ST-segment Elevation Myocardial Infarction. Study Data

Relevance. Kardiovascular diseases remain the leading cause of disability and mortality among people of all ages, not only in Russia, but also in other developed countries. Death from myocardial infarction occurs from its complications. The creation of vascular centers in the Russian Federation, as well as the use of modern technologies for the provision of specialized care for acute coronary syndrome (ACS) have clearly led to a decrease in cases of complicated myocardial infarction and mortality rates from them in general. At the same time, the still fairly frequent occurrence of these life-threatening conditions requires further efforts to improve the quality of their diagnosis and treatment. Aim of Study. To study the course of complicated myocardial infarction (MI) and assess the frequency of its early and late complications. Material and Methods. The study included 2,172 patients who were treated in the emergency cardiology department for patients with MI of the N.V. Sklifosovsky Research Institute for Emergency Medicine for the period from 2011 to 2021 with complicated MI. This cohort accounted for 79% of the total number of hospitalized patients (n=2,741) during the specified observation period. All patients underwent the necessary diagnostic methods and received treatment at a modern level. Results. The article presents information on the treatment outcomes of patients with complicated MI for the period from 2011 to 2021. The frequency of various MI complications was analyzed, taking into account the modern approach to providing specialized care to patients with ACS within the regional vascular center. As a result of the study, complications in acute myocardial infarction, their frequency of development were studied and algorithms for optimizing the modern approach to diagnosis, prevention and treatment of these complications were developed. The study noted a statistically significant decrease in the frequency of such complications by 1.5–15 times in most cases, especially early post-infarction angina, left ventricular aneurysm formation, mechanical myocardial damage (myocardial ruptures), as well as the development of Dressler syndrome. Conclusion. It has been established that as specialized care for patients with acute coronary syndrome with ST segment elevation improves within the framework of the network of vascular centers, a decrease in the number of complications at different stages of the disease and mortality in general is observed. However, complications such as cardiogenic shock and heart failure dictate the need for further study and development of modern methods for their prevention and treatment.