The Clinician最新文献

{"title":"АФФЕКТИВНЫЕ РАССТРОЙСТВА И КАЧЕСТВО ЖИЗНИ У БОЛЬНЫХ КОРОНАРНОЙ БОЛЕЗНЬЮ СЕРДЦА ПО ДАННЫМ ПСИХОМЕТРИЧЕСКИХ ТЕСТОВ","authors":"С. Ю. Мухтаренко, Т. М. Мураталиев, З. Т. Раджапова, Ю. Н. Неклюдова","doi":"10.17650/1818-8338-2018-12-2-28-36","DOIUrl":"https://doi.org/10.17650/1818-8338-2018-12-2-28-36","url":null,"abstract":"The aim was to study the frequency and severity of affective disorders and quality of life in patients with coronary heart disease (CHD): unstable and stable angina of II–III functional class. Materials and methods. 488 patients with verified CHD were examined to identify and assess anxiety-depressive spectrum disorders by the screening questionnaire of Moscow Research Institute of Psychiatry, Ministry of Health of Russia. 172 patients with CHD from the screening group – 96 (55.81 %) patients with unstable angina and 76 (44.19 %) with stable angina, 136 (79.07 %) men and 36 (20.93 %) women were examined with psychometric tests: Hospital Anxiety and Depression Scale (HADS) and Beck Depression Inventory (BDI). Modified Seattle Angina Questionnaire (SAQ) was used to study quality of life. Excel and Statistica 6.0 programs were used to assess statistical process of the material. Results. According to the screening questionnaire, in screening group of patients with CHD (n = 488) the symptoms of anxiety-depressive disorder were present in 398 (81.56 %) patients, in 90 patients (18.44 %) they were absent (p <0.0001). In the group of patients with CHD examined by psychometric tests (n = 172), the symptoms of anxiety-depressive disorder according to the screening questionnaire were revealed in 137 (79.65 %) patients, in 35 (20.35 %) patients they were absent (p <0.0001). The severity of depression symptoms according to BDI scale (17.11 ± 9.38 vs. 12.73 ± 8.1 points; p <0.04) and the symptoms of anxiety-depressive disorder according to the screening questionnaire were noted more often (p <0.0008) in patients with unstable angina compared with stable angina – in 85 (88.54 %) vs. 52 (68.42 %) patients (р <0.0008). In the group of patients with stable angina the level of depression according to BDI scale in patients taking pharmacological treatment was higher in comparison with the patients who underwent myocardial revascularization (14.56 ± 9.0 vs. 10.03 ± 6.13 points; p <0.01). Quality of life parameter according to modified SAQ was statistically significantly decreased in the subgroups of patients with increasing severity of depression symptoms according to BDI scale (10–63 points) compared with the subgroup of patients with no depression (0–9 points). Conclusion. According to the screening questionnaire, a high incidence of anxiety-depressive disorder was found in patients with CHD. The symptoms of anxiety-depressive disorder and the severity of depression symptoms according to BDI scale were noted more often in the group of patients with unstable angina compared with the group of patients with stable angina. Quality of life parameter according to modified SAQ was statistically significantly reduced with increasing severity of depression symptoms according to BDI scale in subgroup of patients with symptoms of depression compared with the subgroup of patients without depression. According to the results of the study the BDI scale is more sensitive for the ","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"12 1","pages":"28-36"},"PeriodicalIF":0.0,"publicationDate":"2018-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44104083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SAFETY AND EFFECTIVENESS OF TRI VALENT INACTIVATED SPLIT VIRION INFLUENZA VACCINE IN PATIENTS WITH RHEUMATOID DISORD ERS","authors":"D. Bukhanova, В. S. Belov, G. Tarasova, S. Erdes, T. Dubinina, G. Lukina, M. Cherkasova, M. Diatroptov","doi":"10.17650/1818-8338-2018-12-1-25-28","DOIUrl":"https://doi.org/10.17650/1818-8338-2018-12-1-25-28","url":null,"abstract":"Objective: to evaluate the safety and effectiveness of vaccination with trivalent split virion influenza vaccine in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS), estimate the effect of vaccination on rheumatoid disorder (RD) activity and influenza and influenzalike illnesses morbidity.Materials and methods. The study included 86 patients (58 females and 28 males aged 22–82 years) with RDs (52 patients with RA and 34 patients with AS), as well as 40 subjects without RD (control group). At the time of study inclusion, all patients were receiving drug therapy. Duration of RD