ANALYSIS OF MEDICAL PURPOSES ANDPRICE AVAILABILITY OF THE ASSORTMENT OF BETA-ADRENOBLOCKERS USED FOR THE TREATMENT OF MYOCARDIAL INFARCTION

2021 ◽  
Vol 8 (4) ◽  
pp. 13-20
Author(s):  
A.G. Petrov ◽  
N.V. Abramov ◽  
V.V. Kashtalap ◽  
G.T. Glembotskaya ◽  
I.G. Tantsereva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Cardiovascular Death ◽  
Cardiovascular Complications ◽  
Life Threatening ◽  
Treatment Technologies ◽  
Β Blockers ◽  
Source Of Information

Patients who have had myocardial infarction (MI) represent a group of patients with a very high risk of cardiovascular complications: first of all, recurrent myocardial infarction, chronic heart failure and cardiovascular death. Clinical studies have shown an increase in life expectancy after MI when prescribing selective β-blockers for long-term prophylaxis, especially in the presence of chronic heart failure complicating the course of MI. The main clinical goals of prescribing β-blockers are to improve the supply of oxygen to the myocardium and to prevent the development of life-threatening cardiac arrhythmias. In view of the above, drugs in this group should be used indefinitely in patients with MI [7]. In recent years, the analysis of the affordability of the use of treatment technologies, including for cardiovascular diseases (CVD), has stood out as a serious scientific area with its methodology, scientific tools and is currently an important source of information that helps in making management decisions in healthcare [3.6]. The purpose of this article was to conduct such an analysis in relation to the use of β-blockers in MI in Kuzbass.

ACUTE AND CHRONIC HEART FAILURE AFTER MYOCARDIAL INFARCTION: CLINICAL AND FUNCTIONAL MARKERS

2021 ◽  
pp. 83-90
Author(s):  
Lozhkina N.G. ◽  
Mukaramov I.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Coronary Revascularization ◽  
Cardiovascular Death ◽  
Functional Markers ◽  
History Of ◽  
One Year ◽  
Main Subgroup

Вackground. The last decade has seen an increase in the number of people who have had myocardial infarction (MI). This phenomenon contributes to an increase in the long-term incidence of chronic cardiovascular diseases, including chronic heart failure. Purpose of the study. To identify the most significant clinical and functional indicators characterizing acute and chronic heart failure after myocardial infarction. Patient Characterization and Research Methods. This analysis included 186 patients who had myocardial infarction from January 2019 to January 2020: 86 people, the main subgroup, with signs of CHF above FC 2 (NYHA) (mean age 64.3 g) and 100 people, the comparison subgroup, without signs of CHF or had CHF 1 FC (NYHA) (mean age 62.6 l). After 1 year, clinical outcomes were assessed: cardiovascular death, repeated hospitalizations due to decompensation of CHF, death from other causes, stroke, repeated myocardial infarction, unplanned coronary revascularization. Results. In the acute period of myocardial infarction in the main subgroup (MI + CHF more than 2cl NYHA), all patients had symptoms of acute heart failure (AHF) in the form of Killip II and Killip III. Predictors of the development of chronic heart failure were the presence of a history of ischemic heart disease, confirmed in accordance with the recommendations, before myocardial infarction; decreased fraction of the left ventricle, detected before discharge and on the 30th day of myocardial infarction; the presence of atrial fibrillation (AF). One-year unfavorable outcomes in the main group were significantly more frequent. Subanalysis of long-term drug therapy showed that cardiovascular death was significantly less common in the subgroup of patients taking ARNI than in the subgroup of enalapril. Conclusion. In the present study, we studied postinfarction myocardial remodeling, which is realized in the form of the formation of a syndrome of acute and chronic heart failure. It has been shown that immediate reperfusion and restriction of the necrosis zone, as well as long-term use of drugs that inhibit SAS and RAAS, stimulating NPP, can inhibit the development of AHF and death. The CHF problem requires further fundamental research in order to develop new approaches that can affect more subtle mechanisms, such as the expression of specific genes involved in the disease, in order to reduce the persisting excess mortality for this pathology.

scholarly journals Posthospital Cardiovascular Complications in Patients after Non-Cardiac Surgery

