V. Denesyuk, O. Barska, O. Bilonko, N. Muzyka
National Pirogov Memorial Medical University, Vinnytsya
Introduction. More than 15 million cases of acute myocardial infarction (MI) are registered annually in the world, and in Ukraine during 2017 this number corresponded to 41,786 cases. Undoubtedly, acute coronary syndrome (ACS) is accompanied with various complications of blood flow. However, in such patients significantly far less attention is payed to study the predictors of other complications of the cardiovascular system.
The aim of the study. To complete a review of literature supplemented with own results concerning the predictors of adverse cardiovascular events and other complications of the blood circulatory system in case of acute coronary syndrome.
Materials and methods. The survey of literature included 49 recently published articles, which were supplemented with the results of our own research results regarding the predictors of adverse cardiovascular events and other complications of blood circulatory system accompanuing the ongoing ACS. Obtained results are presented in a complex algorithm including our own criteria for prediction of sudden cardiac death and other adverse cardiovascular events.
Results. It was revealed that an increase in the thickness of the left ventricle wall in patients with hypertension can be associated with almost 7-fold increase in the risk of sudden cardiac death. In our opinion, left ventricular hypertrophy in ST elevation MI in combination with hypertension has negative impact on the development of cardiovascular events. Pathological remodeling of the left ventricle leads to further dilatation, deformation of the wall sand cavities of the heart, a progressive decrease in the inotropic function of the left ventricle with further development of congestive heart failure. Some authors suggest prognostic predictors of the development of acute left ventricular failure. The prognostic role of endothelial dysfunction in cardiovascular events is poorly understood.
In recent years, predictors of the development of cardiovascular events (death, non-fatal MI, stroke, UA), as well as such complications of the blood flow system as acute left ventricular failure, progression of heart failure, development of ventricular extrasystoly of 3-5 grades according to B. Lown have been established in patients with a transferred MI with ST elevation and unstable angina in recent years, severe heart blocks with the occurrence of syncopal conditions.
Conclusions. According to our data, clinical, electrocardiographic, and echocardiographic diagnostic criteria are predictors of cardiovascular events. The specified predictors of cardiovascular events and various complications of the blood flow system after a myocardial infarction with ST elevation and unstable angina need to be taken into account by cardiologists, emergency physicians, and family physicians in the practice and to carry out therapeutic measures aimed at preventing their occurrence in patients.
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