Prognosing of myocardial infarction outcome in arterial hypertension patients

Abstract

7-year prospective trial in 352 patients with essential hypertension (EH) was performed. The essence of the research was an original complex clinical-instrumental examination of hospitalized patients, with their annual follow-up in out- and in-patient conditions. Two clinical groups were formed: Group 1 - patients with uncomplicated EH (n = 263); Group 2 - patients with EH complicated by myocardial infarction (MI) (n = 89). Prognostic decision was based on disease manifestations at baseline investigation. The final result, reflected in the classification, was MI registered in the 7-year follow-up period. Total prognostic accuracy of the classification, verified in the control group, reached 88. 5 %. IM predictors were: smoking, absence of regular antihypertensive therapy (AHT), increased peripheral vascular resistance, enhanced angiotensin 1 level, advanced left ventricular hypertrophy, with increased end-diastolic volume, low ejection fraction, high level of very low-density lipoprotein cholesterol, and myocardial ischemia during stress tests. Integral index of individual severity, calculated on the basis of prognostic decision rule, gives a possibility to perform the targeted prevention of cardiac complications.