Study of environmental pollution as a factor in the development of coronary heart disease

Abstract The aim of the study is to determine the main risk factors for the development of coronary insufficiency due to environmental pollution in the workplace. Material and methods The medical records of 116 patients with coronary heart disease (CHD) were analyzed (84 men and 32 women; mean age 53.12±8.04 years). Of these patients, 35 were hospitalized for acute coronary syndrome, including 8 with acute myocardial infarction (MI) with ST segment elevation, 10 with acute MI without ST segment elevation, 6 with recurrent MI, 9 with unstable angina. The professional activity of 39 patients (group 1) was associated with long-term exposure to pollutants, and 77 patients (group 2) had no history of exposure to pollutants. Results Stenosis was most often localized in the anterior interventricular branch (LAD): in the proximal section - in 18.83% of patients, in the middle section - in 12.03%, the right coronary artery (RCA): in the proximal section — in 14.01%, in the middle section — in 10.2%, in the circumflex branch: in the proximal section — in 9.61%, in the middle section — in 5.54%, as well as in the left coronary artery (LCA) trunk — in 5.99%, and more than 3 bifurcation lesions of the trunk were detected in patients with a history of exposure to chemical pollution. Predominantly in the same areas of the coronary bed, vascular stenosis was hemodynamically significant. The dependence of the degree of coronary artery (CA) stenosis on the influence of a combination of the studied factors was revealed. According to the results obtained, the combination of the studied factors primarily influenced the formation of stenosis in the second and third order of CA of others. At the same time, industrial pollutants accelerated the progression of atherosclerotic changes localized in the distal part of the left anterior coronary artery, the left coronary artery trunk, the distal part of the right coronary artery, and the proximal part of the left anterior coronary artery. Conclusions The set of studied factors primarily affects the growth of atherosclerotic plaques in the coronary arteries of the second and third order; industrial hazards, in addition, stimulate atherogenesis in the left coronary artery trunk. The obtained results indicate the importance of environmental pollution in the workplace as a risk factor for the development of atherosclerotic changes in the coronary arteries, the role of which must be taken into account along with such factors as physical inactivity, smoking, dyslipidemia, arterial hypertension, and diabetes mellitus.

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