Clinical Status Features of the Patients Hospitalized Concerning the Acute Myocardial Infarctions

Galachenko O. O., Ocheredko O. M., Galachenko V. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

With the purpose of study clinical description the patients with the acute myocardial infarction (MI) and predicted estimation of risks of postinfarction period by the method of cohort design 1122 patients, hospitalized on an occasion MI in the cardiologic department of Vinnitsa clinical hospital, are inspected, in a period from 2006 to 2008. Clinical variables of patients were being measured. Data analysis exploited log-linear modeling. Diagnoses consist of ICD-10 codes І21. 0-І21. 3, І21.4, І21. 9, І22. The most pervasive localization happened to be anterior (33,2 %), posterior (37,4 %), and frontolateral (12,0 %) MI. There are reliable view on depending localization MI from availability of pathologic wave Q (р < 0,0001), which was is present in 76,3 % patients. Cardiac decompensation present in 25,2 % patients. The second stage predominated (14,6 %), while the third and fourth stages made 6,0 % and 4,0 %, accordingly. On the basis of the got results we also set reliable dependence of distributing of examined patients on the stages of cardiac insufficiency and by the presence of pathological Q, %2(4) = 27,6 (p < 0,0001). At Q- positive MI, cardiac insufficiency is fixed at 29 % patients, at Q-negative MI - at 13,2 %. Rhythm disorder with fibrillation and without fibrillation ventricles of the heart had an practically equal campaign particles - 14,6 % and 14,9 %. This dependence consisted in two features: first, at available pathological wave Q of infringement of a rhythm met in 31,5 % of cases, whereas in the absence of Q - only in 23,0 %. Secondly, a part of patients with fibrillation, as well as a parity of the patients who have and not having fatal arrhythmia (9,8/13,2 and 16,1/15,4) were obviously above at Q-MI. 17. 2 % of the surveyed patients had infringements of conductivity in the form of AV-blockade and blockade of the His band legs. At formation of pathological wave Q of infringement of conductivity it was registered in 18,9 %, at non-Q-MI - only in 11,6 %. The difference has appeared authentic, %2(1) = 7,5 р = 0,006. Less widespread snag (thromboembolism, pericarditis, postinfarction syndrome (Dressler's syndrome), aneurysm) were supposed to authentically higher fractions provided it receives pathological wave Q. Acquired heart valvular diseas met in 25,5 % hospital patients and in 77,6 % from them with formation of pathological Q wave. Prevailed mitral incompetence (12,8 %) and sclerotic consolidation of the valve of heart (8,7 %). Among all retrospective research the patients surveyed by us with MI persons at the age of 60-70 years prevailed and is more senior (63,46 %). In structure of those, who smokes, younger pacients at the age of 50-60 years (40,3 %) dominated. The specified distinctions of age structures are authentic (%2(4) smoking*age = 13,82; p = 0,0079). Besides, the share of men among smokers almost is twice more that among persons who do not smoke tobacco (95,0 % against 55,7 %). The particularity of the cohort was high burden of comorbidity with Charlson index above 4 in 13 % of persons. Obviously, it is connected with age structure of patients to what authentic communication between increase in age and higher loading an accompanying pathology testifies, %2(11) age*index = 32,57; p = 0,0006. As a result, short-term (the hospital forecast) with Q-MI authentically is worse than patients in comparison with not-Q-MI. Registered complications MI have higher risk of occurrence and heavier clinical current at wave Q.

acute myocardial infarction, Q-negative myocardial infarction, Q-positive myocardial infarction, complications, forecasting

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