Analysis of the outcomes of myocardial infarction against the background of chronic obstructive pulmonary disease among residents of the Astrakhan region

T. V. Prokof'eva, O. S. Polunina, E. Polunina, I. V. Sevost’yanova
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Abstract

Objective. To analyse the course of coronary heart disease within a year after the development of myocardial infarction in residents of Astrakhan region with chronic obstructive pulmonary disease.   Materials and Methods. We examined 325 patients with myocardial infarction, residents of Astrakhan region. 195 patients had heart attacks against the background of COPD and 130 patients without COPD. During 12-month follow-up 30 people dropped out - 19 in the group of patients with myocardial infarction against COPD, 11 in the group of patients with myocardial infarction without COPD. Correspondingly, by the end of the observation period the number of patients under observation was: 176 - in the group of patients with myocardial infarction against COPD, and 119 - in the group of patients with myocardial infarction without COPD.   Results. It was found that in patients with myocardial infarction against COPD the annual mortality from conditions associated with cardiovascular pathology was twice as frequent as in patients with MI without COPD. There was also a tendency to more frequent development of recurrent myocardial infarction. In the structure of mortality in patients with myocardial infarction against COPD and without COPD and there was a tendency to a more frequent occurrence of acute heart failure expressed stages (Killip III-IV) and decompensation of chronic heart failure as causes of mortality. The odds of developing a combined endpoint, including recurrent myocardial infarction, stroke and mortality from cardiac causes, among patients with myocardial infarction against COPD were 2.7 times higher compared to patients with myocardial infarction without COPD. The combined endpoint, which combines clinically significant events in patients with myocardial infarction, makes the existing differences in the outcomes of infarction in patients with and without COPD evident.
分析阿斯特拉罕州居民在慢性阻塞性肺病背景下心肌梗死的后果
目的分析阿斯特拉罕州患有慢性阻塞性肺病的居民在发生心肌梗塞后一年内的冠心病病程。 材料与方法我们对阿斯特拉罕州的 325 名心肌梗塞患者进行了调查。其中 195 名患者在慢性阻塞性肺病的背景下发生心肌梗塞,130 名患者没有慢性阻塞性肺病。在为期 12 个月的随访期间,有 30 人退出了随访,其中 19 人是心肌梗死合并慢性阻塞性肺病患者,11 人是心肌梗死合并慢性阻塞性肺病患者。相应地,在观察期结束时,接受观察的患者人数为:心肌梗死合并慢性阻塞性肺病患者组 176 人,心肌梗死合并慢性阻塞性肺病患者组 119 人。 研究结果结果发现,心肌梗塞合并慢性阻塞性肺病患者每年死于心血管病变的频率是心肌梗塞合并慢性阻塞性肺病患者的两倍。此外,复发性心肌梗死的发病率也呈上升趋势。在心肌梗死合并慢性阻塞性肺病和不合并慢性阻塞性肺病患者的死亡率结构中,有一种趋势是,急性心力衰竭分期(Killip III-IV)和慢性心力衰竭失代偿作为死亡原因的发生率更高。与无慢性阻塞性肺病的心肌梗死患者相比,有慢性阻塞性肺病的心肌梗死患者出现合并终点(包括复发性心肌梗死、中风和心源性死亡)的几率要高出2.7倍。合并终点将心肌梗死患者中具有临床意义的事件合并在一起,使患有和未患有慢性阻塞性肺病的心肌梗死患者在预后方面的现有差异变得显而易见。
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