varied from 2 months to 46 years. The Vaxigrip vaccine containing the currents trains of the flu virus for 2016–2017 season or 2017–2018 season was administered subcutaneously as 1 dose (0.5 ml) with continuing antirheumatic therapy. The main control stages were visits 1, 3, and 6 months after vaccination. During the visits, standard clinical and labtests, clinical examination with disease activity evaluation were performed.Results. In 98 patients, vaccination tolerability was high, no post vaccination reactions were observed. In 20 cases, pain, swelling, and hyperemia of the skin 2 cm in diameter at the point of vaccination were observed; in 8 cases, low-grade fever, myalgia, discomfort, headache were observed. No RD flares or development of new autoimmune disorders were diagnosed during the follow-up period. No cases of influenza or influenza-like illnesses were registered during the follow-up period.Conclusion. The obtained data demonstrate high tolerability, clinical effectiveness of trivalent split virion influenza vaccine in patients with RA and AS.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46721719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STILL’S DISEASE IN A DULTS (CLINICAL CASES)","authors":"M. Z. Kanevskaya, T. Kondratyeva","doi":"10.17650/1818-8338-2018-12-1-57-62","DOIUrl":"https://doi.org/10.17650/1818-8338-2018-12-1-57-62","url":null,"abstract":"Objective: to analyse and describe clinical cases of Still’s disease in adults and peculiarities of therapy in patient with a monocyclic course of the disease who had at the beginning of the observation a high systemic account (12) and in patient with a recurrent course of the disease with a positive result for 25 and 10 years of a dynamic observation. Materials and methods. Patient L., a female, 35 years old, was taken to the therapeutic department of the clinic with fever of 38–39 °С, chills and sweating, resistant not itching rash, lymphadenopathy, signs of myocarditis, loss of 20 kg of weight, exudative pleurisy, pronounced orthopnea with respiration rate of 40–48, tachycardia up to 130 beats per minute, myalgia, hepatosplenomegaly and abdominal pains. In past medical history for 2 months of the disease the patient was examined, and the sings of disease progression were present. The clinical constellation in patient L. allowed us to formulate a diagnosis of Still»s disease. Some investigations were conducted repeatedly to track the changes. The following therapy by Indomethacin in a daily dose of 150–200 mg/day for 1 year and for 6 months in combination with D-penicillamine in a dose of 450 mg/day induced remission. Till the end of 2016 the disease recurrence was not revealed. In another patient B., a male of 57 years old, the disease manifested with sub-febrile temperature, pain in a testicular area, thrombocytosis, and the symptoms increased in 2 weeks and included resistant febrile temperature, lymphadenopathy, changes of laboratory tests, signs of nephropathy and encephalitis. The patient was examined to exclude oncology. Results. Still’s disease was diagnosed and the following therapy was administrated: diclofenac and methotrexate for 4 years with episodes of disease recurrence in case of decreasing the doses of the medications, but in future the therapy managed to cancel, and there was no recurrence observed. Conclusion. These clinical cases have demonstrated peculiarities of course, diagnostic and management of patients with Still’s disease, the possibility of prescribing non-steroidal anti-inflammatory drugs and synthetic basic anti-inflammatory drugs for achievement of persistent disease remission.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67771138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORRELATION BETWEEN VAS OPRESSIN CONCENTRATION AND CHRONIC HEART FAILURE SEVE RITY: CHARAC TERISTICS OF PA TIENTS WITH TERMINAL AND DECOMPE NSA TED HEART FAILURE","authors":"E. S. Trofimov, A. S. Poskrebysheva, N. Shostak","doi":"10.17650/1818-8338-2018-12-1-36-42","DOIUrl":"https://doi.org/10.17650/1818-8338-2018-12-1-36-42","url":null,"abstract":"Objective: to evaluate vasopressin (VP) concentration in patients with varying severity of chronic heart failure (CHF), intensity of clinical symptoms, and decreased level of left ventricular ejection fraction (LVEF). Materials and methods. In total, 120 patients (44 males, 76 females) with CHF of varying genesis (mean age 72.12 ± 10.18 years) and 30 clinically healthy individuals (18 males, 12 females) as a control group (mean