Aim. To study the sex characteristics of cognitive functions in a cohort of patients undergoing coronary artery bypass grafting (CABG) by comparing the results of Mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores.

Material and methods. The prospective cohort study included 272 people, including 74 women aged 41 to 82 years, who were admitted to the Research Institute of Complex Issues of Cardiovascular Diseases for CABG surgery. All patients underwent clinical, laboratory, electrophysiological and ultrasound examinations. The Charlson comorbidity index (CCI) was calculated. Assessment of cognitive functions was carried out using the MMSE and MoCA scores. All types of statistical analysis were performed using the STATISTICA 10 program (StatSoft Inc., USA).

Results. It was found that women scheduled for CABG have an older age and a higher CCI score compared to men (p=0,008). According to the MMSE, the likelihood of moderate and severe cognitive impairment in men compared with women was 1,36 times higher (odds ratio (OR), 1,35; 95% confidence interval (CI), 0,79-2,32, Z=1,11, p=0,27). The MoCA scores showed that half of the male (49%) and female (50%) participants had severe cognitive impairment. The likelihood of moderate

and severe cognitive impairment in men compared with women was 1,33 times higher (OR, 1,33; 95% CI, 0,68-2,59, Z=0,841, p=0,40). According to subtests of the MoCA, men were better in naming (p=0,002), abstraction (p=0,005), and women outperformed men in verbal fluency (p=0,04). Regression analysis revealed that the most significant negative predictors for cognitive status as measured by the MMSE and MoCA scores for men and women were age and CCI.

Conclusion. Women scheduled for CABG, having the worst clinical and demographic indicators, are comparable with men in cognitive status using the MMSE score. The MoCA score shows sex differences in naming, abstraction, and verbal fluency domains and revealed a higher percentage of severe cognitive disorders (up to 50%) compared to the MMSE score (7-9%). In male and female candidates for CABG, age and comorbidities are negatively associated with cognitive status.

Aim. To describe profile of a modern portrait with non-ST-segment elevation myocardial infarction (non-STEMI) through a comprehensive analysis of the Emergency Cardiology Unit (ECU) practice, which discharge a function of a regional vascular centre.

Material and methods. To describe the non-STEMI trends of the last decade, we analysed the annual reports on ECU work. The main analysis included patients with a documented non-STEMI treated in 2019 (n=221). We used information from the department database. A Microsoft Excel software was used to create the database. The base has been filled in by the ECU head in real time since 2009. Statistical data processing was performed using the Statistica 10,0 software package. The methods of descriptive statistics and Yates-corrected chi-square test were used.

Results. The following clinical and demographic trends of the last decade were revealed: an increase in the number of patients with non-STEMI, proportion of male patients, mean age of patients, proportion of patients with MI with non-obstructive coronary artery disease; no decrease in in-hospital mortality, despite the introduction of modern guidelines, pharmacological and invasive treatment of non-STEMI. In 2019, the proportion of male patients and patients 75 years and older was 62,4% and 32%, respectively. The mean age of patients was 64,6±13,0 years. Clopidogrel was the predominant P2Y12 receptor blockers (56,1%). A total of 176 patients (79,6%) underwent the invasive procedures. Endovascular myocardial revascularization was performed in 97 patients (43,9%), while in the group over 75 years old — in 16 (7%) patients. The leading causes for absence of myocardial revascularization were chronic kidney disease (4,6%), severe coronary artery disease (6,3%), “borderline” (50-60%) coronary artery stenosis. The overall in-hospital mortality rate was 9,0%, while in the group of patients over 75 years old — 19,7%. Mortality rates did not differ in patients with and without myocardial revascularization (p=0,2). However, the incidence of pulmonary oedema was higher in the conservative treatment group (p=0,04).

Conclusion. Treatment of patients 75 years and older remains the main barrier in management of patients with non-STEMI. We observe the treatment-risk paradox, which consists in choosing a less aggressive treatment strategy in the group of the most high-risk patients. Other relevant aspects in the management of non-STEMI patients are the selection of a method for myocardial revascularization in multivessel coronary artery disease, assessment of the hemodynamic significance of coronary artery stenosis, and patients with non-obstructive coronary artery disease.

Aim. To evaluate the prognostic value of growth differentiation factor-15 (GDF-15) in patients with acute myocardial infarction (MI).

Material and methods. The study included 118 patients under the age of 70 with STand non-ST segment elevation myocardial infarction, who, in addition to routine examination, were tested for GDF-15 by enzyme-linked immunosorbent assay in the first 48 hours from the onset. The statistical significance of the differences in quantitative indicators was assessed by the Student’s t-test for a normal distribution and by the nonparametric U Mann-Whitney test for a non-normal distribution, while in qualitative indicators — by Pearson’s chisquared test. Pearson’s correlation coefficient and Spearman’s rank correlation coefficient were used as an indicator of strength of relationship between quantitative indicators.

