Questions of secondary prevention and rehabilitation of patients with myocardial infarction at different stages

Abstract

Research objective: increase of efficiency of secondary prevention of a myocardial infarction (MI) and rehabilitation of patients at an out-patient stage.Materials and methods: 164 patients of both floors with the transferred MI with enzymatic and endovascular restoration of a blood-groove of an ischemic myocardium are surveyed. The diagnosis of a MI is established according to standards of diagnostics of ESC/ACCF/AHA (European Society of Cardiology/American College of Cardiology Foundation/American Heart Association, 2007) also it is documented by an extract from the clinical record of office of medical institution where hospital treatment of the patient according to emergency indications was carried out. Patients were divided into 3 groups: the 1st (supervision with rehabilitation in out-patient conditions), the 2nd (rehabilitations in the round-the-clock specialized office), the 3rd (comparisons). To all patients continuous reception of pharmacological therapy according to standards of treatment of patients with the sharp coronary syndrome (SCS) was appointed; recommendations of the general character about healthy lifestyle observance are made; laboratory blood tests, electrocardiography and heart echocardiography, holter (daily) monitoring of the electrocardiogram, assessment of degree of heart failure on the scale of an assessment of a clinical state and the test of 6 minute walking, a commitment assessment to treatment with use of test of Moriski-Green, quality of life of patients with heart failure on the Minnesota questionnaire, episodes of repeated hospitalization concerning SCS and lethal outcomes are carried out. In addition to the 1st group of patients «Health school» and medical physical culture, the 2nd group - a rehabilitation course in specialized office of recovery treatment of City clinical hospital №19 were on an outpatient basis carried out.Results: on achievement of commitment to treatment, estimates of an average value of quality of life, episodes of repeated SCS, to reduction of weight of a functional class of heart failure indicators of patients of the 1st group surpassed data on patients of the 3rd group, but conceded to the 2nd.Conclusion. Use of rehabilitation actions at an out-patient and polyclinic stage of treatment of patients with transferred MI as element of secondary prevention of cardiovascular complications positively influence final points irrespective of a method of a myocardium revascularization.