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Patients With Non-Obstructive Coronary Artery Disease and Polyvascular Disease. Sub-Analysis of the Real-World Registry KAMMA (Clinical Registry on Patient Population With Polyvascular Disease in the Russian Federation and Eurasian Countries)

  G. P. Arutyunov,   E. I. Tarlovskaya,   A. G. Arutyunov,   T. I. Batluk,   N. A. Koziolova,   A. I. Chesnikova,   A. Yu. Vaskin,   D. S. Tokmin,   I. G. Bakulin,   O. L. Barbarash,   N. Yu. Grigoryeva,   I. V. Gubareva,   N. V. Izmozherova,   U. K. Kamilova,   S. G. Kechedzhieva,   Z. F. Kim,   N. A. Koriagina,   S. V. Mironova,   N. P. Mitkovskaya,   S. V. Nemirova,   L. M. Nurieva,   M. M. Petrova,   E. A. Polyanskaya,   A. P. Rebrov,   A. V. Svarovskaya,   E. A. Smirnova,   A. B. Sugraliev,   Ya. B. Khovaeva,   G. V. Shavkuta,   I. I. Shaposhnik,   M. Yu.K. Alieva,   A. B. Almukhanova,   A. V. Aparkina,   R. A. Bashkinov,   L. N. Belousova,   E. I. Blokhina,   V. O. Bochkareva,   M. V. Buianova,   F. Yu. Valikulova,   A. D. Vende,   A. S. Galyavich,   V. V. Genkel,   E. V. Gorbunova,   E. D. Gordeychuk,   E. A. Grigorenko,   E. V. Grigoryeva,   I. L. Davydkin,   D. S. Evdokimov,   A. N. Ermilova,   Sh. B. Zhangelova,   N. V. Zhdankina,   E. I. Zheleznyak,   N. S. Ilyanok,   D. A. Kapsultanova,   N. A. Karoli,   E. A. Kartashova,   A. S. Kuznetsova,   A. T. Kumaritova,   N. A. Magdeeva,   S. A. Makarov,   E. S. Melnikov,   M. V. Novikova,   I. A. Obukhova, E. V. Ponomarenko,   A. O. Rubanenko,   O. A. Rubanenko,   F. E. Rustamova,   V. A. Safronenko,   E. I. Suchkova,   A. I. Sycheva,   D. R. Tagaeva,   M. A. Trubnikova,   T. P. Trunina,   A. G. Frolov,   V. V. Khatlamadzhiyan,   Yu. I. Khokhlova,   A. I. Chernyavina,   O. Yu. Chizhova,   M. A. o. Shambatov,   T. V. Shnyukova,   Yu. V. Shchukin

https://doi.org/10.18087/cardio.2024.8.n2683

Abstract

Aim. To study the clinical status and data of laboratory and instrumental examination of patients with non-obstructive ischemic heart disease (IHD) and multifocal atherosclerosis (MFA) included in the KAMMA registry.
Material and methods. The subanalysis included 1,893 IHD patients who underwent coronary angiography (CAG) and ultrasonic examination of peripheral arteries. Based on the CAG data, patients were divided into two groups: group 1, patients with obstructive coronary atherosclerosis (CA) (maximum stenosis ≥50% and/or history of percutaneous coronary intervention/coronary artery bypass grafting, n=1728; 91.3%) and group 2, patients with non-obstructive CA (maximum stenosis <50%, n = 165; 8.7%).
Results. A comparative analysis based on the degree of coronary obstruction in patients with verified IHD who were included in the KAMMA registry showed that 8.7% of them had coronary artery stenosis of less than 50%. The overwhelming majority of patients with non-obstructive CA had MFA affecting the brachiocephalic arteries in 94.3% and the lower extremity arteries in 40.2%. Among patients with non-obstructive IHD, women predominated; risk factors such as smoking and type 2 diabetes mellitus were less frequent in this group than in the obstructive IHD group. Patients with non-obstructive CA more frequently had a history of dyslipidemia; they had higher total cholesterol and non-high-density lipoprotein cholesterol; and they more frequently received moderate-intensity statin therapy than patients with obstructive CA (55.8% vs. 34.5%). Characteristic features of patients with non-obstructive CA were less severe IHD and less frequent history of acute coronary syndrome. However, the incidence of stroke, peripheral arterial thrombosis, and chronic arterial insufficiency of the lower extremities did not differ in groups 1 and 2, whereas the incidence of paroxysmal atrial fibrillation was higher in the non-obstructive IHD group.
Conclusion. IHD patients without coronary obstruction also require assessment of the peripheral arterial status, as they may have advanced MFA, which should be taken into account when choosing the “aggressiveness” of therapy.