Results. The average GDF-15 level in patients with MI was 2,25±1,0 ng/ml. For 6 months of follow-up, 15,25% of patients were rehospitalized for unstable angina or recurrent myocardial infarction. The GDF-15 level in 82,6% of cases was in the third and fourth quartiles (≥2,07 ng/ml). All patients with recurrent MI had GDF-15 levels in the upper quartile (≥2б73 ng/ml). Patients with GDF-15 levels in the upper quartile had a significantly higher risk of rehospitalization (hazard ratio, 3,3 (95% CI, 1,65-6,76), p<0,05) compared with patients with GDF-15 levels in other quartiles. The potential for the combined use of GDF-15 and N-terminal probrain natriuretic peptide (NT-proBNP) levels to assess the risk of readmission has been evaluated. Patients who had both GDF-15 and NT-proBNP levels in the upper quartiles (GDF-15>2,73 ng/ml, NT-proBNP>1418 pg/ml) had 4,8 times higher risk of rehospitalizations for unstable angina or recurrent myocardial infarction.

Conclusion. In patients with MI, the determination of the GDF-15 level has prognostic value and may serve as an additional marker of the risk of recurrent cardiovascular events.

Purpose. To assess the effect of preexisting atrial fibrillation (AF) on prognosis in patients with type 1 myocardial infarction (MI).

Material and methods. These patients were selected from 1660 patients with MI admitted to cardiology department of the NWSMU named after I.I. Mechnikov in 2013-2018. They formed the main group (100 patients). The control group included 200 patients with type 1 MI without AF with the same gender, age. In order to balance groups by prognostically significant factors propensity score matching was carried out. Тhen effect of AF on endpoints was assessed.

Results. Patients with type 1 MI and preexisting AF have higher comorbidity, lower ejection fraction. In this group in-hospital pulmonary embolism (PE) (9 % versus 1 % in patients without AF, p=0,0011), minor bleeding (21 % versus 9,5 %, p=0,0057), combined endpoint (stroke + PE + mortality) (19 % versus 10,5 %, p=0,0415) were more common. In the long-term period patients with AF had a higher rate of hospitalizations due to decompensation of chronic heart failure (CHF) (OR=2,47 (95 % CI =1,20–5,08), p=0,0137) and higher incidence of minor bleeding (OR=10,77 (95 % CI =2,36–49,24), p=0,0022). Preexisting AF in patients with type 1 MI (after adjustment for prognostically significant factors) increased the risk of all-cause (OR=5,0 (95 % CI =1,5-17,1), p=0,0072) and cardiovascular mortality (OR=4,1 (95 % CI =1,1-14,9), p=0,0236), increased the risk of CHF III-IV (OR=4,9 (95 % CI =1,2–20,4), p=0,0147), but had no effect on the frequency of ischemic events.

Сonclusion. In patients with type 1 MI and pre-existing AF in-hospital and long-term prognosis is worse than in patients without AF. Preexisting AF in these patients is an independent predictor of severe CHF at discharge, cardiovascular and all-cause mortality over follow-up period.

Aim. To compare parameters of prothrombotic activity in patients with myocardial infarction (MI) with obstructive (MICAD) and non-obstructive coronary artery disease (MINOCA).

Material and methods. The study included 40 patients with MI, which were divided into experimental (n=19) and control group (n=21). Three patients (15,7%) with acute myocarditis were excluded from the analysis. Hemostasiological and hematological blood tests were studied upon admission, on the 2nd, 4th, 7th days from hospitalization. Blood samples for protein C, antithrombin, von Willebrand factor (VWF), plasminogen, homocysteine were performed on 4th±1 day from hospitalization. To determine the IgG/IgM anticardiolipin (aCL) and anti-beta 2 glycoprotein I (β2-GPI) antibodies in order to diagnose antiphospholipid syndrome (APS), the ORGENTEC Anti- β2-Glycoprotein I IgG/IgM ELISA enzyme immunoassay was used. Blood tests for lupus anticoagulant were performed using an ACL-Top 700 analyzer (Werfen) with HemosIL SynthASil dRVVT screen/dRVVT confirm and with a SCT screen/SCT confirm quartz activator.

Results. According to the data obtained, it was found that patients with MINOCA had a significantly lower level of plasminogen (p=0,007), as well as a higher level of homocysteine (p=0,03). For such indicators as protein C, antithrombin, ejection fraction, differences between the groups were not revealed (p<0,05). At the same time, protein C deficiency was detected in 2 (12,5%) patients with MINOCA and in 1 (5,3%) patient in the control group. Antithrombin deficiency was detected in 2 (12,5%) patients with MINOCA and in 2 (9,5%) patients with MICAD. An increase in the level of ejection fraction was found in 6 (37,5%) patients in the study group and in 7 (33,3%) patients in the control group. There were no differences in levels of lupus anticoagulant, aCL and β2-GPI antibodies (p>0,05). There was a higher platelet count in patients with MINOCA on the 2^nd and 4^th days of acute MI (p=0,46 and p=0,01, respectively). However, the hemoglobin level in patients with MINOCA was significantly lower on admission, 4^th and 7^th day of MI (p=0,02, p=0,03 and p=0,04, respectively).

