Adverse cardiovascular events in patients with vibration sickness

Introduction. The interrelationships of vibration sickness (VS) and prognostically unfavorable acute cardiovascular events have not been studied sufficiently. The study aims to determine the frequency and phenotype of adverse cardiovascular events in patients with vibration disease in comparison with people working in vibration conditions, without occupational diseases and in dynamics over 10 years. Materials and methods. Study design: a retrospective, observational, single-center study. Vibration induced disease patients (n=1505) and workers exposed to vibration above occupational exposure limits without occupational diseases (n=1505) were included. The authors have obtained the data from the registry of the Center for Occupational Pathology and the medical information system. The endpoints were cases of myocardial infarction and unstable angina. Using the pseudorandomization method, the scientists compared the groups by gender, age, and type of production vibration. They determined the relative risk (RR) and 95% confidence interval (CI) of the event under study. To assess the 10-year dynamics of adverse cardiovascular events in the main group, the experts calculated moving averages of morbidity with an interval of two years. The significance level is p<0.05. Results. Patients with vibration sickness had a higher incidence of all endpoints, relative risk (95% CI) 2.18 (1.79–2.65), acute myocardial infarction, RR 3.00 (2.13–4.22), with ST segment elevation, RR 4.73 (2.72–8.22) and without ST segment elevation, RR 2.04 (1.29–3.21), unstable angina, RR 1.78 (1.38–2.29). In the subgroups of myocardial infarction in patients with vibration disease, scientists noted an increase in the proportion of multivessel damage, RR 1.63 (1.09–2.43), as well as myocardial infarction without coronary artery obstruction (MICAO), RR 2.67 (1.002–7.10), MICAO and unstable angina in combination with signs of ischemia according to the results of stress tests or myocardial scintigraphy. The authors observed the maximum increase in the relative risk and the number of associated acute forms of coronary heart disease in patients with vibration syndrome from exposure to local or combined vibration. The relative risk increased with the second degree of severity of the disease. During the 10-year follow-up period, the incidence of acute forms of coronary heart disease in the VS group increased: 1.6 times regardless of the nosological form, 1.9 times — acute myocardial infarction with ST segment elevation, 1.6 times — without ST segment elevation, and 1.5 times — unstable angina. Conclusion. Vibration sickness is associated with an increased frequency of adverse cardiovascular events and is a promising risk factor. Ethics. The study was conducted in compliance with the ethical principles set out in the Helsinki Declaration of the World Medical Association and in accordance with the Ethical standards and regulations stipulated in the Bulletin of the Higher Attestation Commission of the Ministry of Education, Russian Federation, No. 3 of 2002. The study was approved by the Ethics Committee of the Federal State Budgetary Educational Institution of Higher Medical Education of the Ministry of Health, Russian Federation, Protocol No. 161 dated 10/14/2024.