Introduction. The problem of cardiovascular morbidity and mortality remains an urgent issue of modern medicine, and arterial stiffness is its independent predictor. Lively discussions about the correct approach to the prevention and treatment of comorbid conditions – increased vascular stiffness as an influential factor of the cardiovascular events and decreased bone mineral density (osteoporosis), primarily arise against the background of the need and safety of calcium and vitamin D supplements. The purpose was to search for literature data as for possible common pathogenetic links in the progression of arterial stiffness and the development of osteoporosis in order to assess the safety of the use of drugs to prevent osteoporotic fractures. Results. Analysis of literature sourses had showed that possible osteogenic factors affecting arterial stiffness may be: secondary hyperparathyroidism, disbalance of the RANK/RANKL/OPG system, inhibition of vitamin K-dependent matrix proteins (Gla-protein), osteopontin, etc. Conclusions. Today, there are many hypotheses confirming the possible influence of osteogenic factors on vascular stiffness and arterial calcification. Therefore, the search for sensitive markers and the development of screening protocols for the patients with risk factors for both osteoporosis and vascular changes are extremely relevant. A special issue is the possibility of using monotherapy for these comorbid pathologies, which can safely and efficiently influence the prevention of complications – both low-energy osteoporotic fractures and cardiovascular catastrophes. This will be the focus of our further research.
Aim of the study is to determine the features of the clinical course and study the state of erectile function in young men who have suffered MI. 112 male patients of Caucasian race of the Ukrainian population under the age of 50 (mean 43.21±2.8 years) who have had MI were examined. Clinical and anamnestic data indicate the similarity of young men who have suffered MI with their peers. Yes, there are no significant differences in the percentage of smokers, burdened family history. Analysis of erectile dysfunction, according to the IIEF-5 questionnaire, indicates the presence of problems in young men who have suffered MI. All examined patients were admitted to the hospital within 12 hours from the first symptoms of MI, which allowed to perform urgent coronary angiography with subsequent endovascular intervention - stenting. According to the cardiac ventriculography, about half of the patients (50 - 44.6%) had a three-vessel disease despite the young age. One third of patients received as a beta-blocker the new class of drug of the 3rd generation - nebivalol (37 patients - 33.0%), which is important for young patients, as this drug has no adverse effects on erectile function in men. 44 (39.3%) received bisoprolol, a more common long-term beta-blocker. 31 patients had contraindications to beta-blockers. Conclusions. Myocardial infarction in young men was characterized by a high frequency of anginal form of the clinical course, multivessel disease of the coronary arteries, lipid profile disorders, a high proportion of patients with erectile dysfunction. Erectile dysfunction in young men is an early marker of coronary heart disease. All men with ED should undergo a thorough cardiac examination to determine lipid profile and testosterone levels. In patients with coronary heart disease, the symptoms of ED should be actively identified, initiate targeted lifestyle changes to reduce risks, as well as taken into account when choosing drugs for medical treatment.
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