age 33.4 ± 6.23 years) were examined. All patients underwent comprehensive clinical and instrumental examination in accordance with the standards for patients with CHF. The VP level was determined using ELISA. Statistical analysis was performed using the IBM SPSS Statistics v. 23 software.Results. The patients with CHF had significantly higher blood VP levels compared to the control group (72.91 ± 53.9 pg/ml versus 6.6 ± 3.2 pg/ml respectively; p <0.01). At the same time, patients with stage III CHF had significantly lower VP levels than patients with stages IIВ and IIА (35.61 ± 21.53 pg/ml versus 71.67 ± 48.31 pg/ml and 86.73 ± 59.78 pg/ml respectively; p<0.01). A similar picture was observed for the functional classes (FC). For instance, for CHF FC II and III, the VP level was 91.93 ± 67.13 pg/ml and 77.95 ± 54.01 pg/ml respectively, while for FC IV it decreased to 50.49 ± 28.18 pg/ml (p <0.01). The VP concentration in patients who subsequently perished was significantly lower than in patients who survived (48.79 ± 26.30 pg/ml versus 79.72 ± 57.73 pg/ml; p = 0.012). Moreover, in patients with LVEF <50 %, the VP level was significantly lower than in patients with LVEF >50 % (59.43 ± 42.51 pg/ml versus 86.43 ± 62.46 pg/ml respectively; p <0.05).Conclusion. The observed significant differences in VP in patients with stage III and IV CFH can indicate depletion of neurohumoral mediators in this patient category. However, a correlation between the VP level and the level of LVEF decrease can indicate a significant difference in the role of VP in CHF pathogenesis in patients with preserved and decreased LVEF. This observation requires further research.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44620906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ГЕНДЕРНАЯ И ВОЗРАСТНАЯ СТРУКТУРА МНОЖЕСТВЕННЫХ ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЙ ПАЦИЕНТОВ РЯЗАНСКОЙ ОБЛАСТИ","authors":"Н. С. Асфандиярова, О. В. Дашкевич, Е. В. Заикина, Е. И. Сучкова, Н В Хотеенкова, А Н Якубенко, И А Прокудина, Т С Волхонцева, Е А Печенкина, Е В Красильникова, О А Маркина, М. Н. Алексеева","doi":"10.17650/1818-8338-2017-11-3-4-65-72","DOIUrl":"https://doi.org/10.17650/1818-8338-2017-11-3-4-65-72","url":null,"abstract":"The study objective is to investigate gender and age structure of multiple chronic conditions (MCC) among patients seeking medical help from a primary care physician. Materials and methods . In total, 1940 patients under the care of primary care physicians in several polyclinics of Ryazan and the Ryazan Region were examined: 646 men and 1294 women aged 18–99. The list of conditions included cardiovascular disorders, lung, gastrointestinal, kidney diseases, oncological diseases, diabetes mellitus, etc. All diagnoses were made per the generally accepted criteria. The patients were divided into 5 age groups; age and gender structure of MCC, as well as polymorbidity index (total number of conditions per 1 patient), were determined. Results. Among all patients with MCC in all age groups, the number of women was larger than men. In the structure of MCC, predominance of cardiovascular disorders, diseases of the kidneys and joints was observed. With age, the fraction of patients in whom the majority of organs and systems was affected increased. However, in older patients, peptic ulcer disease, diabetes mellitus, oncological and autoimmune diseases were comparatively rare. In men, the mean number of diseases per 1 patient was higher, but after 75 years of age the number  of conditions in women exceeded the number in men. In obese patients, age increase led to quicker polymorbidity increase than in normal patients. The gender differences consisted of the prevalence of stomach/duodenal peptic ulcer, non-specific lung diseases, obliterating atherosclerosis of the lower extremities in men, and kidney diseases, diabetes mellitus type 2 in women. Conclusion. The main causes of polymorbidity are old age and obesity. In the structure of MCC, cardiovascular diseases, kidney and joint disorders are the most common. A gender difference in the incidence of some diseases is observed.