The immune system is essential for maintaining the homeostasis. At present, there is convincing evidence for participation of the immune system in the pathogenesis of cardiovascular pathology, including the final step of cardiovascular continuum, heart failure. Objective difficulties in understanding subtle processes of loss of the normal cardiac structure and function are based on the diversity of pathogenetic factors of development and progression of chronic heart failure (CHF) and the involvement of most organs and body systems. Russian and international scientists actively study issues of immune homeostasis, including the efficacy of current immune therapy. At the same time, available reports are largely uncompiled and reflect isolated parts of the immunopathogenesis of cardiovascular diseases. This review focuses on comprehensive elucidation of major patterns of immune processes in the CHF pathogenesis to form an integral view of the problem under study.

Aim: to develop a graphic risk meter scale concerning major adverse cardiovascular events (MCVEs) during the 5-year post-infarction period, taking into account patients’ compliance to the treatment.Patients and Methods: the analyze was conducted on the data from a prospective five-year follow-up of patients (n=115) who experienced a myocardial infarction (MI) and were registered in the database of the Registry of Acute Myocardial Infarction (Tomsk). The following endpoints were analyzed: repeated MI, hospitalization for exacerbation of coronary heart disease, advanced chronic heart failure (CHF), and cardiac arrhythmias.Results: the study identified a set of factors that had a significant impact on the clinical course of the post-infarction period. CHF (diagnosed before the development of index MI) increased the chances of adverse course of post-infarction period in 9.5 times. The lack of achievement of systolic blood pressure target values increased the risk of cardiovascular complications in 5 times. The patients’ age of 75 years and older increased the possibility of an adverse postinfarction period course in 8.5 times. The predictor that favorably affected the post-infarction period course was an integral indicator equal to the product of the specific weight of vital drugs (in the general structure of prescriptions) and the treatment compliance degree. This indicator reduced the risk of MCVEs by 61% for each unit value, i.e. with the highest possible compliance to therapy that meets the recommendations; an adverse course risk of the post-infarction period decreased by 2.5 times.Conclusion: the results emphasize the importance of compliance with medical recommendations by patients who have experienced MI. The proposed graphic risk meter scale can be used to predict the development of adverse MCVEs during the 5-year post-infarction period. KEYWORDS: coronary heart disease, myocardial infarction, cardiovascular risk, treatment compliance, Morisky-Green test, disease prognosis.FOR CITATION: Kuzheleva E.A., Fedyunina V.A., Alexandrenko V.A. et al. Prediction of adverse cardiovascular events in the post-infarction period, taking into account treatment compliance. Russian Medical Inquiry. 2020;4(7):431–436. DOI: 10.32364/2587-6821-2020-4-7-431-436.

Aim: to analyze an adherence to treatment, factors affecting it, and the quality of life of patients with cardiovascular diseases at the outpatient stage of medical care.Material and methods. The population of the study was 225 people. The Moriski-green compliance scale was used to analyze patients’ adherence to treatment, and the EuroQol EQ-5D-5L international questionnaire was used to assess the quality of life of patients. Statistical data processing was performed using the program STATISTICA 10.0.Results. The percentage of committed to treating patients who sought outpatient care was 59%. The main reason for poor adherence was forgetfulness – 25,27 %. It is patient’s opinion, in 73.8% of cases, communication with a doctor plays an important role in improving their compliance. The total index of quality of life (QOL) of patients with cardiovascular diseases (CVD) was 0.712 ± 0.165. In estimating the relationship between quality of life and adherence to treatment, a positive correlation was found: the more compliant the patient, the higher their quality of life, and vice versa (r=0.2, p=0.013). The relationship between high adherence to treatment and quality of life was confirmed in the group of men (p=0.01), while the statistical significance of differences was not achieved in women (p=0.2). In examining the aspect of a disease of chronic heart failure (CHF), the worsening of NYHA functional class (from I to II) was accompanied by a sharp decrease in self-esteem of health for both sexes (p=0.01).Conclusion. Almost every second patient is against of the rules of the medication regimen. Better adherence to treatment can be facilitated by more careful attention from the attending physician with a detailed explanation of the causes and the aspect of the disease, treatment methods, as well as ways to self-control the symptoms of the disease. The degree of treatment adherence is correlated with the level of quality of life on the EQ-5D-5L scale, mainly in the male population.