Strokova S. Adherence to treatment and high residual risk as factors influencing the clinical course of the disease after myocardial infarction.

The thesis is devoted to optimize and improve the effectiveness of treatment of patients with myocardial infarction, based on the study of factors affecting the prognosis and course of the disease during long-term follow-up. A register of patients with myocardial infarction, analyzed the data in 1920, "reports of patients with a diagnosis of myocardial infarction", based on which it is shown that the lack of efficacy of treatment of patients with myocardial infarction may be partly due to a lack of awareness about the disease patients (24.7 % cases, the diagnosis of myocardial infarction is set at a reception in the clinic), not following the standards of pre-hospital patients in its entirety, as well as a high proportion of patients with myocardial infarction was the first manifestation of ischemic heart disease (35 %). To study the problem of adherence to treatment and its impact on the 3-year forecast was a retrospective analysis of 316 case histories of patients who had at discharge from the hospital for long-term use of four drugs were assigned to groups of basic therapy. Three years after myocardial infarction we conducted a survey of patients or their families about adherence to therapy and the further course of the disease with which found that one of the factors that influence the development of complications in the remote period after myocardial infarction is low adherence to recommended therapy. For the purpose of testing methods to improve adherence to therapy and learned how to correct high residual risk examined 157 patients after myocardial infarction. Based on the data proved that the tested approaches to improve adherence to therapy (telephone reminders) and the correction of high residual risk not only contribute to a more strict implementation of the recommendations of a physician, but also reduce the number of complications within 6 months after myocardial infarction. The results of the comparative evaluation of two strategies for the correction of high residual risk (the maximum dose of a statin or a combination of a statin and fenofibrate) show a higher efficiency of receiving maximum doses of statins.