During the dissertation work, 200 patients with non-ST-segment elevation myocardial infarction (NSTEMI) were examined and treated. Among the examined patients, 142 were male and 58 were female. The analysis of data in the main clinical array was carried out according to the following principle: by age qualification: 1st group – patients under 60 years of age; 2nd – 60-74 years and 3rd – 75 years and older; according to the degree of risk according to the GRACE score: group 1 – patients with a high risk of fatal consequences (> 140 points), group 2 – with a moderate risk (140-109 points), group 3 – with a low risk of fatal consequences in the near future (< 109 points); by the value of the plasma level of ST2, Troponin I and their associations (1st group – relatively high; 2nd – moderate and 3rd – relatively low level of the indicator in the examined mass of patients).
According to the results of the study, it was found that by determining the total score of coronary artery damage, it is possible to stratify the adverse course of NSTEMI, in particular, the occurrence of fatal ventricular arrhythmias in the early period. On the basis of the revealed association between the total score of coronary artery damage and the occurrence of ventricular arrhythmias in the early period, it is possible to recommend assessing the risk of the occurrence of these arrhythmias as high with a total score > 3. Determination and evaluation of the ST2 level > 90 ng/ml before coronary angiography can predict such dangerous complications of NSTEMI, as heart failure and potentially dangerous ventricular arrhythmias. Appropriate stratification scales are proposed to predict the risk of ischemic coronary events and heart failure in patients with NSTEMI during the 1st year of follow-up. In the presence of the listed signs and the sum of points ≥ 4: 1) the presence of frequent ventricular extrasystoles on the 1st-3rd day of MI (2 points), 2) 2-3 vascular hemodynamically significant stenosis of the coronary arteries according to coronary angiography (4 points), 3) final diastolic size > 52 mm according to echocardiography (2 points), 4) early ventricular extrasystoles (1 point) and 5) episodes of painless myocardial ischemia > 3 per day (4 points) according to Holter ECG, the sensitivity of predicting ischemic coronary events is 80.0 %, specificity – 97.0% and accuracy – 95.0%. In the presence of the listed signs and the sum of points ≥ 2: 1) the presence of acute heart failure on the 1st-3rd day of MI (1 point), 2) persistent episodes of ventricular tachycardia on the 1st-3rd day of MI (1 point), 3) level of ST2 in plasma > 90 ng/ml on the first day of MI (1 point) and 4) level of quality of life according to MIDAS-35 > 37 points on day 5-7 of MI (1 point), the sensitivity of predicting the development of heart failure is 86, 0%, specificity – 98.0% and accuracy – 97.0%.
Key words: ST-segment elevation myocardial infarction, growth stimulating factor expressed by gene 2, features of coronary artery lesion, structural and functional state of the myocardium, arrhythmias, heart failure, quality of life indicators. Branch - medicine.
