Indicators of the SECOND MANIFESTATION OF ARTERIAL DISEASE scale on the background of chemotherapy
for malignant neoplasms in patients with chronic heart failure 

Andrey S. Ankudinov, Doctor of medical sciences, associate professor, professor of the sub-department of simulation technologies and emergency medical care, Irkutsk
State Medical University (2 Krasnogo Vosstaniya street, Irkutsk, Russia), andruhin.box@ya.ru
Jargalma T.-B. Galsanova, Therapist, City polyclinic No. 6 of the Ministry of Health of the Republic of Buryatia (1a Moskovskaya street, Ulan-Ude, Russia), dr.galsanova@mail.ru
Albina L.-N. Zhamyandabayeva, Head of the department No. 3, therapist, City polyclinic No. 6 of the Ministry of Health of the Republic of Buryatia (1a Moskovskaya street, Ulan-Ude, Russia), alinaarsalan@gmail.com

Background. Assessment of the parameters of the course of cardiovascular dis eases against the background of chemotherapy for malignant neoplasms in patients with diseases such as coronary heart disease (CHD) and chronic heart failure (CHF) is an urgent task. The cardiotoxic effects of chemotherapy should be evaluated in a timely manner in order to prevent the progression of the underlying cardiac pathology. The aim of the study was to analyze the parameters of the lipidogram of patients with CHF undergoing chemo therapy for cancer, with patients with CHF without cancer, as well as to assess the 10–year risk of death using the Second manifestation of arterial disease (SMART) scale. Materials and methods. 41 patients participated in the study. Of these, 21 patients with CHF devel oped on the background of coronary heart disease and hypertension with malignant neo plasms of the larynx (14%), intestines (14%), mammary glands (22%), uterus (11%), brain (19%), lungs (5%), prostate (15%). 20 patients are a group of patients with CHF without oncological pathology. The nature of therapy for CHF had no statistically signif icant differences. The lipid spectrum was analyzed in patients with oncological pathology on the background of chemotherapy and concomitant CHF. A regression analysis of the parameters of the lipidogram and chemotherapy was performed. Statistical processing of the material was carried out using the Statistica 12 program. Results. Statistically signifi cant differences in total cholesterol levels were revealed, with values prevailing in the study group: 5.37 (4.66; 6.14) and 4.76 (3.76; 5.5) (p=0.011) mmol/L. In the group of pa tients with CHF and oncological pathology, a significant increase in the level of low density lipoprotein cholesterol was found compared with patients without oncology: 2.6 (2.4; 2.9) and 2.04 (1.85; 2.96) mmol/l (p=0.0365), respectively. Statistically significant differences in the levels of C–reactive protein (CRP) was also revealed: 18.45 (12.3; 23.6) and 2.29 (1.11; 4.45) mg/l (p=0.001), which was investigated as a marker of sys temic inflammation. The indicators of the 10-year risk of death in the studied groups had statistically significant differences: 17.6% in the group with CHF and cancer and 9.4% in the group with CHF without cancer (p=0.001). In the group of patients with CHF and on cological pathology, a statistically significant regression was found between chemothera py and CRP levels with a deterioration in lipidogram parameters (R=0.43; R2=0.2; beta=0.003; F=4.4). The p value for the model is 0.048. Conclusions. Statistically significant differences in lipidogram parameters, as well as the risk of mortality according to the SMART scale in the study group require more careful monitoring of the lipidogram. It is possible to prescribe higher dosages of statins for the duration of chemotherapy, fol lowed by dynamic monitoring.

malignant neoplasm, lipidogram, SMART, chronic heart failure, chemotherapy

Ankudinov A.S., Galsanova Zh. T.-B., Zhamyandabayeva A. L.-N. Indicators of the SECOND MANIFESTATION OF ARTERIAL DISEASE scale on the background of chemotherapy for malignant neoplasms in patients with chronic heart failure. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2025;(2):99 109. (In Russ.). doi: 10.21685/2072-3032-2025-2-9