Portrait of the patient with myocardial infarction over a 30-year period.

Abstract

Aim. To study how to change the portrait of the patient with acute myocardial infarction (AMI) for a 30-year period in the global aging of the population, and conduct a comparative assessment of the main epidemiological indicators of AMI over the period of time. Material and methods. The study included patients with AMI registered in the database «Register of acute myocardial infarction» in 1986 (593 cases) and 2015 (729 cases), respectively. Statistical processing of the results was performed using the statistical program Statistica V10.0. Results. Over a 30-year period, the proportion of elderly patients increased by 13.4% (p<0.001). Among men younger than 60 years decreased morbidity, mortality, and hospital mortality from AMI. In persons 60 years and older reduced the incidence of first AMI, however, the incidence of re-AMI and morbidity and mortality has not decreased. Often the AMI was to develop on the background of comorbidities (p<0.001). A marked increase in the number of atypical forms of the disease from 11.6% in 1986 to 33.2% in 2015 (p<0.001), mostly among patients of older age groups. Elderly patients are often hospitalized in non-core hospitals (7.7% in 1986 compared to 13.6% - in 2015; p<0.001). There was an increased incidence of acute left ventricular failure, cardiogenic shock, arrhythmias (p<0.001). Conclusions. Thus, the significant increase ofpatients' age at the time of development of AMI in 2015, compared with 1986, is a reflection of the process of demographic aging of the population, and inevitably leads to the accumulation of comorbid pathology, weighting demographic status of patients, the clinical picture of the disease and causes to significant difficulty in providing effective specialized medical care to patients.