Трудности Диагностики Инфаркта Миокарда При Атипичной Грудной Боли

Шевченко, Н. В.; Кузнецов, С. М.; Дармаев, А. Д.; Borisenko, A. V.; Онищук, Ю. В.; Таргашина, Т. Б.; Кудрин, В. Б.; Дунгуров, О. Ц.; Грязнов, М. А.; Штуккерт, В. В.; Цыремпилов, Б. Б.; Румянцева, А. В.; Сморкалова, Н. В.; Семенова, Я. Р.; Суфианова, Е. О.; Струнова-Лескова, В. В.

doi:10.18101/2306-1995-2021-1-9-19

Cited by 2 publications

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“…при этом атипичная клиническая картина им ассоциируется с повышением уровня догоспитальной и госпитальной летальности пациентов [6]. это обусловлено не только клинико-анамнестическими особенностями больных, но и объективными сложностями своевременной диагностики инфаркта миокарда [5,[7][8][9][10]. при этом изучение частоты и особенностей клинического течения атипичного им является крайне сложной задачей ввиду высокой частоты госпитализации таких пациентов в непрофильные стационары и невключения таких больных в клинические исследования [5].…”

Section: Introductionunclassified

Predictors of high risk of atypical clinic of myocardial infarction

Garganeeva¹,

Кужелева²,

Тукиш³

et al. 2022

jour

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Objective: analysis of predictors allowing to predict a high probability of atypical clinical course of myocardial infarction (MI) at an early stage of development of acute coronary insufficiency before complex diagnostic procedures.Materials and methods: the study included patients from the Tomsk population with confirmed MI in the period 2001–2017, registered in the database "Register of Acute Myocardial Infarction" (ROIM) (n=7775). In 79.6% (n=6188), the clinical picture of MI was characterized by typical manifestations in the form of a prolonged angina attack (group 1), in the remaining 20.4%; patients (n=1587) recorded atypical manifestations of MI (group 2).Results: patients with atypical clinical manifestations of MI were more often represented by women, had an older age and a burdened comorbid background. The anamnesis of IM and coronary artery revascularization were more commonly recorded in a cohort of patients with typical clinical manifestations of coronary catastrophe. All parameters that demonstrated significant differences in patients with different types of clinical flow IM were included in the logistic regression model. As a result of a step-by-step procedure for elimination of factors, independent associations with the development of atypical symptoms of acute MI showed the following indicators: female sex, elderly age, IM history, type 2 diabetes mellitus, history of myocardial revascularization, atrial fibrillation, alcohol consumption before MI, obesity, smoking.Conclusion: female gender, elderly age, the presence of atrial fibrillation, diabetes mellitus, obesity and condition after alcohol intoxication predisposes to atypical acute MI, whereas male gender transferred to IM or revascularization, as well as smoking are currently more common in patients with a typical clinical pattern.

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Section: Introductionunclassified

Predictors of high risk of atypical clinic of myocardial infarction

Garganeeva¹,

Кужелева²,

Тукиш³

et al. 2022

jour

View full text Add to dashboard Cite

show abstract

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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Трудности Диагностики Инфаркта Миокарда При Атипичной Грудной Боли

Cited by 2 publications

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Predictors of high risk of atypical clinic of myocardial infarction

Predictors of high risk of atypical clinic of myocardial infarction

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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