 

About the Authors

G. P. Arutyunov
Eurasian Association of Therapists; Pirogov Russian national research medical university
Russian Federation
MD, PhD, professor, corresponding member of the Russian academy of sciences, President of the Association “Eurasian Association of Internal Medicine”, head of the department of propaedeutics of internal diseases (pediatric school) Pirogov Russian national research medical university, honored doctor of the Russian Federation


E. I. Tarlovskaya
Eurasian Association of Therapists; Privolzhsky research medical university
Russian Federation
MD, PhD, professor, Chairperson of the Association "Eurasian Association of Internal Medicine", head of the department of therapy and cardiology, Privolzhsky research medical university


A. G. Arutyunov
Eurasian Association of Therapists; Avdalbekyan National Institute of Health
Armenia
MD, PhD, member of the board of the Association “Eurasian Association of Internal Medicine”, FEFIM, FESC, professor at national institute of health named after S. Avdalbekyan, honorary professor of the national medical university of Kazakhstan


T. I. Batluk
Association “Eurasian Association of Internal Medicine”
Russian Federation
PhD., senior medical advisor Association “Eurasian Association of Internal Medicine”


N. A. Koziolova
Perm State Medical University ak. E.A. Wagner
Russian Federation
MD, PhD, professor, head of the department of propaedeutics of internal diseases No.2 Perm State Medical University ak. E.A. Wagner, member of the Presidium of the Board of RKO, member of the Board of OSSN, member of the Board of the NOA, member of the Board of the Association “Eurasian Association of Internal Medicine”


A. I. Chesnikova
Rostov State Medical University
Russian Federation
MD, PhD, professor, professor in the department of internal medicine No.1 Rostov State Medical University


A. Yu. Vaskin
Association "Eurasian Association of Internal Medicine"
Russian Federation
Project Manager Association "Eurasian Association of Internal Medicine"


D. S. Tokmin
"Alphastat" analytic agency
Russian Federation
head of "Alphastat" analytic agency


I. G. Bakulin
«Mechnikov North-Western State Medical University»
Russian Federation
MD, PhD, professor, head of the chair of the propedeutics of internal diseases, gastroenterology and dietology n.a. S.M. Riss «Mechnikov North-Western State Medical University»


O. L. Barbarash
institute Scientific research institute for complex issues of cardiovascular disease
Russian Federation
RAS Academician, professor, MD, PhD, head of institute Scientific research institute for complex issues of cardiovascular disease


N. Yu. Grigoryeva
National Research Lobachevsky State University of Nizhni Novgorod
Russian Federation
MD, PhD, associate professor, head of the department of clinical medicine of the National Research Lobachevsky State University of Nizhni Novgorod


I. V. Gubareva
Samara State Medical University
Russian Federation
MD, PhD, Associated professor, head of the department of internal diseases Samara State Medical University


N. V. Izmozherova
Ural State Medical University Healthcare Ministry of Russia
Russian Federation
MD, PhD, Docent, head of department of pharmacology and clinical pharmacology, Ural State Medical University Healthcare Ministry of Russia


U. K. Kamilova
SI "Republican specialized scientific and practical medical center of therapy and medical rehabilitation"
Uzbekistan
MD, PhD, professor, deputy director for research SI "Republican specialized scientific and practical medical center of therapy and medical rehabilitation"


S. G. Kechedzhieva
Stavropol State Medical University
Russian Federation
PhD, associate professor, head of the department of geriatrics, medical and social expertise with a course of general medical practice Stavropol State Medical University


Z. F. Kim
City clinical hospital No. 7
Russian Federation
PhD, deputy head physician on medical affairs of City clinical hospital No. 7; Chief freelance cardiologist of the Ministry of health of Republic of Tatarstan


N. A. Koriagina
Women's health clinic LLC
Russian Federation
chief physician of Women's health clinic LLC, MD, PhD


S. V. Mironova
SBHI PR Perm regional hospital for veteran’s war
Russian Federation
PhD, associated professor, cardiologist SBHI PR Perm regional hospital for veteran’s war


N. P. Mitkovskaya
Republican scientific and practical center of cardiology
Belarus
MD, PhD, professor, director of the Republican scientific and practical center of cardiology


S. V. Nemirova
Privolzhsky research medical university of the Ministry of Health of the Russian Federation
Russian Federation
PhD, associate professor of B.A. Korolev department of hospital surgery Privolzhsky research medical university of the Ministry of Health of the Russian Federation


L. M. Nurieva
City clinical hospital No. 7
Russian Federation
cardiologist of the cardiology department No. 1 of City clinical hospital No. 7


M. M. Petrova
КГБУЗ «Красноярская межрайонная клиническая больница скорой медицинской помощи имени Н. С. Карповича»
Russian Federation
MD, PhD, professor V.F.Voino - Yasenetsky Krasnoyarsk State Medical University


E. A. Polyanskaya
Perm State Medical University ak. E.A. Wagner
Russian Federation
PhD, assistant professor of the department of propaedeutic of internal diseases №2 Perm State Medical University ak. E.A. Wagner, cardiologist


A. P. Rebrov
Federal State educational institution of high education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation
Russian Federation
MD, PhD, professor, head of hospital therapy department of Federal State educational institution of high education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation


A. V. Svarovskaya
Tomsk national research medical center Russian Academy of Sciences
Russian Federation
MD, PhD, senior researcher, department of myocardial pathology Cardiology research institute, Tomsk national research medical center Russian Academy of Sciences


E. A. Smirnova
Ryazan State Medical University
Russian Federation
MD, PhD, associate professor, head of the department of internal diseases Ryazan State Medical University


A. B. Sugraliev
Asfendiyarov Kazakh national medical university
Kazakhstan
PhD., head of the department of internal medicine Asfendiyarov Kazakh national medical university


Ya. B. Khovaeva
Perm State Medical University
Russian Federation
professor, head of therapy and family medicine department, Perm State Medical University


G. V. Shavkuta
Rostov-on-Don State Medical University
Russian Federation
MD, PhD, professor, head of the department of general medical practice (family medicine) with courses in geriatrics and physiotherapy) Rostov-on-Don State Medical University


I. I. Shaposhnik
Federal State Budgetary Educational Institution of Higher Education "South Ural State Medical University " of the Ministry of Health of the Russian Federation
Russian Federation
head of the department of propaedeutics of internal diseases, MD, PhD, professor Federal State Budgetary Educational Institution of Higher Education "South Ural State Medical University " of the Ministry of Health of the Russian Federation


M. Yu.K. Alieva
SI "Republican specialized scientific and practical medical center of therapy and medical rehabilitation"
Uzbekistan
junior researcher SI "Republican specialized scientific and practical medical center of therapy and medical rehabilitation"


A. B. Almukhanova
Asfendiyarov Kazakh national medical university
Kazakhstan
PhD., associate professor of the department of internal medicine Asfendiyarov Kazakh national medical university


A. V. Aparkina
State Educational Institution of Higher Professional Education «Saratov State Medical University n.a. V.I. Razumovskiy»
Russian Federation
PhD, associate professor, department of hospital therapy of general medicine faculty, State Educational Institution of Higher Professional Education «Saratov State Medical University n.a. V.I. Razumovskiy»


R. A. Bashkinov
"North-Western State Medical University named after I.I. Mechnikov"
Russian Federation
medical advisor, rheumatologist, postgraduate of the "Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E. E. Eichwald" "North-Western State Medical University named after I.I. Mechnikov"


L. N. Belousova
«North-Western State Medical University after I.I. Mechnicov»
Russian Federation
PhD, assistant professor of the chair of the propaedeutics of internal diseases, gastroenterology and dietology n.a. S.M. Riss «North-Western State Medical University after I.I. Mechnicov»


E. I. Blokhina
National research Lobachevsky State University of Nizhny Novgorod
Russian Federation
cardiologist, assistant of the Department of clinical medicine of the National research Lobachevsky State University of Nizhny Novgorod


V. O. Bochkareva
«Krasnoyarsk interdistrict clinical emergency hospital named after N.S. Karpovich»
Russian Federation
pulmonologist Regional State budgetary healthcare institution «Krasnoyarsk interdistrict clinical emergency hospital named after N.S. Karpovich»


