The heart rate variability and a potential risk of complications during the in-hospital period in the elderly patients with acute coronary syndrome undergoing the coronary stenting

• Esina O.P.
• Esin S.G.
• Nosov V.P.
• Koroleva L.Yu.
• Kovaleva G.V.

Abstract

The aim - the risk factors of the heart rate variabiLity (HRV) for the deveLopment of an potentiaL unfavorabLe outcomes in the eLderLy patients with acute coronary syndrome (ACS) undergoing the coronary stenting were studied.

Material and methods. 116 patients were incLuded in the study with deveLoped ACS, requiring PTCA in the first 6 hours from the onset of cardiac pain. The bare-metaL coronary stents mostLy were used. 24-hour ECG monitoring with evaLuation of HRV was performed in aLL hospitaLized patients. The SYNTAX Score was evaLuated to assess the severity of coronary artery disease. The GRACE and CRUSADE scaLes were used to identify patients with a high potentiaL risk of compLications during the in-hospitaL period.

Results. The eLderLy patients with ACS with ST-segment eLevation undergoing the coronary stenting had a statisticaLLy significant predominance of the infLuence of the parasympathetic division of the autonomic nervous system. In age-reLated patients with ACS without ST-segment eLevation, a significant predominance of very Low-frequency wave power was noted. In the eLderLy a significant predominance of sharpLy reduced HRV was estabLished. In patients with ACS associated with LAD damage and sharpLy reduced HRV a significant risk increasing on the GRACE and CRUSADE scaLes was reveaLed.

Conclusions. The aged patients with ACS with ST-segment eLevation undergoing the coronary stenting had a statisticaLLy significant predominance of the influence of the parasympathetic division of the autonomic nervous system and a HRV decreasing. In the eLderLy patients with ACS without ST-segment eLevation a significant predominance of humoraL metaboLic and sympathetic mechanisms activity of HRV reguLation was noted. Low HRV associated with LAD damage in the aged patients undergoing PTCA and coronary stenting are associated with a high risk of the potentiaL compLications during the in-hospitaL period.

Keywords:heart rate variability, coronary artery stenting, elderly

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