THE CLINICAL COURSE OF MYOCARDIAL INFARCTION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH RECURRENT EPISODES OF ISCHEMIA

Abstract

Relevance. Recurrent myocardial infarction and early postinfarction angina negatively affects on the prognosis of myocardial infarction. Aim. To evaluate myocardial infarction clinical features in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 79 patients; II - control, without it - 432 patients. A comparative assessment of the myocardial infarction clinical features frequency in selected groups were performed. Results. The studied groups did not differ in the frequency of the main variants of the myocardial infarction course. In patients of the study group more often than in the control group, a complicated course of the disease was observed (88.2 and 50.2%, respectively; p < 0.0001), deaths (13.6 and 3.4%; p < 0.0001). Complications in the study group were dominated by arrhythmias (47.3 and 33.7%; p = 0.007), cardiogenic shock (13.6 and 6.1%; p = 0.006), myocardial ruptures (3.6 and 0.5% ; p = 0.004), thromboembolism (15.5 and 2.2%; p <0.0001), urinary dysfunction (7.3 and 2.5%; p = 0.01), Dressler's syndrome (4.5 and 1.1%; p = 0.009) and mental disorders (16.4 and 5.6%; p < 0.0001). Conclusions. Nonanginal forms of the disease in the study group were observed in 17% of cases. The complications of the disease for group I are characterized by cardiac arrhythmias and conduction disorders, thromboembolism, myocardial ruptures, cardiogenic shock, extracardiac complications of myocardial infarction. The study group has a worse prognosis, which requires early diagnosis, revascularization, the use of auxiliary mechanical devices, and careful implementation of standardized treatment algorithms.