Cardiac volume load and heart failure prognosis in patients with uncomplicated myocardial infarction

То predict heart failure (HF) in 192 patients with Q-wave myocardial infarction (Q-MI), a brief cardiac volume load (VI) test was performed at MI Day 3. Group I included 50 patients with Q-MI and HF II (Killip) (n=50), Group II- 108 patients with Q-MI and no HF (left ventricular ejection fraction, IVEF >40 %), Group III - 34patients with Q-MI, no HF (IVEF>40 %), but with pathologic VI test reaction. These participants received alpha-blocking beta-blocker carvedilol instead ofmetoprolol. The control group included 20 healthy people. In controls, VI test was associated with improved IV systolic and diastolic functions (SF, DF); IV form became more ellipsoid (normal VI reaction). In Group I, VL test was associated with disturbances in SF and IV filling structure; IF form became more spheroid (pathologic reaction). In Group II, normal reaction was observed in 40 %, pathologic reaction - in 60 %. During one-year follow-up period, HF developed only in patients with pathologic VI reaction (28,1 %). long-term carvedilol therapy reduced HF incidence inpatients with uncomplicated Q-MI and pathologic VI reaction, from 28,1 % to 11,8 % (p<0,05)

Effectiveness of preJhospital betaJblocker therapy in patients with acute coronary syndrome

To assess the effectiveness of pre-hospital beta-blocker therapy in patients with acute coronary syndrome (ACS), 76 individuals with Q-wave myocardial infarction (Q-MI), and 62 persons with non-Q wave MI (non-Q-MI) were examined. Q-IM patients received aspirin, streptokinase, heparin, beta-blocker, and enalapril. They were divided into two groups, according to reperfusion status after thrombolysis (TL): Group I (reperfusion), Group II (no reperfusion). Each group was divided into subgroups, by the time of beta-blocker administration: subgroups Ia and IIa – pre-hospital administration, Ib and IIb – hospital treatment. Patients with non-Q-IM (Group III) were also divided into subgroups: IIIa – pre-hospital beta-blocker administration, IIIb – hospital beta-blocker treatment. Early (pre-hospital) beta-blocker therapy was associated with reduced area of myocardial necrosis, improved systolic and diastolic function, left ventricular geometry and clinical prognosis in MI patients

LEFT VENTRICLE DIASTOLIC DYSFUNCTION IN PATIENTS WITH ANTERIOR WALL MYOCARDIAL INFARCTION AND DRUG PREVENTION OF CONGESTIVE HEART FAILURE (A LONG-TERM OBSERVATION)

The aim of this study was to evaluate LV diastolic reserve (DR) and possibilities of long>term prevention of congestive heart failure with long>term administration of Captopril and Carvedilol in patients with anterior wall MI and silent LV diastolic dysfunction. DR was measured in patients with MI by means of volume stress, and accordingly the patients were divided into 2 groups: 1st (n=20) with preserved LV DR treated by Streptokinase, aspirin, heparin, captopril and atenolol, 2nd (n=43) with decreased LV DR. Patients with decreased LV DR were divided into groups: A – treatment identical to the 1st group, B – atenolol substituted for carvediolol. The results of the study have shown that severe types of LV DD – congestive HF – developed only in patients with decreased LV DR, whereas long>term (6 months) combined administration of Captopril and Carvedilol reliably decreases the incidence of congestive HF in patients with MI

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries

WOS: 000468732700018PubMed ID: 31054483Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient.ESC - EORP; AmgenAmgen; Eli LillyEli Lilly; PfizerPfizer; SanofiSanofi-Aventis; Ferrer; Novo NordiskNovo NordiskThe EUROASPIRE V survey was carried out under the auspices of the ESC - EORP. Since the start of EORP, the following companies have supported the programme: Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk. The sponsors of the EUROASPIRE surveys had no role in the design, data collection, data analysis, data interpretation, decision to publish, or writing the manuscript

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries

Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8\% of the patients and had been started or increased in intensity in 11.7\%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8\% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient