3.3. Ischemic heart disease

Ischemic heart disease (IHD) is the most common disease in the large group of all cardiovascular diseases. The prevalence of ischemic heart disease in patients with a transplanted kidney is five times higher than in the general population. The main cause of ischemic heart disease is atherosclerosis of the coronary arteries, and in patients with transplanted kidney there are many risk factors that contribute to atherosclerosis: elevated arterial blood pressure, lipid metabolism disorder, microinflammation, hyperhomocysteinemia, oxidative stress and secondary hyperparathyroidism.

In patients with a transplanted kidney, there is a high risk of sudden cardiac death. The main causes are coronary arterial heart disease, left ventricular hypertrophy, and reduced coronary perfusion. In patients with a transplanted kidney, the prevalence of coronary heart disease is five times higher than the general population [6].

In all patients with ischemic heart disease, the following should be done: detailed anamnesis and physical examination, ECG at rest, blood biochemical analysis (lipids, glucose, creatinine, urea, hepatogram, complete blood count, uric acid, fibrinogen, hsCRP, etc.) echocardiographic examination, ergometric testing. In patients with transplanted kidney, the risk factors for the development of atherosclerosis should be controlled in the primary prevention and prevention of coronary artery disease development. In clinical practice, patients with acute myocardial infarction with elevation of ST connectors are using modern reperfusion therapy (thrombolysis or percutaneous coronary intervention). Medical treatment implies the use of anti-aging therapy, statins and beta blockers.
