THE RELATIONSHIP BETWEEN MAGNESIUM LEVELS AND THE SEVERITY OF CONNECTIVE TISSUE DYSPLASIA IN PATIENTS WITH ACUTE CORONARY SYNDROME

Sultanova Oksana Esedullayevna, Chernysheva Elena Nikolaevna, Aliyeva Madina Aliaskhabovna, Mutausova Dagman Omarovna, Dzhabrailova Marietta Arifovna, Murtazaeva Amina Zakirovna, Batralieva A.

Study Objective: To investigate the relationship between magnesium (Mg) levels, hydroxyproline (HP) levels, the severity of undifferentiated connective tissue dysplasia syndrome (UCTDS), and depressive disorders in patients with acute coronary syndrome (ACS). Materials and Methods: We examined 367 patients (35-65 years old), who were divided into the following groups: ACS with UCTDS (n=156), ACS without UCTDS (n=202), and a control group (n=50). All patients underwent clinical and laboratory blood tests; biochemical blood tests; assessment of mineral content (Mg, K, Ca); myocardial necrosis markers; and coagulation tests. Instrumental investigations were also performed, including: 12-lead standard ECG, Holter monitoring of heart rhythm, echocardiography, and selective coronary angiography. The diagnosis of UCTDS was based on clinical guidelines: the clinical part – a questionnaire according to Yelykomov V.A. and Kopylov A.N. (detection of 6 or more stigmata of disembryogenesis); the laboratory part – determination of the level of human antibodies to collagen types II and III by ELISA (hydroxyproline (HP)). The Zung Self-Rating Depression Scale (adapted by T.I. Balashova) [72] was used for the differential diagnosis of depressive states. Statistical analysis of the results was carried out on IBM using STATISTICA 28.0 and StatTech v.3.1.8 statistical programs. Results: The prevalence of UCTDS in patients with ACS was found to be 42%. Hypomagnesemia was detected in 91% of patients with ACS and UCTDS, which is significantly higher than in the ACS without UCTDS group (52%). Mg levels were inversely proportional to the severity of UCTDS, especially in the ACS with UCTDS group. The prevalence of depression in patients with ACS and UCTDS was 72%, in the group of patients with ACS – 39%, and in the comparison group 37%. Conclusion: Hypomagnesemia is a common occurrence in patients with ACS and UCTDS, and its severity is related to the severity of UCTDS. UCTDS may contribute to the earlier development of cardiovascular diseases. The study also showed that UCTDS is more common in patients with ACS (42% versus 25% in the general population) and is associated with earlier development of ACS (mean age 48.1 years versus 54.0 years). In patients with ACS and UCTDS, the prevalence of hypomagnesemia reaches 91%, and Mg levels decrease with increasing severity of UCTDS. A psychological feature of patients with UCTDS and ACS is the high prevalence of depression. The data obtained indicate the importance of assessing Mg levels in patients with ACS and UCTDS for timely correction of the deficiency and improvement of prognosis. A decrease in magnesium levels can trigger the occurrence of depressive states, which worsen the prognosis and increase the number of complications in patients with ACS against the background of UCTDS.

Keywords:acute coronary syndrome, undifferentiated connective tissue dysplasia, magnesium level, structural and functional parameters of the heart, hydroxyproline, depressive disorders