To the question of the main of acute urinary retention development during myocardial infarction in young and middle-aged men predictors

BACKGROUND: Importance in assessing the course and prognosis of myocardial infarction is given to the study of a combination of two or more chronic diseases in one patient, interconnected by a single pathogenetic mechanism. Urological diseases are not among the most common in myocardial infarction, but during this period they significantly worsen the quality of life, increase the cost of treatment and are also associated with a worse prognosis.

AIM: To study the development of acute urinary retention during the acute and subacute periods of myocardial infarction risk factors in men under 60 years old to improve prevention and outcomes.

MATERIALS AND METHODS: The study included men aged 19–60 years with type I myocardial infarction. Patients were divided into two age-comparable groups: I — study group, with acute urinary retention — 22 patients; II — control, without urination disorders — 644 patients. A comparative analysis of the main and additional cardiovascular risk factors observation frequency, the features of the clinical course in the selected groups were performed. Pearson’s Chi-square method was used to analyze the risks of developing acute urinary retention.

RESULTS: The structure of cardiovascular risk factors in the study group differed from the control group in a higher frequency of coronary artery bypass surgery in the medical history (I: 31.8%; II: 8.4%; p = 0.0002) and pacing (9.1 and 0.5%; respectively; p < 0.0001), as well as fibrillation and/or atrial flutter in the medical history (27.3 and 9.2%; p = 0.005), chronic cerebrovascular insufficiency (77.3 and 51.3%; p = 0.02), alcohol abuse (63.6 and 25.2%; p < 0.0001), frequent (four and more per year) colds (27.3 and 12.6%; p = 0.04), cardiac arrhythmias and conduction disorders at the onset of coronary artery disease (61.9 and 24.9%; p = 0.0007), smoking for 20 years or more (36.4 and 16.8%; p = 0.003), chronic kidney disease (46.7 and 16.2%; p = 0.02), chronic infection foci of internal organs (77.3 and 39.4%; p = 0.002), urinary (27.3 and 8.6%; p = 0.006) and cholelithiasis (13.6 and 5.4%; p = 0.006). Among the features of the clinical course of the disease, the study group was distinguished by a higher incidence of multiple complications of myocardial infarction (100 and 44.0%; p < 0.0001), severe and extremely severe condition of patients (59.0 and 19.6%; p < 0.0001). Asystole (absolute risk: 42.1%; relative: 18.0; p < 0.0001), hydrothorax (absolute risk: 41.7%; relative: 15.9; p < 0.0001), the patient’s severe condition in the first hours of illness (absolute risk: 100%; relative: 36.5; p < 0.0001), alcohol abuse (8.0%; 4.9; p < 0.0001), smoking (absolute risk: 4.4%; relative: 8.0; p = 0.01) and onset of CHD with heart rhythm and conduction disturbances (7.7%; 4.6; p = 0.0001) were the most significant predictors of acute urinary retention.

CONCLUSIONS: Patients with acute urinary retention are characterized by a more severe course of myocardial infarction. Combinations of listed above factors indicate an increased risk of developing this complication. It is advisable to use them for predictive modeling and the formation of risk groups for early prevention.