2021 ◽  
Vol 18 (4) ◽  
pp. 62-72
Author(s):  
D. A. Sokolov ◽  
P. A. Lyuboshevsky ◽  
I. N. Staroverov ◽  
I. A. Kozlov
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiac Surgery ◽  
Chronic Heart Failure ◽  
Cardiac Risk ◽  
Cardiovascular Complications ◽  
Cardiac Events ◽  
Risk Indices ◽  
Medium Risk ◽  
Potential Risk Factors

The objective: to analyze the incidence and spectrum of cardiovascular complications within 12 months after noncardiac surgery, as well as to assess the association of preoperative values of various cardiac risk indices (CRI) and other potential risk factors with the actual development of complications.Subjects and Methods. We analyzed data of medical records and telephone interviews of 141 patients aged 65 [60-71] years who had undergone non-cardiac surgery a year before the interview The operations were low risk in 13.5% of observations, medium risk in 64.5%, and high risk in 22%. A retrospective calculation of the Revised CRI (RCRI), Individual CRI (Khoronenko CRI), and the American College of Surgeons Perioperative Risk for Myocardial Infarction or Cardiac Arrest (MICA) was performed.Results. Cardiac events (myocardial infarction, decompensation of chronic heart failure, new arrhythmias, stroke, and/or the need to prescribe or escalate the dose of cardiovascular drugs and/or hospitalization for cardiac indications, and/or death from cardiovascular diseases) within 12 months after elective noncardiac surgeries were detected in 27.7% of cases, and in 2.1% of patient's death occurred due to cardiac disorders. Predictors of cardiac events were concomitant ischemic heart disease (OR = 2.777; 95% CI 1.286-5.966; p = 0.0093) and chronic heart failure (OR = 2.900; 95% CI 1.224-6.869; p = 0, 0155), RCRI (OR = 1.886; 95% CI 1.2-8-2.944; p = 0.005), Khoronenko CRI (OR = 3254.3; 95% CI 64.33-164,638; p = 0.0001), MICA (OR = 1.628; 95% CI 1.156-2.292; p = 0.005), creatininemia on the first postoperative day (OR = 1.023; 95% CI 1.010-1.061; p = 0.005), and propensity for bradycardia during surgery (OR = 0.945; 95% CI 0.908-0.983; p = 0.005). Combined analysis of Khoronenko's CRI and postoperative creatininemia provided a very good model: area under the ROC-curve - 0.823 (95% CI 0.728-0.641; p = 0.0002).Conclusion. All studied CRIs can be used to predict posthospital cardiac events; however, the most promising is a joint assessment of Khoronenko's CRI and postoperative creatinemia.

The long-term use of β-blockers in chronic heart failure

2016 ◽  
Vol 34 (5) ◽  
pp. 931
Author(s):  
Mustafa Aparci ◽  
Omer Uz ◽  
Zafer Isilak
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Β Blockers

scholarly journals A Combination of Tachycardia-Mediated Heart Failure and Coronary Artery Vasospasm-Induced Silent Myocardial Infarction in a Patient with Severe Thyrotoxicosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Serena Sert Kim Khoo ◽  
Chong Mow Chu ◽  
Yin Khet Fung
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Cardiovascular Complications ◽  
Exertional Dyspnea ◽  
Coronary Artery Vasospasm ◽  
Severe Coronary Artery ◽  
Life Threatening ◽  
Silent Myocardial Infarction

Severe thyrotoxicosis can present with a myriad of cardiovascular complications. It may be mild features such as palpitations, tachycardia, and exertional dyspnea or may progress to life-threatening consequences such as atrial fibrillation, tachyarrhythmias, heart failure, myocardial infarction, and shock. In rare cases, they may present with myocardial ischemia secondary to coronary artery vasospasm. We report a case of a 59-year-old Malay gentleman who presented with fast atrial fibrillation and tachycardia-mediated heart failure that evolved to a silent myocardial infarction secondary to severe coronary artery vasospasm with undiagnosed severe thyrotoxicosis. He had complete resolution of heart failure and no further recurrence of coronary artery vasospasm once treatment for thyrotoxicosis was initiated and euthyroidism achieved. This life-threatening consequence has an excellent prognosis if recognised early and treated promptly.

