ENDOVASCULAR INTERVENTION EFFECTS ON POST-INFARCTION CLINICAL COURSE IN PATIENTS UNDER 60 YEARS

Abstract

Aim. One of the major issues in modern cardiology is the treatment and prevention of complications in younger patients (under 60 years) after myocardial infarction with ST segment elevation (STEMI). According to the available evidence, in female patients, endovascular interventions are less common, and coronary artery bypass graft surgery is more common than in male patients. Material and methods. The study included 102 male and female patients aged under 60 years and diagnosed with STEMI. In all participants, coronary angiography was performed within first 6 hours, followed by infarct-related artery revascularisation via balloon angioplasty and stenting. At Days 10–15, as well as 6 and 12 months later, clinical examination (presence of angina, heart failure, or arrhythmias), Holter ECG monitoring, and treadmill test were performed. Results. The results of the one-year follow-up suggested that in female patients, heart failure developed earlier, ejection fraction was significantly lower, and Functional Class II angina was more prevalent than in their male peers. Moreover, female patients more often demonstrated clinically significant cardiac arrhythmias, reduced exercise capacity, and decreased heart rate variability. Conclusion. Post-infarction clinical course in women under 60 years was characterised by earlier development of heart failure, which justifies adequate control of its clinical manifestations and more aggressive therapy. The prevalence of effort angina or supraventricular extrasystolia was higher in women, which requires the antianginal therapy correction, via increasing the doses of β-adrenoblockers or calcium channel blockers. In men, ventricular arrhythmias were more prevalent, which might require antiarrhythmic drug therapy.

Keywords

• myocardial infarction
• coronary heart disease
• coronary angiography
• chronic heart failure