The role of analysis of indices of autonomic regulation in predicting the outcome of surgical treatment of acute coronary syndrome

The aim of this study was to determine the relationship between the indices of autonomic regulation of hemodynamics with the frequency of complications and unfavorable outcomes of acute coronary syndrome in operated patients. A comprehensive examination of 169 patients with ischemic heart disease (IHD) admitted with a diagnosis of acute coronary syndrome (ACS) within the first 2 hours after the development of prolonged ischemic pain syndrome or its equivalent was carried out. Criteria for the inclusion of patients in the study were the following: age from 40 to 75 full years; the presence of a diagnosis of ACS upon admission; coronary angiography within 2 hours. The diagnosis of IHD and its clinical forms were verified on the basis of modern examination methods, which included general clinical data, ECG, B-mode EchoCG, and coronary angiography. For coronary angiography, a Siemens Artis Zee apparatus with a detector size of 30x40 cm was used. The examination was carried out in the period from 1 to 12 hours from the moment of the onset of pain syndrome associated with the genesis of the current ACS. The control group to obtain comparative indices of autonomic regulation included 50 people aged 40 to 70 years, clinically healthy, without a history of cardiovascular disease. The data obtained determine the pronounced heterogeneity of the examined group of patients in relation to the indicators of the state of the autonomic nervous system (ANS). In our study, it was established that the typical characteristics of autonomic regulation are preserved in most patients and on average for the selected subgroups after surgery. Prospective analysis data also indicate the persistence of the negative impact of pronounced violations of this regulatory system on the state of the cardiovascular system and related outcomes. The most unfavorable in relation to all outcomes was the presence of a pronounced parasympathetic reaction. It was realized in a high frequency of development of acute forms of IHD, including against the background (or associated) with life-threatening cardiac arrhythmias.

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