M. V. Buianova
National Research Lobachevsky State University of Nizhny Novgorod
Russian Federation
PhD., therapist, cardiologist, assistant of the department of clinical medicine of the National Research Lobachevsky State University of Nizhny Novgorod


F. Yu. Valikulova
«Privolzhsky research medical university» of the Ministry of Health Care of the Russian Federation
Russian Federation
PhD, associate professor of therapy and cardiology department, vice dean of the faculty of network educational programs, cardiologist of the highest certification category Federal State Budgetary Educational Institution of Higher Education «Privolzhsky research medical university» of the Ministry of Health Care of the Russian Federation


A. D. Vende
“Siberian State Medical University” of the Ministry of Healthcare of the Russian Federation
Russian Federation
student Federal state-funded educational institution of higher education “Siberian State Medical University” of the Ministry of Healthcare of the Russian Federation


A. S. Galyavich
Kazan State Medical University
Russian Federation
MD, PhD, professor, the head of the Department of cardiology of Kazan State Medical University; Chief freelance cardiologist of the Ministry of Health of the Russian Federation in the Volga Federal District


V. V. Genkel
Federal State Budgetary Educational Institution of Higher Education "South Ural State Medical University " of the Ministry of Health of the Russian Federation
Russian Federation
PhD, associated professor at the department of propaedeutics of internal medicine Federal State Budgetary Educational Institution of Higher Education "South Ural State Medical University " of the Ministry of Health of the Russian Federation


E. V. Gorbunova
Kuzbass clinical cardiology dispensary named after academician L.S. Barbarash
Russian Federation
MD, PhD, leading researcher head of outpatient department Kuzbass clinical cardiology dispensary named after academician L.S. Barbarash


E. D. Gordeychuk
Pirogov russian national research medical university
Russian Federation
medical advisor, pediatric cardiology resident, Pirogov russian national research medical university


E. A. Grigorenko
SI "Republican scientific and practical center of cardiology" of the Ministry of Health of the Republic of Belarus
Belarus
deputy director for international partnership and analytical work SI "Republican scientific and practical center of cardiology" of the Ministry of Health of the Republic of Belarus


E. V. Grigoryeva
Federal State Educational Institution of High Education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation
Russian Federation
PhD, assistant of professor of hospital therapy department of Federal State Educational Institution of High Education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation


I. L. Davydkin
Samara State Medical University
Russian Federation
MD, PhD, professor, head of the hospital therapy department Samara State Medical University


D. S. Evdokimov
North-Western State Medical University named after I.I. Mechnikov
Russian Federation
assistant of the department of faculty therapy of the North-Western State Medical University named after I.I. Mechnikov


A. N. Ermilova
Association "Eurasian Association of Internal Medicine"
Russian Federation
psychiatrist, psychotherapist, senior medical advisor Association "Eurasian Association of Internal Medicine"


Sh. B. Zhangelova
Asfendiyarov Kazakh national medical university
Kazakhstan
professor of the department of internal diseases, PhD., associate professor Asfendiyarov Kazakh national medical university


N. V. Zhdankina
National Research Lobachevsky State University of Nizhny Novgorod
Russian Federation
PhD., associate professor of the department of clinical medicine National Research Lobachevsky State University of Nizhny Novgorod


E. I. Zheleznyak
Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University»
Russian Federation
PhD, assistant department of internal medicine N2 Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University»


N. S. Ilyanok
Ryazan State Medical University
Russian Federation
resident of the department of internal diseases, therapist, general practitioner Ryazan State Medical University


D. A. Kapsultanova
Asfendiyarov Kazakh national medical university
Kazakhstan
PhD., associate professor of the department of internal medicine Asfendiyarov Kazakh national medical university


N. A. Karoli
V. I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of the Russia
Russian Federation
MD, PhD, professor of hospital therapy chair of general medicine department, V. I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of the Russia


E. A. Kartashova
Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University»
Russian Federation
PhD, assistant professor, department of Internal medicine N2, Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University»


A. S. Kuznetsova
Federal State Budgetary Educational Institution of Higher Education "South Ural State Medical University" of the Ministry of Health of the Russian Federation
Russian Federation
PhD, associate professor of the department of clinical therapy Federal State Budgetary Educational Institution of Higher Education "South Ural State Medical University" of the Ministry of Health of the Russian Federation


A. T. Kumaritova
«Mechnikov North-Western State Medical University»
Russian Federation
resident of the chair of the propedeutics of internal diseases, gastroenterology and dietology n.a. S.M. Riss «Mechnikov North-Western State Medical University»


