FEATURES OF THE PATHOGENESIS OF ACUTE CORONARY SYNDROME IN PATIENTS WITH CONNECTIVE TISSUE DYSPLASIA: THE ROLE OF METABOLIC DISTURBANCES AND PSYCHOEMOTIONAL STATUS

Sultanova Oksana Esedullayevna, Chernysheva Elena Nikolaevna, Beksultanova Asiyat Shamilovna, Savelev Maxim Sergeevich, Gorodovenko Olga Ilinichna, Zarandia Nino Ramazievna, Bukurova Victoria Timurovna

Objective: To investigate the features of the pathogenesis of acute coronary syndrome (ACS) in patients with undifferentiated connective tissue dysplasia syndrome (UCTD) through a comprehensive assessment of clinical, laboratory, and instrumental characteristics. Materials and Methods: The main group included 156 patients with ACS against the background of UCTD. The comparison group consisted of 202 patients with ACS without UCTD. Levels of homocysteine, oxyproline, blood lipids (LDL, HDL, total cholesterol), coronary artery status by coronary angiography, heart structure by echocardiography (ECHO), electrophysiological characteristics by electrocardiogram (ECG), as well as the psychoemotional status of study participants were assessed. UCTD diagnosis was made based on clinical guidelines: clinical part – questionnaire by V.A. Elykomov and A.N. Kopylov (identification of 6 or more dysembryogenesis stigmata); laboratory part – determination of human antibodies to type II and III collagen by ELISA (oxyproline (OP)). Statistical analysis was performed using IBM software with STATISTICA 28.0 and StatTech v.3.1.8. Results: Significant differences were found in homocysteine, oxyproline, LDL, and HDL levels between groups. Patients with UCTD had high homocysteine levels and low HDL, associated with increased thrombosis risk. Patients with ACS showed elevated LDL and low HDL, indicating pronounced dyslipidemia. Associations between ACS severity and depression measures were detected in both cohorts. Conclusion: The findings confirm the need for an individualized approach to managing patients with UCTD and ACS, considering specific metabolic disturbances and concurrent psychosomatic issues. These results may serve as a basis for developing preventive strategies and optimizing treatment for these patient categories.

Keywords:acute coronary syndrome, undifferentiated connective tissue dysplasia syndrome, magnesium, oxyproline, homocysteine, depression