Possibilities of predicting adverse cardiovascular events based on the analysis of clinical and instrumental research methods, as well as sST2 in patients after myocardial infarction

OBJECTIVE

Aim: To determine the possibility of predicting adverse cardiovascular events based on the analysis of clinical and instrumental research methods, as well as sST2 in patients after myocardial infarction.

PATIENTS AND METHODS

Materials and Methods: The study included 64 patients who suffered an acute myocardial infarction and underwent PCI with balloon angioplasty and stenting of the infarct-related vessel in the acute period. The predictors of adverse cardiovascular events were assessed events during 1 year of observation. Indicators of echocardiography and coronary angiography were assessed and concentrations sST2.

RESULTS

Results: A worse prognosis was associated with intermediate ejection fraction (EF) (odds ratio (OR)=3.981, p<0.05), left aneurysm ventricle (LV) (OR=29.5, p<0.05), high concentrations of sST2 (OR=1.017, p<0.05) and scores on the Syntax scale (OR=1.001, p<0.05).

CONCLUSION

Conclusions: In patients who underwent percutaneous coronary intervention for myocardial infarction, adverse outcome during the next 2 years is associated with coronary and echocardiographic parameters, as well as biochemical indicators of myocardial stress and fibrosis. HF patients with intermediate EF, LV aneurysm, high sST2 concentrations, and high Syntax scores have the worst prognosis.

THE ROLE OF BIOCHEMICAL MARKERS AND PATIENT-REPORTED OUTCOMES IN PREDICTING COMPOSITE ONE-YEAR ENDPOINT IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

OBJECTIVE

Aim of our study was to determine the role of the clinical and biochemical markers in predicting the outcomes at one year in patients with STEMI who have undergone primary PCI.

PATIENTS AND METHODS

Materials and methods: The study included 165 patients admitted with STEMI within 12 hours of the onset of symptoms be¬tween January 2020 and August 2021. All patients underwent primary PCI according to the guidelines, followed by standard examination and treatment at the hospital. Blood samples for biomarker analysis (MMP-9, cTnI) and other routine tests were taken on admission. At six months after the event, all patients underwent clinical follow-up. Patients were contacted either by phone, through family members or their physicians 1 year after the event.

RESULTS

Results: The composite endpoint reached 9% of patients at one-year follow-up. ROC analysis of MMP-9 with the one-year com¬posite endpoint showed an AUC=0.711, with 91.7% sensitivity, and 47.4% specificity, 95% CI - 0.604 to 0.802, p=0.0037. ROC analysis of EQ-5D questionnaire with the one-year composite endpoint showed AUC = 0.73, the 95% CI - 0.624 to 0.820, p< 0.0195, with sensitivity 54.5% and specificity 94.7%. A logistic regression model showed a statistical association with the com¬posite endpoint at one year after STEMI in both EQ-5D (OR=0.89, 95% CI: 0.8313- 0.9725, p=0.0079) and MMP-9 (OR=1.0151, 95% CI:1.0001-1.0304, p=0.0481).

CONCLUSION

Conclusions: The level of MMP-9 more than 194 ng/ml and <55 points in EQ-5D predicts major adverse cardiovascular events, in¬cluding cardiovascular mortality and progressive heart failure, as well as other elements of composite endpoints, during a 1-year follow-up in patients with STEMI after primary PCI. Future studies are needed to clarify this result.

REHABILITATION IN PATIENTS AFTER MYOCARDIAL INFARCTION: CLINICAL AND SOCIAL ASPECTS

OBJECTIVE

The aim: To assess the effects of cardiac rehabilitation on the health of myocardial infarction patients, the risk of a relapse and the possibility of restoring full physical fitness.

PATIENTS AND METHODS

Materials and methods: The study was conducted in a group of 40 patients after myocardial infarction treated at the Cardiac Rehabilitation Department. The subjective and objective condition of the patients was assessed. Study patients underwent physical therapy and rehabilitation over a period of 3 weeks.

RESULTS

Results: The physical therapy and rehabilitation programme conducted in study patients resulted in an improved physical function and a weight reduction. The cholesterol and blood pressure levels were both decreased. Study patients expressed a very favourable opinion about the effects of physical therapy and rehabilitation.

CONCLUSION

Conclusions: 1. Myocardial infarction is a clinical and social problem. 2.Physical therapy after myocardial infarction is one of the main elements of treatment of this disorder. 3. Physical therapy should be used more widely in coronary heart disease prevention.

Epidemiology of diseases of the circulatory system among the population of Poltava region

OBJECTIVE

Introduction: In Ukraine more than half of deaths have been caused by cardio-vascular diseases (CVD). Among the able-bodied population, the share of CVD in the structure of causes of mortality is 29,9%. In the structure of causes of mortality among the persons of retirement age, CVDs accounted for 75,9% and exceeded the proportion of neoplasms in 6,5 times. The aim is to analyze of morbidity and mortality rates of diseases of the CVD among the population of Ukraine and Poltava region, to conduct a comparative analysis of data to identify possible ways to improve the situation.

PATIENTS AND METHODS

Materials and methods: A retrospective study of morbidity and mortality rates by age, gender and cause (2014-2018) was conducted and the statistical method was used to analyze dynamic (time) series.

RESULTS

Review: An analysis of the dynamics of population mortality indicates significant fluctuations in it`s levels over ten years. At the same time, by the method of alignment of the dynamic series, a tendency to a slight decrease in the mortality rate of the population from 17,1‰ to 16,9 ‰ was established. The mortality of the population of Ukraine in 2018 from diseases of the circulatory system was 1000,8 per 100 thousand people. Data on mortality rate in the Poltava region significantly higher than those in Ukraine.

CONCLUSION

Conclusions: The age structure of the population of Poltava region belongs to the regressive type. The mortality rate among the population of Poltava region is slightly decreasing but remains at a very high level (16,9 ‰). In the structure of causes of death, diseases of the circulatory system are at the first place (70,8%), the second place belongs to neoplasm (13,5%), and third are the external causes of death (4,8%).