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Content available remote Prognostic factors in patients who have survived myocardial infarction
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EN
Patients who have survived myocardial infarction (MI), compared to the general population, have an increased risk of reinfarction, myocardial revascularization, and death. In this study we investigated the prognostic significance of the predictors of the risk for adverse coronary events in 118 patients, both male and female, with a confirmed diagnosis of MI in the last 3 years. The predictors of reinfarction, revascularization and death in patients who survived MI were: poor adherence to hypolipemics (hazard ratio [HR] 3.06, p=0.006), physical inactivity (HR 2.22, p=0.056), the number of variable risk factors (HR 1.29, p=0.025), and age (HR 1.06, p=0.007). After the inclusion of the invariable risk factors in the model of multivariant analysis, the following factors were singled out as significant predictors of the risk: gender (HR 3.86, p=0.0015), physical inactivity (HR 2.38, p=0.007), change in the level of triglycerides (HR 1.49, p=0.040), change in the number of variable risk factors (HR 1.41, p=0.0007), and age (HR 1.05, p=0.009). A 3-year follow-up of the patients who survived the first MI and who were enrolled in this study of secondary prevention demonstrated that physical inactivity, the number of variable risk factors and age significantly contributed to an increased risk of reinfarction, revascularization, and death.
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Content available remote Prognosis of elderly patients hospitalized in the cardiac ward
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Introduction Cardiovascular diseases affect nearly 80% of the elderly, and they are the major cause of death in this population. The aim was to evaluate the clinical profile and prognostic factors for patients aged 80 years and more who have been hospitalized for cardiologic reasons. Material and Methods The study included 100 patients aged 80–91 years (46% men) referred to the Department of Cardiology. We analyzed the reasons and length of hospitalization, clinical factors, results of basic laboratory tests, echocardiography, angiography, comorbidities and number of deaths during the hospitalization and in one year of follow-up. Patients were divided and analyzed, depending on the total mortality rate.Results The most common causes of hospitalization were myocardial infarction (67%) and heart failure (10%). Coronary angiography was performed in 72% of patients and percutaneous coronary intervention in 81%. The most common cause of hospital deaths was myocardial infarction (67%). The proportion of deaths in hospital was 8%, and during a year of observation it was 26%. Deaths were found to be related to ventricular conduction blocks (OR=4.0; P=0.03) and atrial fibrillation (OR=11.15; P=0.04). Conclusions In the elderly hospitalized in cardiac wards, myocardial infarction was the most common cause of hospitalization and hospital death. The mortality rate was high and associated with ventricular conduction blocks and atrial fibrillation.
EN
Purpose: To analyse knowledge of patients in the Interventional Cardiology Department in the field of theory of the disease entity, i.e. myocardial infarction and factors predisposing to its occurrence. Materials and methods: The study was carried out at the Interventional Cardiology Department of the Regional Specialist Hospital in BiałaPodlaska between 3.11.2017 and 20.12.2017. Sixty respondents were included, 62% women and 38% men. The largest group were patients between 46 and 60 years of age. The work involved an anonymous questionnaire, which contained 28 questions, including two open ones. Patients participated in the study were informed that the study was voluntary and the questionnaire was anonymous. Results: According to the respondents, the main cause of myocardial infarction is atherosclerosis (43.4%). The respondents indicate that cardiovascular diseases (including myocardial infarction) which are on the third place in Poland, right after cancer and injuries, cause death (63.3%). As the main factor that influences the occurrence of myocardial infarction is overweight and obesity (79.8%). More than half of the respondents assess their knowledge of myocardial infarction on average, while 18.3 % said that they have very good knowledge. Conclusions: Patients with myocardial infarction have quite a good knowledge about the risk factors for this disease. A large group of respondents tries to counteract the risk factors for myocardial infarction. A small part of the respondents undergoes regular blood tests (blood glucose level, total cholesterol and its fractions, measurement of blood pressure).
EN
Objectives To investigate the aspects of return to work, socio-economic and quality of life aspects in 145 employed patients under 60 years of age treated with primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Material and Methods During hospital treatment demographic and clinical data was collected. Data about major adverse cardiovascular events, rehabilitation, sick leave, discharge from job and retirement, salary, major life events and estimation of quality of life after myocardial infarction were obtained after follow-up (mean: 836±242 days). Results Average sick leave was 126±125 days. Following myocardial infarction, 3.4% of patients were discharged from their jobs while 31.7% retired. Lower salary was reported in 17.9% patients, major life events in 9.7%, while 40.7% estimated quality of life as worse following the event. Longer hospitalization was reported in patients transferred from surrounding counties, those with inferior myocardial wall and right coronary artery affected. Age, hyperlipoproteinemia and lower education degree were connected to permanent working cessation. Significant salary decrease was observed in male patients. Employer type was related to sick leave duration. Impaired quality of life was observed in patients who underwent in-hospital rehabilitation and those from surrounding counties. Longer sick leave was observed in patients with lower income before and after myocardial infarction. These patients reported lower quality of life after myocardial infarction. Conclusions Inadequate health policy and delayed cardiac rehabilitation after myocardial infarction may lead to prolonged hospitalization and sick leave as well as lower quality of life after the event, regardless of optimal treatment in acute phase of disease.
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