The dissertation proposes to determine the risk factors for myocardial infarction (MI) at a young age based on the study of clinical, instrumental and laboratory data, the peculiarities of its clinical course and substantiate recommendations for rehabilitation and treatment of this group of patients. The relevance of the study is due to the need to improve the primary and secondary prevention of cardiovascular disease in young patients.
The main criteria for inclusion in the work: men under the age of 50.
The clinical diagnosis of myocardial infarction was confirmed on the basis of clinical, electrocardiographic and laboratory criteria in accordance with the recommendations of the European Society of Cardiology and the the Ukrainian Association of Cardiology.
Aim of the study: Improving the treatment of young patients with myocardial infarction based on a comprehensive assessment of risk factors, endothelial function, folate metabolism and analysis of the effectiveness of individual β -blockers.
Objectives of the study:
1. Assess the main risk factors in men who have suffered MI at a young age.
2. To study the clinical course and features of coronary artery disease in young men who have suffered MI.
3. Investigate platelet aggregation, NO, homocysteine and endothelin-1 levels in young MI patients.
4. To study the indicators of total and free testosterone, erectile dysfunction in patients with MI at a young age.
5. To evaluate the influence of certain groups of β -blockers on the indicators of physical endurance in patients after MI at a young age and to develop recommendations for their differentiated use.
Object of the study:
Ischemic heart disease: myocardial infarction, acute coronary syndrome with ST elevation and without ST segment elevation, coronary artery disease.
Subject of the study: Changes in biochemical parameters and indicators of endothelial function, platelet function, results of bicycle ergometric research, survey data.
Scientific novelty of the study:
For the first time, complex changes in the acute period of myocardial infarction were found in young patients, which were manifested by multivascular lesions of the coronary arteries, disorders of endothelial function, folate metabolism and platelet aggregation.
A high proportion of patients with erectile dysfunction was found and the relationship between decreased levels of total and free testosterone and the state of erectile function in patients with myocardial infarction at a young age was defined.
The relationship between exercise tolerance in myocardial infarction patients at a young age and total and free testosterone levels has been established.
Scientific data on the differentiated use of certain groups of ꞵ-adrenoblockers (BAB) with different pharmacological properties in patients with myocardial infarction at a young age have been supplemented.
Exclusion criteria for the study were as follows: concomitant congenital and acquired heart defects; severe concomitant pathology of internal organs; valvular heart disease requiring surgical correction, severe diabetes mellitus (DM), severe renal and hepatic insufficiency, bronchial asthma, trauma or major surgery, acute (or exacerbation of chronic) inflammatory process, bleeding, cancer and systemic diseases.
The main method of revascularization in patients with ACSST was urgent CVG with subsequent endovascular intervention. All patients received standard therapy that met the recommendations of European Society of Cardiology and the the Ukrainian Association of Cardiology at the time of enrollment in the study. Patients in the hospital were performed: electrocardiography (ECG), CPX test, determination of platelet aggregation, endothelial function, folate metabolism, testosterone levels, lipid spectrum and other laboratory tests. Outpatient follow-up (for 6 months).
