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THE EVALUATION OF REHABILITATION TREATMENT COURSE FOR PATIENTS AFTER MYOCARDIAL INFARCTION WITH COMORBID ARTERIAL HYPERTENSION

Journal: Art of Medicine (Vol.4, No. 1)

Publication Date:

Authors : ;

Page : 117-121

Keywords : acute myocardial infarction; arterial hypertension; remodeling; post infarction period; stenting;

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Abstract

Currently, cardiovascular diseases (CVDs) are an actual problem in the whole world. According to the WHO data, ischemic heart disease (IHD) mortality is 9.4 million per year or 16.5% of all mortality cases. IHD morbidity is 1859.99 in Ukraine, 807.76 in the European Region per 100,000 population. Physicians pay special attention to acute myocardial infarction (AMI) among CVDs which is associated with significant widespread and high mortality levels among the working-age population. Every year about 50,000 MI cases are reported in Ukraine, and mortality for this pathology remains high. 30% of patients die from AMI, at the time, in Western countries this amount is 5%. Lately, the problem of emergency medical aid improving for the patients with AMI got special relevance. World tendencies in this direction lean to the wider use of thrombolytic therapy, intervention, and cardiac surgery. These problems need detailed justification and analysis to improve conditions of medical aid and decrease of mortality among patients with AMI. Despite the achievements of modern interven-tional surgery, introducing of early invasive strategy, improved pharmacologic treatment options, improved quality and availability of medical aid, cardiovascular diseases in general and acute coronary syndrome (ACS) in particular remain a leading cause of mortality in devel-oped countries and in Ukraine remaining a global healthcare problem. According to modern guidelines for the man-agement of patients with ACS, as MI with ST elevation (STEMI), as well as MI without ST elevation (non-STEMI) of high, very high and intermediate risk, the using of early invasive treatment strategy is necessary, in order to provide maximum quick restoring of coronary blood flow. Despite the data of numerous randomized studies that proved early invasive treatment strategy and myocardial revascularization improves significantly not only ACS course, but also supports decrease in lethality indices. But the vast part of patients in our country get for one reason or another only conservative therapy. Patients with ACS are a heterogenic group that dependent on disease type, present with significantly different clinical and hemodynamic characteristics of ACS and its consequences. In last years, frequency of invasive surgery in patients with STEMI increased significantly in our country, while revascularization for patients with non-STEMI remains on relatively low level. Taking the high frequency of conservative management strategy for such patients into account, optimization of pharmacologic therapy is one of main tasks for modern cardiology. The most effective treatment method for AMI is endovascular myocardial reperfusion via the stenting of the infarction-dependent artery. Performing PCI contrib-utes in patients to probable left ventricular ejection frac-tion increase, probable end-systolic volume, myocardial mass and left ventricular myocardial performance index decrease compared to patients without done revasculari-zation. PCI improves progression, prognosis, and course of post infarction cardiosclerosis in patients after Q-, QS-wave myocardial infarction and therefore has to be a priority direction for the treatment of these patients.

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Last modified: 2020-04-08 04:26:19