Long term prognostic impact of gender in patients with stable coronary disease: an analysis of the CICCOR registry, a seventeen years, prospective, monocentric, cohort study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Ruiz Ortiz ◽  
J.J Sanchez Fernandez ◽  
C Ogayar Luque ◽  
E Romo Penas ◽  
M Delgado Ortega ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cohort Study ◽  
Cardiovascular Death ◽  
Female Sex ◽  
The Impact ◽  
Overall Mortality

Abstract Purpose Women and men with stable coronary artery disease (sCAD) have different clinical features and management, but 1-year prognosis has been reported to be similar in large observational registries. The objective of the present study was to investigate the impact of female sex in the prognosis of the disease in the very long-term. Methods The CICCOR registry (“Chronic ischaemic heart disease in Cordoba”) is a prospective, monocentric, cohort study. From February 1, 2000 to January 31, 2004, all consecutive patients with sCAD attended at two outpatient cardiology clinics in a city of the south of Spain were included in the study and prospectively followed. Differential clinical features of women and men were described and the impact of female sex in long term prognosis was investigated. Results The study sample included 1268 patients, 337 women (27%) and 931 men (73% male). Women were older than men (70±9 versus 65±11 years, p<0.0005), more likely to have hypertension (72% versus 49%, p<0.0005) and diabetes (45% versus 26%), and less likely to be ex-smoker/active smoker (5%/2% versus 49%/9%, p<0.0005). They had more frequently angina in functional class ≥II (22% versus 17%, p=0.04) and atrial fibrillation (8% versus 5%, p=0.04), but had received less frequently coronary revascularization (32% versus 44%, p<0.0005). Prescription of statins (64% versus 68%, p=0.22), antiplatelets (89% versus 93%, p=0.07) and betablockers (67% versus 63%, p=0.28) at first visit was similar than men, but women received more frequently nitrates (78% versus 64%, p<0.0005), angiotensin-conversing enzyme inhibitors or receptor antagonists (56% versus 47%, p=0.004) and diuretics (41% versus 22%, p<0.0005). After up to 17 years of follow-up (median 11 years, IQR 4–15 years, with a total of 12612 patients-years of observation), probabilities of acute myocardial infarction (12% versus 14%, p=0.55) or stroke (14% versus 12%, p=0.40) at median follow up were similar for women and men. However, the risks of hospital admission for heart failure (22% versus 13%, p<0.0005) or cardiovascular death (35% versus 24%, p<0.0005) were significantly higher for women, with a non-significant trend to higher overall mortality (45% versus 39%, p=0.07). After multivariate adjustment, the risks of most events were similar for women and men (Hazard Ratios [95% confidence intervals]: 0.79 [0.55–1.14], p=0.21 for acute myocardial infarction; 0.89 [0.61–1.29], p=0.54 for stroke; 1.13 [0.82–1.57], p=0.46 for admission for heart failure; and 0.92 [0.73–1.16], p=0.48 for cardiovascular death), with a non-significant trend to lower overall mortality (0.83 [0.67–1.02], p=0.08). Conclusion Although women and men with sCAD presents a different clinical profile, and crude rates of hospital admissions for heart failure and cardiovascular death were higher in women, female sex was not an independent prognostic factor in this observational study with up to 17 years of follow-up. Funding Acknowledgement Type of funding source: None

scholarly journals Donepezil Markedly Improves Long-Term Survival in Rats With Chronic Heart Failure After Extensive Myocardial Infarction

2013 ◽  
Vol 77 (10) ◽  
pp. 2519-2525 ◽  
Author(s):  
Meihua Li ◽  
Can Zheng ◽  
Toru Kawada ◽  
Masashi Inagaki ◽  
Kazunori Uemura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Term Survival ◽  
Long Term Survival

