022
Lesions of the Gastro-Duodenal Zone and their Relationship with Clinical and Angiographic Data in Patients with Ischemic Heart Disease
Nagaeva GA*, Zhuraliev M Zh, Li VN, Olimov Kh A, Akhmedov Sh M and Samadov A Kh
JV LLC Multidisciplinary Medical Center “Ezgu Niyat”, Tashkent, Uzbekistan
*Corresponding Author: Nagaeva GA, JV LLC Multidisciplinary Medical Center “Ezgu Niyat”, Tashkent, Uzbekistan.
Received: February 08, 2022; Published: March 17, 2022




Abstract

Purpose: Analysis of lesions of the gastroduodenal zone in relation to angiographic and clinical laboratory parameters in patients with coronary artery disease (CAD).

Materials 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.

 

Keywords: Cardiovascular System (CVS); Coronary Artery Disease (CAD); Acetylsalicylic Acid (ASA); Coronary Arteries (CA); Gastrointestinal Tract (GIT); Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

 

References

  1. Lapina TL. “Gastropathies, induced non-steroidal anti-inflammatory agents: clinical significance, treatment, prevention”. Consilium Medicum 9 (2001): 438-442.
  2. Maev IV., еt al. “NSAID-induced Gastropathies: Pathogenetically Substantiated Approaches to Prevention and Therapy”. Pharmateka 2 (2016): 49-54.
  3. Lazebnik LB and Zvenigorodskaya LA. “Chronic ischemic disease of the digestive system”. M: Anacharsis (2003): 136.
  4. Peterson WL. “The role of acid in upper gastrointestinal haemorrhage due to ulcer and stress related mucosal damage”. Alimentary Pharmacology and Therapeutics 1 (1995): 43-46.
  5. Quandalle P., еt al. “Diagnostic et traitement chirurgical de langor abdominal par stenose atheromateuse des arteres digestives”. Journal de Chirurgie 12 (1989): 643-649.
  6. Kolkina V Ya., еt al. “Vascular diseases of the stomach (literature review)”.
  7. Endovascular surgery: angiography, stenting, vascular embolization in cases of narrowing and aneurysms.
  8. Kolobov SV., еt al. “Acute erosive and ulcerative lesions of the stomach in emergency conditions in patients with a therapeutic profile”. Abstracts. report VI Congress of the Scientific Society of Gastroenterologists of Russia. (2006): 24-25.
  9. Khokhlova EE., еt al. “Acute erosive and ulcerative gastroduodenal lesions and bleeding in patients with a therapeutic and neurological profile”. Proceedings of the III Congress of the Russian Society of Pathologists. Samara: Samara State Medical University (2009): 325.
  10. Yarema IV., еt al. “Acute erosive and ulcerative gastroduodenal lesions in patients with ischemic heart disease, cerebrovascular disease and chronic obstructive pulmonary disease”. Surgeon 12 (2009): 5-13.
  11. Kolobov SV., еt al. “Acute erosive and ulcerative gastroduodenal lesions in patients with cardiovascular diseases”.
  12. Eggleston A., еt al. “Clinical trial: the treatment of gastro-oesophageal reflux disease in primary care--prospective randomized comparison of rabeprazole 20 mg with esomeprazole 20 and 40 mg”. Alimentary Pharmacology and Therapeutics 9 (2009): 967-978.
  13. Gilbert DA and Silberstain FE. “Acute upper gastrointestinal bleeding”. Gastroenterologic Endoscopy 1 (2000): 284-299.
  14. A study to assess the effectiveness of maintenance treatment with esomeprazole 20 mg od in patients with reflux disease previously maintained with lansoprazole 30mg od - A 3 month, randomised, double blind, double dummy, multicentre study- (30/20 Study). SUMMARY. AstraZeneca Clinical Trials web site (2010).
  15. Zayratyants OV., еt al. “Acute erosive and ulcerative gastroduodenal lesions in therapeutic and neurological patients”. Sat. scientific. works of the conference in memory of Yu.L. Perova/Ed. Acad. RAS and RAMS V.A. Tkachuk. M.: Publishing house of Moscow State University (2009): 35-43.
  16. Hawkey CI and Wight NJ. “NSAIDs and gastrointestinal complications”. LSC Life Science Communications. London (2001): 1-56.
  17. Deepak LB., еt al. “ACCF/ACG/AHA 2008 Expert Consensus Document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use”. Circulation18 (2008): 1894-1909.
  18. Wallace JL. “Non-steroidal anti-inflammatory drugs and gastropathy: the second hundred years”. Gastroenterology 3 (1997): 1000-1016.
  19. Anand SS and Yusuf S. “Oral anticoagulant therapy in patients with coronary artery disease: a meta-analysis”. Journal of the American Medical Association 21 (1999): 2058-2067.
  20. Iskakov BS., еt al. “Clinical and endoscopic characteristics of NSAID gastropathy in patients with coronary heart disease”. KazNMU Bulletin1 (2013): 258-261.
  21. Spirt MJ. “Stress-related mucosal disease: risk factors and prophylactic therapy”. Clinical Therapeutics 2 (2004): 197-213.
  22. Markovtseva MV., еt al. “Clinical course and structural and functional changes in the myocardium in patients with ischemic heart disease in conditions of comorbidity with cholelithiasis”. Russian Journal of Gastroenterology Hepatology Coloproctology5 (2011): 111.
  23. Fedorova ES and Slepykh LA. St. Petersburg (2017).
  24. Nordestgaard BG., еt al. “Lipoprotein(a) as a cardiovascular risk factor: current status”. European Heart Journal 23 (2010): 2844-2853.
  25. Tabas I., еt al. “Subendothelial lipoprotein retention as the initiating process in atherosclerosis: update and therapeutic implications”. Circulation16 (2007): 1832-1844.
  26. Mach F., еt al. “2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk”. European Heart Journal 1 (2020): 111-188.
  27. Sergienko IV., еt al. “Dyslipidemia, atherosclerosis and ischemic heart disease genetics, pathogenesis, phenotypes, diagnostics, therapy, comorbidity”.
  28. Roitberg GE., еt al. “Diagnosis and treatment of iron deficiency anemia on an outpatient basis”. Training manual. Moscow (2018): 38.
  29. Jürgen Stein., еt al. “Anemia and iron deficiency in gastrointestinal and liver conditions”. World Journal of Gastroenterology 35 (2016): 7908-7912.
Citation: Nagaeva GA., et al. “Lesions of the Gastro-Duodenal Zone and their Relationship with Clinical and Angiographic Data in Patients with Ischemic Heart Disease”. EC Gastroenterology and Digestive System 9.4 (2022): 52-61.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


July Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the July issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 15, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.