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PREDICTORS OF ADVERSE CLINICAL COURSE AND CARDIOVASCULAR MORTALITY DURING HOSPITAL PERIOD OF ACUTE MYOCARDIAL INFARCTION AMONG FEMALE PATIENTS

Authors: Netyazhenko N.V.

Pages: 468-474

Abstract


Aim To identify predictors of adverse course and cardiovascular mortality during hospital period of acute myocardial infarction among female patients.

Materials and Methods. The study included 65 women with myocardial infarction (MI) with elevation segment ST. In order to find predictors of unfavorable development of MI combined end point (CEP) (acute left ventricular failure class III-IV and recurrence by T.Killip MI) and cardiovascular mortality was promoted single-factor analysis, options which were identified fairly significant, used in multivariate stepwise discriminant analysis with determination of the odds ratio (OR).

Results. Risk of  CET increased in women with MI and presence of following indicators of progress plasma coagulation hemostasis the concentration of soluble complexes fibrynmonomers > 4x10 g / l (OR 4.1), reduction of protein C normalized ratio <0.72 (OR 3.7 ), the duration activated partial thromboplastin time <50 c (3.0 HS) and thrombin time <22s (OR 4.4). The most influential parameter functional activity of platelets appeared extent of platelet aggregation induced by arachidonic acid> 3.3% (OR 5.1) and adenosine diphosphate> 4.1% (OR 2.2). Microalbuminuria (MAU) with albumin-creatynin ratio (ACR) from 3 to 30 mg / mol in 6 times increased risk of CEP (OR 6.6). In the course of development of complications of MI and impact indicators such as coronary artery disease duration <3 years (OR 1.8) and hypertension> 5 years (OR 1.6)). An adverse effect on course of MI had a duration of postmenopausal period (<5 years), which is up to 3.9 times increased the likelihood of CEP MI and cardiovascular mortality up to 7.1 times (p <0.05).

Conclusion: The results of indicators plasma coagulation and platelet hemostasis, MAU definition with ACR and a history, especially the duration of postmenopausal period have prognostic value and should be used to differentiate women with MI risk stratification for.

Key words: myocardial infarction, predictors, weather, woman.

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