N. A. Magdeeva
Federal State Educational Institution of High Education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation
Russian Federation
PhD, assistant of professor of hospital therapy department of Federal State Educational Institution of High Education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation


S. A. Makarov
Scientific Research Institute for Complex issues of cardiovascular disease
Russian Federation
MD, PhD, head of laboratory for modeling management technologies, head Dr Scientific Research Institute for Complex issues of cardiovascular disease


E. S. Melnikov
"North-Western State Medical University named after I.I. Mechnikov"
Russian Federation
medical adviser, rheumatologist, postgraduate student of the "Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E. E. Eichwald" "North-Western State Medical University named after I.I. Mechnikov"


M. V. Novikova
Stavropol regional cardiology centre
Russian Federation
PhD., cardiologist Stavropol regional cardiology centre


I. A. Obukhova
Regional State Budgetary Healthcare Institution "Krasnoyarsk interdistrict clinical emergency hospital named after N.S. Karpovich
Russian Federation
pulmonologist Regional State Budgetary Healthcare Institution "Krasnoyarsk interdistrict clinical emergency hospital named after N.S. Karpovich


E. V. Ponomarenko
"Health formula LLС"
Russian Federation
cardiologist "Health formula LLС"


A. O. Rubanenko
Samara State Medical University
Russian Federation
PhD, associate professor of the propaedeutic therapy department Samara State Medical University


O. A. Rubanenko
Samara State Medical University
Russian Federation
MD, PhD, associate professor of the hospital therapy department Samara State Medical University


F. E. Rustamova
Asfendiyarov Kazakh National medical university
Kazakhstan
PhD., associate professor of the department of internal medicine Asfendiyarov Kazakh National medical university


V. A. Safronenko
Rostov State Medical University
Russian Federation
PhD, associate professor of the department of internal diseases No. 1, Rostov State Medical University


E. I. Suchkova
Ryazan State Medical University
Russian Federation
PhD., assistant of the department of internal diseases Ryazan State Medical University


A. I. Sycheva
Perm State Medical University
Russian Federation
postgraduate student of therapy and family medicine department, Perm State Medical University


D. R. Tagaeva
Republican specialized scientific and practical medical center of therapy and medical rehabilitation
Uzbekistan
junior researcher Republican specialized scientific and practical medical center of therapy and medical rehabilitation


M. A. Trubnikova
Association "Eurasian Association of Internal Medicine"
Russian Federation
nephrologist, medical advisor, Association "Eurasian Association of Internal Medicine"


T. P. Trunina
Ryazan State Medical University
Russian Federation
PhD, associate professor of the department of internal diseases Ryazan State Medical University


A. G. Frolov
Hospital №5 Nizhny Novgorod
Russian Federation
doctor Hospital №5


V. V. Khatlamadzhiyan
Rostov State Medical University
Russian Federation
6th year student of the faculty of medicine and prevention, laboratory assistant of the department of internal diseases No. 1 Rostov State Medical University


Yu. I. Khokhlova
«Mechnikov North-Western State Medical University»
Russian Federation
resident of the chair of the propedeutics of internal diseases, gastroenterology and dietology n.a. S.M. Riss «Mechnikov North-Western State Medical University»


A. I. Chernyavina
SBHI PR Perm regional hospital for veterans war
Russian Federation
PhD, cardiologist, associated professor SBHI PR Perm regional hospital for veterans war


O. Yu. Chizhova
«Mechnikov North-Western State Medical University»
Russian Federation
MD, PhD, professor of the chair of the propaedeutics of internal diseases, gastroenterology and dietology n.a. S.M. Riss «Mechnikov North-Western State Medical University»


M. A. o. Shambatov
Ural State Medical University Healthcare Ministry of Russia
Russian Federation
therapist, postgraduate student, Ural State Medical University, Healthcare Ministry of Russia


T. V. Shnyukova
Rostov-on-Don State Medical University
Russian Federation
PhD, assistant professor of the department of general medical practice (family medicine) (with courses in geriatrics and physiotherapy) Rostov-on-Don State Medical University


Yu. V. Shchukin
Samara State Medical University
Russian Federation
MD, PhD, professor of the propaedeutic therapy department Samara State Medical University


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ISSN 0022-9040 (Print)
ISSN 2412-5660 (Online)