Features of the management of coronary heart disease in patients with metabolically associated fatty liver disease

Abstract

Among chronic non-communicable diseases, which make a significant contribution to mortality rates in the developed countries of the world, the leading positions are occupied by diseases of the circulatory system. According to statistics, one million people a year die from cardiovascular diseases in Russia. In an extensive nosological group of diseases of the circulatory system, coronary heart disease is the main cause of death and disability in the adult population. The annual mortality from coronary heart disease among the population of Russia is 27 %. To date, the number of patients with coronary heart disease with comorbid pathology, especially with diseases of the hepatobiliary system, metabolic syndrome, is increasing. The prevalence of metabolically associated fatty liver disease is 20 to 30 % in the population and tends to increase. The combined course of metabolically associated fatty liver disease and coronary heart disease occurs in 14-18 % of cases. Objective: to determine the impact of metabolically associated fatty liver disease on the course of coronary heart disease and the possibility of correcting metabolic disorders to prevent the development of cardiovascular complications. Materials and methods. 35 patients with coronary heart disease and metabolically associated fatty liver disease were examined; they were noted to have more severe clinical course of stenocardia and higher risk of cardiovascular complications, then those patients without liver diseases. Results and its discussion. It was estimated, that using thiotriazoline and ursodeoxycholic acid in addition to standard medicamentous therapy improves clinical course of stenocardia as well as overall quality of life due to high antianginal and antioxidant effects. Conclusions. Hepatoprotective therapy increases possibility of correction of metabolic defects, dyslipidemia, decreases the risk of oxidative stress, prevents development of life threatening cardiovascular conditions and can be used to optimize treatment of comorbid patients.