Long-term impact of the burden of new-onset atrial fibrillation in patients with acute myocardial infarction: data from the NOAFCAMI-SH registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.L Xu ◽  
J Luo ◽  
H.Q Li ◽  
Z.Q Li ◽  
B.X Liu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Ischemic Stroke ◽  
Cardiovascular Death ◽  
Funding Source ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Background The prognostic implication of the burden of paroxysmal new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI) remains unclear. We aimed to determine the impact of NOAF burden on long-term cardiovascular outcomes in the setting of AMI. Methods This retrospective study was conducted to investigate the association of NOAF burden with the major adverse cardiac events (MACE, a composite of cardiovascular death, recurrent MI, worsening of heart failure, or ischemic stroke), using data from the New Onset Atrial Fibrillation Complicating Acute Myocardial Infarction in ShangHai registry. AF burden was defined as the percentage of time (%) spent in AF. Patients with paroxysmal NOAF were divided into three groups according to AF burden tertiles: low burden: 22.4%. A restricted cubic spline analysis was performed to illusrate the relationship between the burden of NOAF and MACE. Results Of 2399 participants, 278 developed NOAF during a median monitoring period of 194.9 hours. The mean age was 65.8±12.4 years, and the median burden of NOAF was 8.4% (IQR: 1.9%-38.1%). During up to 5-years follow-up, the incidence of MACE was 8.6, 17.4, 35.4, and 79.2 per 100 person-years in the sinus rhythm, low-, intermediate-, and high-burden groups, respectively. After adjustment, patients with high NOAF burden had the highest risk of MACE (hazard ratio [HR]: 3.10; 95% confidence interval [CI]: 2.36–4.07), cardiovascular death (HR: 2.26; 95% CI: 1.58–2.23), worsening of heart failure (HR: 4.90; 95% CI: 3.48–4.91), and ischemic stroke (HR: 4.42; 95% CI: 2.03–9.63). Our splines analyses uncovered a nonlinear dose-response pattern, as the HRs of MACEs increased with the progression of NOAF burden and appeared stable after approximately 15% of NOAF burden. Conclusions A greater burden of NOAF during AMI was strongly associated with a higher risk of adverse cardiovascular events. Cumulative incidence of outcomes Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): 1. National Natural Science Foundation of China, 2. Natural Science Foundation of Shanghai

scholarly journals Impact of concomitant impairments of the left and right ventricular myocardial strain on the prognoses of patients with ST-elevation myocardial infarction

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
LAI Wei ◽  
HENG Ge ◽  
JUN Pu
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Coronary Artery ◽  
Predictive Power ◽  
Independent Predictor ◽  
Cardiovascular Death ◽  
Cerebrovascular Events ◽  
St Elevation ◽  
Left And Right

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): the National Key Research and Development Program of China OnBehalf Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University Background  The impact of concomitant impairments of left and right ventricular (LV and RV) strain on the long-term prognosis of acute ST-elevation myocardial infarction (STEMI) is not clear. Methods  We analyzed CMR images and followed up 420 first STEMI patients from the EARLY Assessment of MYOcardial Tissue Characteristics by CMR in STEMI (EARLY-MYO-CMR) registry (NCT03768453). These patients received timely primary percutaneous coronary intervention (PCI) within 12h and CMR examination within 1 week (median,5 days; range, 2-7 days) after infarction. Global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of both ventricles were measured based on CMR cine images. Conventional CMR indexes were also assessed. Primary clinical outcome was composite major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, re-hospitalization for heart failure and stroke. Results During follow-up (median: 52 months, interquartile range: 29–78 months), 80 patients experienced major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, heart failure, and stroke. LV-GCS > -11.20% was an independent predictor of MACCEs (P < 0.001). The impairment of RV strain was found in 177 patients (42.14%), including 37.8% of patients with left anterior descending occlusions, 37.5% with left circumflex occlusions, and 51.5% with right coronary artery occlusions. Although none of the three individual RV strain measurements, the RV-GLS, RV-GRC and RV-GCS, was independently associated with the risk of MACCEs, patients who had RV-GRS ≤ 38.79% in addition to an impaired LV-GCS however were more likely to experience MACCEs than patients with decreased LV-GCS alone (log rank P = 0.010). Moreover, the addition of RV-GRS to LV-GCS improved the predictive power for MACCEs compared to the predictive power of LV-GCS alone (continuous NRI: 0.327; 95% CI: 0.095 - 0.558; P = 0.006). Finally, Tobacco use (P = 0.003), right coronary artery involvement (P = 0.002), and LV-GCS > -11.20% (P = 0.012) were found to be independent risk factors of RV-GRS impairment. Conclusions  Impairment of the RV strain is prevalent in infarctions occurring at all cardiac locations. While LV-GCS is an independent predictor of long-term MACCEs, the concomitant impairment of RV-GRS results in a worsened prognosis. Combination assessment of both LV and RV strain indexes could improve risk stratification of STEMI patients.

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