[Current trends in the treatment and outcome of acute myocardial infarction (MI)].
Current trends in the treatment and outcome of acute myocardial infarction were studied in a trial entering 2411 patients with macrofocal myocardial infarction (MI) treated in 1993-1998. There were many cases of severe and repeated MI. The age of the patients tends to increase. Lethal outcomes' probability is very high in multiple stenosis of the coronary arteries. This condition is associated with a high risk of cardiac insufficiency progression because of inadequate blood supply to necrosis-free myocardial zones. Thrombolytic therapy (TLT), ACE inhibitors reduce lethality but their use is limited by such factors as concurrent diseases, time from MI onset, rethrombosis risk. As a result, only 1/5 of the patients received pharmacological treatment. Balloon angioplasty is indicated in contraindications to TLT, in TLT failure or large residual stenosis. ACE inhibitors slow down the progression of cardiac insufficiency giving time for surgical revascularization. Updated treatment of MI improved its outcomes, but further progress in lowering MI lethality will be insignificant unless efficient methods providing adequate blood supply to the myocardium are introduced.
Golikov
A P
AP
Riabinin
V A
VA
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002391:Catchment Area, Health; D003331:Coronary Vessels / Q000601:surgery; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D005343:Fibrinolytic Agents