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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.

The purpose:to follow-up the pathological changes in the cardiac  muscle using contrast-enhanced MRI (in comparison with  endomyocardial biopsy), in patients with chronic heart failure due to dilated cardiomyopathy.Materials and methods.This study comprised 29 pa tients (as  51.1 ± 11.03 years old). Everybody underwent cardiac contrast- enhanced MRI, at admission and in 6 month, the endomyocardial  biopsy was carried out in 19 patients.Results.Myocarditis with different degrees of activity was revealed  in 14 patients, from the results of a histological examination of the  cardiac muscle. The patients were assembled to two groups,  depending on the severity of the inflammatory changes; the data were compared with the results of the endomyocardial biopsy. In the group of patients with a moderate degree of activity of the  inflammatory process, myocardial fibrosis prevailed, in the group of patients with pronounced activity it was oedema, with a relatively  smaller volume of myocardial fibrosis. In six months of monitoring,  the number of pathologically altered segments of the myocardium  increased (from 2.7 ± 1.7 to 3.05 ± 1.7) and the thickness of the  paramagnetic contrast uptake to the cardiac muscle also increased (from 4.4 ± 1.4 to 4.8 ± 1.9 mm), despite the specific therapy kept carried out this time. Conclusion.The development of dilated cardiomyopathy and  chronic heart failure, in a significant number of cases causes of  inflammatory changes in the myocardium, followed by manifestation  of dilated cardiomyopathy, and the progression of fibrotic changes in  the myocardium was observed even after elimination of the causative agent.