Elaboration of New Medical Technology for Predicting the Risk of Ischemic Heart Disease in the Workers of the Coal Industry

Background. Ischemic heart disease is the leading cause of death in the majority of developed countries, including Russia. It determines the importance of elaboration of individual risk prediction of ischemic heart disease for primary prevention.

Aim: to develop a strategy for predicting the ischemic heart disease in coal industry workers.

Materials and methods. Ischemic heart disease incidence and its risk factors were studied in 196 coalmine workers (sinkers, stope miners). Rose Questionnaire, daily ECG monitoring and bicycle ergometry were used to detect angina. The indices of lipid metabolism, hemostatic system, the level of homocysteine, uric acid, C-reactive protein, constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems were studied.

When elaborating the prognostic system, we used the Bayes method. A prognostic coefficient was calculated for each factor. Prediction of ischemic heart disease was carried out according to the sum of prognostic coefficients.

Results. Ischemic heart disease was detected in 18 (9.2 %) miners. According to the above mentioned indices, a medical technology was elaborated to predict the ischemic heart disease, based on the determination of the most significant risk markers: age, work experience in harmful working conditions, type A behavior, arterial hypertension, fasting hyperglycemia, metabolic syndrome, hypercholesterolemia, decrease in the level of high density lipoprotein cholesterol, increase in the value of low density lipoprotein cholesterol, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increase in the level of soluble fibrin monomer complexes and C-reactive protein, abdominal obesity, hypersthenic constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems.

Conclusion. Based on the most significant markers, a personalized strategy for ischemic heart disease prediction in miners was elaborated, which allowed timely undertaking therapeutic and preventive measures.

1. Izmerov NF. (ed.) Occupational pathology: national guidelines. Moscow: GEOTAR-Media; 2011. (in Russ.)

2. Berstein LL, Katamadze NO, Laznam SS, Grishkin YuN. Individual coronary heart disease risk prediction as part of primary prevention. Kardiologiya. 2012; 52(10): 65-74. (in Russ.)

3. Vorobyeva EN. Method for diagnosis and predicting course of ischemic heart disease. No 2173853 (Patent) 2001. (in Russ.)

4. Veselovskaya NG, Chumakova GA, Gritsenko OV, Ott AV, Shenkova NN. Scale of risk of coronary atherosclerosis in patients with obesity. Sovremennyye problemy nauki i obrazovaniya. 2014; (2): 329. (in Russ.)

5. Marusin AV, Stepanov VA, Spiridonova MG, Kharkov VA, Pels JR, Puzyrev VP. Association analysis of alcohol metabolizing enzymes ADH1B, ADH7, CYP2E1 gene polymorphism with risk for coronary atherosclerosis. Genetika. 2007; 43(3): 409-416. (in Russ.)

6. Panev NI, Korotenko OYu, Zaxarenkov VV, Filimonov SN, Gafarov NI, Luzina FA, et al. A method for predicting the probability of atherosclerosis in miners with anthracosilicosis. No 2595086 (Patent). 2016 (in Russ.)

7. Svitlyk GV, Salo VM, Bubnyak MR, Chngryan GV, Garbar MO, Bilushchak GI. Risk factors of coronary heart disease. Klinicheskaya medicina. 2013; 91(12): 26-30. (in Russ.)

8. Sidorenko BA, Golikova AA, Iosava IK, Sergiyenko IV, Vinokurova AS. Hyperuricemia as a risk factor of cardiovascular diseases. Kremlevskaya meditsina. Klinicheskiy vestnik. 2015; (4): 135-138. (in Russ.)