Key result
Non-compliance with treatment recommendations on the first day of MI, including inadequate antiplatelets (P=0.001) and anticoagulants (P=0.00002), was associated with severe hemodynamic complications.
Why the study?
Does compliance with treatment recommendations on the first day of right ventricular myocardial infarction prevent severe hemodynamic complications?
Observational (n=155)
Does compliance with treatment recommendations on the first day of right ventricular myocardial infarction prevent severe hemodynamic complications?
Answers are grounded in this paper and cite their sources.
Non-compliance with treatment recommendations on the first day of right ventricular myocardial infarction, including underuse of antiplatelets/anticoagulants and overuse of vasodilators, is significantly associated with life-threatening hemodynamic complications.
The aim — to determine the correlation between the implementation completeness of the recommendations for treatment on the first day of the QIM of the left ventricle (LV) posterior wall (PW) with expansion to the right ventricle (RV) on the clinical course of the disease.Materials and methods.155 patients with QMI of the PWLV with expansion to the RV aged 64.11 ± 2.42 years, 103 (66.5 %) men and 52 (33.5 %) women were examined. Patients were divided into two groups: the 1st group — 29 (18.7 %) patients, who demonstrated severe hemodynamic complications (cardiogenic shock (CS) and Killip III); the 2nd group — 126 (81.3 %) patients with a stable hemodynamics. The quality of therapy was evaluated in the first 24 hours of MI treatment.Results and discussion. Severe hemodynamic complications were more common in women (p = 0.0016) and were associated with later hospitalization (p < 0.05), and with a low frequency of the ECG RV3—RV4 (p = 0.00001) recording at the prehospital stage. The development of CS and Killip III in patients with QIM of the PWLV with expansion to the RV was associated with low frequency of adequate doses of antiplatelet drugs prescription (p = 0.001), anticoagulants (p = 0.00002) and statins (p = 0.037) in the prehospital stage. The correlation between the development of severe hemodynamic disorders and the insufficient use of infusion solutions for the purpose of preload restoration on the RV (p = 0.011) and the high frequency of drugs with vasodilator properties application, in particular, ACE/ARA (p = 0.0004), nitrates (89 7 %, p = 0.0005), diuretics (62.1 %, p = 0.0012) and MgSO4 (51.7 %, p = 0.002) was established.Conclusions. In patients with QIM PWLV with expansion to the RV, the development of lifethreatening hemodynamic complications, in particular, CS and Killip III, is significantly associated with a low level of diagnosis of the RV MI and noncompliance with the requirements of treatment recommendations on the first day of MI.
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Tseluyko et al. (2018) conducted an observational in Q-wave myocardial infarction of the left ventricle posterior wall with expansion to the right ventricle (n=155). Non-compliance with treatment recommendations vs. Compliance with treatment recommendations was evaluated on Severe hemodynamic complications (cardiogenic shock and Killip III). Non-compliance with treatment recommendations on the first day of MI, including inadequate antiplatelets (P=0.001) and anticoagulants (P=0.00002), was associated with severe hemodynamic complications.
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