Prediction of adverse cardiovascular events in the post-infarction period, taking into account treatment compliance
DOI: 10.32364/2587-6821-2020-4-7-431-436
E.A. Kuzheleva, V.A. Fedyunina, V.A. Alexandrenko, M.Yu. Kondratiev,
V.D. Aptekar, A.A. Garganeeva
Research Institute of Cardiology at the Tomsk National Research Medical Center
of the Russian Academy of Sciences, Tomsk, Russian Federation
Aim: to develop a graphic risk meter scale concerning major adverse cardiovascular events (MCVEs) during the 5-year post-infarction period, taking into account patients’ compliance to the treatment.
Patients and Methods: the analyze was conducted on the data from a prospective five-year follow-up of patients (n=115) who experienced a myocardial infarction (MI) and were registered in the database of the Registry of Acute Myocardial Infarction (Tomsk). The following endpoints were analyzed: repeated MI, hospitalization for exacerbation of coronary heart disease, advanced chronic heart failure (CHF), and cardiac arrhythmias.
Results: the study identified a set of factors that had a significant impact on the clinical course of the post-infarction period. CHF (diagnosed before the development of index MI) increased the chances of adverse course of post-infarction period in 9.5 times. The lack of achievement of systolic blood pressure tar get values increased the risk of cardiovascular complications in 5 times. The patients’ age of 75 years and older increased the possibility of an adverse postinfarction period course in 8.5 times. The predictor that favorably affected the post-infarction period course was an integral indicator equal to the product of the specific weight of vital drugs (in the general structure of prescriptions) and the treatment compliance degree. This indicator reduced the risk of MCVEs by 61% for each unit value, i.e. with the highest possible compliance to therapy that meets the recommendations; an adverse course risk of the post-infarction period decreased by 2.5 times.
Conclusion: the results emphasize the importance of compliance with medical recommendations by patients who have experienced MI. The proposed graphic risk meter scale can be used to predict the development of adverse MCVEs during the 5-year post-infarction period.
Keywords: coronary heart disease, myocardial infarction, cardiovascular risk, treatment compliance, Morisky-Green test, disease prognosis.
For citation: Kuzheleva E.A., Fedyunina V.A., Alexandrenko V.A. et al. Prediction of adverse cardiovascular events in the post-infarction period, taking into account treatment compliance. Russian Medical Inquiry. 2020;4(7):431–436. DOI: 10.32364/2587-6821-2020-4-7-431-436.
About the authors:
Elena A. Kuzheleva — Cand. of Sci. (Med.), Researcher of the Department of Myocardial Pathology, Research Institute of Cardiology at the Tomsk National Research Medical Center of the Russian Academy of Sciences: 111A, Kievskaya str., Tomsk, 634012, Russian Federation; ORCID iD 0000-0003-4019-3735.
Vera A. Fedyunina — Junior Researcher of the Department of Myocardial Pathology, Research Institute of Cardiology at the Tomsk National Research Medical Center of the Russian Academy of Sciences: 111A, Kievskaya str., Tomsk, 634012, Russian Federation.
Victoria A. Alexandrenko — Junior Researcher of the Department of Myocardial Pathology, Research Institute of Cardiology at the Tomsk National Research Medical Center of the Russian Academy of Sciences: 111A, Kievskaya str., Tomsk, 634012, Russian Federation.
Mikhail A. Kondratiev — cardiologist of the Department of Myocardial Pathology, Research Institute of Cardiology at the Tomsk National Research Medical Center of the Russian Academy of Sciences: 111A, Kievskaya str., Tomsk, 634012, Russian Federation.
Vladimir A. Aptekar — Dr. of Sci. (Med.), Head of the Department of Myocardial Pathology, Research Institute of Cardiology at the Tomsk National Research Medical Center of the Russian Academy of Sciences: 111A, Kievskaya str., Tomsk, 634012, Russian Federation.
Alla A. Garganeeva — Dr. of Sci. (Med.), Professor, Head of the Department of Myocardial Pathology, Research Institute of Cardiology at the Tomsk National Research Medical Center of the Russian Academy of Sciences: 111A, Kievskaya str., Tomsk, 634012, Russian Federation; ORCID iD 0000-0002-9488-6900.
Contact information: Elena A. Kuzheleva, e-mail: snigireva1209@rambler.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 14.09.2020, revised 28.09.2020, accepted 12.10.2020.
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