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"11 1","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"2018-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67770918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INTERSTITIAL LUNG DISEASES: KEY TARGETS FOR THERAPY","authors":"N. Shostak, A. Klimenko, A. Kondrashov","doi":"10.17650/1818-8338-2017-11-3-4-10-16","DOIUrl":"https://doi.org/10.17650/1818-8338-2017-11-3-4-10-16","url":null,"abstract":"Interstitial lung diseases (ILDs) are a heterogenous group of disorders and pathological conditions of known and unknown nature characterized by extensive and, generally, bilateral damage of the respiratory part of the lungs (alveoli, respiratory bronchioles). Until recently, there weren’t any effective therapies for patients with progressive pulmonary fibrosis, partly because of limited knowledge of the disease pathogenesis. However, in the last decade, new data of etiological, genetic factors and pathogenetic mechanisms of ILD were obtained. Currently, only two drugs were proven effective for treatment of patients with interstitial pulmonary fibrosis: pirfenidone and nintedanib which affect the rate of progression of restrictive changes in the lungs. The search for drugs is continuing in accordance with the growing understanding of pathogenetic mechanisms of ILDs. Notably, recent years saw an “explosion” of pre-clinical studies.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67770748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Антитромботическая терапия пациентов с клапанной болезнью сердца: что нового?","authors":"Надежда Александровна Шостак, А. А. Клименко, Д. Ю. Андрияшкина, Н. А. Демидова","doi":"10.17650/1818-8338-2017-11-2-10-15","DOIUrl":"https://doi.org/10.17650/1818-8338-2017-11-2-10-15","url":null,"abstract":"The article presents an overview of modern data and an analysis of the recommendations of the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery published in 2017 regarding the use of antithrombotic therapy in patients with valvular heart disease. The results of studies devoted to the use of new oral anticoagulants in patients with valvular heart disease are demonstrated.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"11 1","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47363995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"НЕКОМПАКТНЫЙ МИОКАРД ЛЕВОГО ЖЕЛУДОЧКА: ПРИМЕР РЕДКОГО ЗАБОЛЕВАНИЯ В КЛИНИЧЕСКОЙ ПРАКТИКЕ","authors":"О. В. Гайсёнок, Татьяна Борисовна Гребенюк, П. А. Курносов, И. В. Шаталова","doi":"10.17650/1818-8338-2016-10-4-60-64","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-4-60-64","url":null,"abstract":"Objective: to describe the clinical case of a rare heart disease – left ventricular non-compaction. Materials and methods. Patient G., 1948, was hospitalized in connection with complaints of fluctuations in blood pressure, heart failure, discomfort in the heart, dizziness, headaches. The patient underwent the following general examination: general and biochemical blood tests, electrocardiography, Holter ECG monitoring, treadmill test, echocardiography, color duplex scanning of neck vessels, ultrasound of the thyroid and kidneys, chest X-ray. Results. Based on the history, complaints, clinical picture of the disease, objective and instrumental examination data, a clinical diagnosis was made: left ventricular non-compaction. One of the main diagnostic methods that allowed to verify the diagnosis was echocardiographic study: the structure of the myocardium of the lower-apical section of a two-layered one, with the presence of a noncompact layer (with intertabercular breaks), in relation to the compact as 2:1; a small extension of the left atrium; small hypokinesia in the lower-upper segment of the LV, without a decrease in the LVEF (PV = 73 %). Conclusion. This clinical case is interesting because the disease, concealed under the guise of rheumacarditis in an era when ultrasonic methods of examining the heart were not available in clinical practice, has now been diagnosed in the conduct of a reference echocardiographic study. Despite the fact that this disease belongs to rare nosology, it can occur in any age group and can often be asymptomatic.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"11 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2017-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49008226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"КЛИНИЧЕСКИЕ ПРОЯВЛЕНИЯ ИНФЕКЦИОННОГО МИОКАРДИТА У МУЖЧИН И ЖЕНЩИН","authors":"Array А. Сергеева, Array С. Шмойлова","doi":"10.17650/1818-8338-2016-10-4-45-49","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-4-45-49","url":null,"abstract":"The study objective to estimate the clinical manifestations of infectious myocarditis in men compared to women in real clinical practice. Materials and methods . A retrospective analysis of medical records from 