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Jun 07th

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Secondary prevention in patients after myocardial infarction and five prognosis depending on gender

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Yagensky A., Sichkaruk I.

Volyn’ Regional Cardio-vascular pathology center, Lutsk municipal clinical hospital, Lutsk, Ukraine

Summary. The assessment was provided among of 333 patients (pts) who were randomized from 912 pts discharged from Lutsk City Hospital after acute myocardial infarction (MI) in 2000–2008. The study included two phases of clinical examination (first home-based phase – survey, blood pressure and anthropometric measurement, second at the clinic – laboratory and instrumental examination) and phase of 5-years prospective observation. Prevalence all risk factors, excluding physical inactivity and smoking, was significantly higher among women vs men. That is the reason for more careful monitoring of them. But on the other hand, women, including patients with obesity and arterial hypertension used a greater number of medications, and are more adherent to treatment than men. Probably it can cause absence of gender-related difference in recurrent MI, stroke and mortality in long-term prognosis. During 5-years prospective phase of the study 17,4 % of pts after MI died due to cardiovascular causes, in 6,6 % pts recurrent MI and in 8,1 % – stroke occurred (no gender difference). Age (β = 0,03; р = 0,04, HR = 1,7), diabetes mellitus (β = 0,8; р = 0,03, HR = 2,4), smoking (β = 0,7; р = 0,01, HR = 1,7) were independent predictors of cardiovascular death. Gender was not a determining factor in remote prognosis after MI. Most of independent predictors of poor prognosis in pts after MI are modified and could be corrected and controlled. Active efforts should be made to improve situation.

Keywords: myocardial infarction, primary endpoint, combined endpoint, independent predictors of poor prognosis.