Prediction of adverse cardiovascular events in the post-infarction period, taking into account treatment compliance

Кужелева, Е. А.; Fedyunina, V. A.; Alexandrenko, Victoria A.; Kondratiev, M. Y.; Аптекарь, В. Д.; Гарганеева, А. А.

doi:10.32364/2587-6821-2020-4-7-431-436

Cited by 3 publications

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“…The data presented indicate the need for increased attention to patients of older age groups, improvement of measures related to clinical examination to identify, timely correction of risk factors, treatment of concomitant pathologies and secondary prevention of cardiovascular events, especially considering that in 40% of patients before the development of the MI index, a relationship with coronary heart disease had never been observed. The education of patients in this cohort is also of great importance, since it has two objectives: on the one hand, raising patient awareness increases adherence to treatment and improves the effectiveness of secondary prevention; On the other hand, it teaches patients to pay attention to important changes in well-being and seek medical help in a timely manner [ 14 ] . At the same time, attention by medical workers to atypical, including asymptomatic, forms of acute myocardial infarction in people of this age category can help improve survival rates by timely sending patients to institutions specialized doctors.…”

Section: Discussionmentioning

confidence: 99%

Longevity and frailty and their associated factors in the prognosis of coronary heart disease in a Latin American cohort

Dulcey Sarmiento,

Acevedo Peña,

Castillo Goyeneche

et al. 2023

Preprint

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Introduction: to study the characteristics of the anamnestic history, the clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and evaluate their impact on the prognosis of the disease. Material and methods : the study included patients aged 60 years or older, survivors of acute myocardial infarction and registered in the database of the Hospital Universitario de los Andes in Merida , Venezuela (n=410). During the 2013-2018 study, a five-year prospective observation of patients with an assessment of their vital status was conducted. For the statistical processing of the data obtained, the Statistica V10.0 application package (StatSoft Inc.) was used. Results: the analysis showed that 90% of the patients had a history of comorbid pathology. The presence of an atypical manifestation of myocardial infarction lengthened the prehospital stage of medical care for patients who were late in seeking medical attention (120 [49; 311.5] minutes), as well as the longest time until the first medical contact (26.5 [20; 40] minutes (p = 0.005)). One-fifth of patients were treated for acute MI in complementary hospitals, where the level of in-hospital mortality among elderly patients reached 65.7%, three times higher than the same figure in specialized cardiology departments (19, 7%, p< 0.001). Conclusion: The main factors influencing long-term post-infarction in elderly patients were isolated systolic arterial hypertension, diabetes mellitus, renal dysfunction, previous myocardial infarction and acute stroke.

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Section: Discussionmentioning

confidence: 99%

Longevity and frailty and their associated factors in the prognosis of coronary heart disease in a Latin American cohort

Dulcey Sarmiento,

Acevedo Peña,

Castillo Goyeneche

et al. 2023

Preprint

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Prospective 5-year follow-up of patients with acute coronary syndrome and percutaneous coronary intervention

et al. 2022

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Background. The study of predictors that negatively affect the long-term prognosis of patients with an increased risk of coronary syndrome can improve the effectiveness of measures for the secondary prevention of cardiovascular events. Aim. To determine the factors that have a negative impact on 5-year survival in patients with acute coronary syndrome and percutaneous coronary intervention. Material and methods. 135 patients with acute coronary syndrome enrolled in the Register of percutaneous coronary interventions in 20122013 at the Tyumen Cardiology Center, a branch of the Tomsk Research Institute of Cardiology of the Russian Academy of Sciences, were included in the study. After 12 and 60 months, the clinical status of patients and ongoing drug therapy were evaluated, and an examination including echocardiography with an ultrasound scanner, daily monitoring of the electrocardiogram and standard blood pressure measuring was performed. Laboratory studies included general and biochemical blood tests. To calculate the factors associated with poor prognosis, a Cox proportional hazards regression model with stepwise inclusion was used. Survival was assessed by the KaplanMeier method using the Log-rank test (logarithmic test). Results. After 1 year, only three-quarters of patients continued the recommended drug therapy, a similar trend continued after 5 years of follow-up. The number of patients without any antiplatelet therapy increased from 19.9% after 12 months to 29.7% after 60 months. Overall survival after 1 year was 97.1%, after 5 years 86.7%. The risk of death increased in the presence of chronic kidney disease (risk ratio 15.1; 95% confidence interval 4.3052.93; p=0.001); type 2 diabetes mellitus (risk ratio 3.67; 95% confidence interval 1.1811.43; p=0.025), history of stroke (risk ratio 9.07; 95% confidence interval 1.8544.60; p=0.007), in patients with a heart rate 80 beats per minute [risk ratio 4.3; (95% confidence interval 1.5112.26; p=0.006) and at pulse pressure 60 mm Hg (risk ratio 4.68; 95% confidence interval 1.6013.72; p=0.005)]. Conclusion. The predictors that influenced the 5-year survival of patients after acute coronary syndrome and percutaneous coronary intervention were chronic kidney disease, diabetes mellitus, a history of stroke, high pulse pressure, and increased heart rate of more than 80 beats per minute.

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Clinical and anamnestic features and the nature of medical care for patients of older age groups as factors of unfavorable prognosis of myocardial infarction

Тукиш

Garganeeva

Кужелева

et al. 2022

jour

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Objective: to study the features of the anamnestic background, clinical course, as well as the nature of medical care for elderly patients with acute myocardial infarction (MI) and to assess their impact on the prognosis of the disease. Material and methods: the study included patients 60 years and older who survived acute MI and registered in the «Register of Acute Myocardial Infarction»(Tomsk) (n=410). The study conducted a 5-year prospective follow-up of patients with an assessment of their vital status. The Statistica V10.0 application software package («StatSoft Inc.») was used for statistical processing of the data obtained. Results: the analysis showed that 90% of patients had a history of comorbid pathology. In almost 20% of patients, the onset of the disease was characterized by an atypical clinical picture, which in more than a third of cases was represented by a low-symptomatic form. The presence of atypical MI manifestation lengthened the prehospital stage of medical care due to the late treatment of patients for medical help (120 [49; 311.5] minutes), as well as longer time before the first medical contact (26.5 [20;40] minutes (p=0.005)). A fifth of patients were treated for acute MI in non-core hospitals, where the hospital mortality rate among elderly patients reached 65.7%, which was 3 times higher than the same indicator in specialized cardiology departments (19.7%, p<0.001). Conclusion: the main factors affecting the long-term postinfarction period in elderly patients were: isolated systolic arterial hypertension, diabetes mellitus, impaired renal function, a history of myocardial infarction and acute cerebrovascular accident.

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Prediction of adverse cardiovascular events in the post-infarction period, taking into account treatment compliance

Cited by 3 publications

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Longevity and frailty and their associated factors in the prognosis of coronary heart disease in a Latin American cohort

Longevity and frailty and their associated factors in the prognosis of coronary heart disease in a Latin American cohort

Prospective 5-year follow-up of patients with acute coronary syndrome and percutaneous coronary intervention

Clinical and anamnestic features and the nature of medical care for patients of older age groups as factors of unfavorable prognosis of myocardial infarction

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