2011 to 2015 of patients with infectious myocarditis that were hospitalized in the cardiology department No. 1 “Regional Clinical Hospital”. We compared the clinical manifestations of myocarditis in men and women. Statistical data processing was carried out with StatPlus 2009 Professional package. Results. In group of men with moderate myocarditis heart disruptions was a dominated complaint (75 %) in group of women with a similar degree of severity of the disease this complaint was also a major (71 %). However women were significantly more marked hyperthermia in this subgroup compared with men (57 % in females and 25 % males (p 0.05)). The conduction abnormalities were registered in group of women. Conclusions . The clinical manifestations of infectious myocarditis in men and women revealed some interesting features. Dyspnea with severe myocarditis in men is registered more often than in women, probably due to the higher rate of smoking among men, as well as the presence of chronic obstructive pulmonary disease patients in our study. At moderate myocarditis in women hyperthermia dominated compared with men. Cardiac arrhythmias in myocarditis occur with equal frequency in both men and women, the most common extrasystoles recorded in group of women, atrial fibrillation in our study was prevalent in men. Conduction abnormalities were harder and more common in women.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"11 1","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2017-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46660708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫ И ПРИВЕРЖЕННОСТЬ ТЕРАПИИ У ПАЦИЕНТОВ ПОСЛЕ ОСТРОГО ИНФАРКТА МИОКАРДА: ДАННЫЕ РЕГИСТРА (ХАБАРОВСК)","authors":"Илья Михайлович Давидович, Л. Н. Малай, Н. П. Кутишенко","doi":"10.17650/1818-8338-2016-10-4-36-44","DOIUrl":"https://doi.org/10.17650/1818-8338-2016-10-4-36-44","url":null,"abstract":"Objective . To evaluate the long-term outcomes and medical treatment in patients during 2.5 years after reference acute myocardial infarction (AMI), to study adherent to medical treatment and the role of various factors affecting the long-term prognosis. Materials and methods . The AMI Register included data about all patients, whom are consistently hospitalized in the regional vascular center (RVC) of Khabarovsk during the period from 01.01.14 till 31.03.14. The 2.5 years outcomes and adherence to treatment were evaluated by using phone interview. Results . According to prospective part of the AMI Register of 292 patients discharged from the regional vascular center (RVC), the vital status in 2.5 years managed to be established at 274 (93.8 %) from which died 45 (16.42 %, or 15.40 % from all discharged patients). In structure of a mortality the proportion of dead from cardiovascular disease (СVD) patients made 86.6 %. The long-term mortality of patients with myocardial infarction with ST-segment elevation was 19.3 %, the myocardial infarction non-ST-segment elevation – 13.2 %; р = 0.632. The new predictors of death 2.5 years after the onset of AMI were cerebrovascular diseases, the absence of the antihypertensive drugs and β-blockers before reference AMI, not prescribing antiplatelet drugs in loading doses in the early hours of the disease. Frequency of real reception of statins was 65.1 %, angiotensin-renin blockers –76.0  %, β-blocker – 73.8 % of patients after AMI. Only 55.9 % patients Received double antithrombocytic therapy (DATT)  during a year. By  the Moriscors–Green test adherent were only 109 (47.6 %). 79 (34.5 %) know their values cholesterol, blood pressure and blood glucose. Conclusions . Indicators of the remote lethality among patients authentically didn’t differ with a myocardial infarction with ST-segment elevation in AMI and a myocardial infarction non-ST-segment elevation in AMI in the remote period. The register AMI taped failure predictors, showed the insufficient frequency of reception of recommended medicinal drugs in secondary prophylaxis after a referent AMI, especially concerning statines and DATT.  The  commitment of patients of long medicamental therapy, and also awareness on indicators of quality of treatment (level of a cholesterin, blood pressure) in real clinical practice according to the register were low.","PeriodicalId":82998,"journal":{"name":"The Clinician","volume":"11 1","pages":"36-44"},"PeriodicalIF":0.0,"publicationDate":"2017-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41579432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}