Conclusion. According to the study results, in patients with MINOCA and MICAD, differences in blood thrombotic activity were revealed. A higher level of homocysteine and a lower level of plasminogen were determined in patients with MINOCA. For such parameters as protein C, antithrombin, VWF, aCL and β2-GPI antibodies, differences between the groups were not determined. According to laboratory data, patients with MINOCA showed higher platelet count, but lower levels of hemoglobin and hematocrit in the early postinfarction period.

Aim. Assessment of lung volume status and oxygen transport system in patients with coronary artery disease (CAD) with different clinical types of comorbidity before and after coronary artery bypass grafting (CABG).

Material and methods. The observational controlled study included 66 patients with CAD with a median age of 67 years (95% confidence interval [59; 74]), admitted to the Far Eastern Federal University Hospital for elective CABG. Depending on the prevalence of clinical manifestations of comorbidities, CAD patients were ranked into 3 groups of comorbidity: cardiovascular, respiratory and metabolic. The first of them was represented by a combination of CAD and peripheral artery disease, the second — CAD and chronic obstructive pulmonary disease (COPD),

the third — CAD and metabolic syndrome. All patients underwent isolated CABG under cardiopulmonary bypass (CPB). Volume and hemodynamic monitoring was carried out by transpulmonary thermodilution using the Pulsion PiCCO Plus (Germany) technology and the following indices: cardiac function index (CFI), extravascular lung water (EVLW), pulmonary vascular permeability index (PVPI). Pulmonary blood volume and oxygen transport indices were determined: oxygen delivery (DO₂I) and consumption (VO₂I) indices, oxygen-utilization coefficient, and pulmonary shunt fraction (Qs/Qt). The study was carried out in three stages: before the onset of CABG, after its completion and one day after CABG.

Results. The analysis of volume and hemodynamic monitoring data demonstrated the heterogeneity of their changes during CABG and one day after with different comorbidity profile. A more noticeable inhibition of the circulatory component of oxygen transport was revealed in patients with COPD, which was illustrated by the lowest CFI (3,2-3,4 ml/min) in relation to other groups of patients. The imbalance of cardio-respiratory interactions in this cohort after withdrawal from cardiopulmonary bypass was manifested by lower DO₂I and VO₂I and a maximum increase in Qs/Qt, exceeding 1,6 times the comparison groups. The respiratory and metabolic comorbidity of CAD was characterized by a significantly larger volume of extravascular lung water due to the higher permeability of the pulmonary vessels, which was documented by EVLW values, which exceeded the upper reference limit by 1,8-2 times and an increase in PVPI. In patients with cardiovascular comorbidity, lung volume violation was less noticeable.

Conclusion. A comprehensive analysis of lung volume status and oxygen transport makes it possible to more accurately assess the functional status of patients with CAD, to increase the effectiveness of risk stratification and to prevent possible complications during CABG and in the early postoperative period.

Aim. To study the dynamics of procollagen type I carboxy-terminal propeptide (PICP) with an assessment of potential associations with cardiac fibrosis (CF) and diastolic dysfunction (DD) of the left ventricle (LV) during the hospitalization and one year after ST segment elevation myocardial infarction (STEMI).

Material and methods. The study included 120 patients with STEMI. There were following inclusion criteria: diagnosis of STEMI (2015 European Society of Cardiology guidelines); Killip £III acute heart failure (AHF); signed informed consent; patient age >18 years old. There were following exclusion criteria: STEMI due to percutaneous coronary intervention or coronary artery bypass grafting; Killip IV AHF; patient age >80 years; clinically significant comorbidities; death of the patient during the first day of hospitalization. On the 1st, 12th day of the disease and after a year all patients underwent echocardiography and the PICP concentration was determined. One year after myocardial infarction, contrast-enhanced cardiac magnetic resonance imaging was performed to assess CF. In the analyzed group of patients, on day 1 of STEMI, mean values of LV ejection fraction (EF) in the range of 40-49% were observed in 3 (2,5%) patients, LVEF <40% — in 31 (26%), LVEF ≥50% — in 86 (71,7%). The final analysis was performed on a sample of patients with preserved LVEF (n=86) (71,7%).

Results. On the first day of myocardial infarction, signs of DD were noted in 25 (29,1%) patients, while after 1 year, their number increased by 9 (10%) and amounted to 34 (39,5%) patients. In 15 (17,6%) people, worsening of myocardial systolic dysfunction was noted. Patients with a CF ³16% had the highest PICP expression on the first day of the disease. CF ≥16% one year after STEMI with preserved EF is associated with PICP concentration on day 1 of the disease. In addition, multidirectional correlations were revealed between the CF ≥16% and parameters of LV diastolic function (e’, mean pulmonary artery pressure, E/e’).

Conclusion. Determination of the PICP concentration on the 1st day of myocardial infarction will allow early identification of patients at risk of CF one year after STEMI with preserved EF.

Aim. To study the main behavioural and biological risk factors, as well as psychosomatic status among the military men of Azerbaijan with coronary artery disease (CAD).

Material and methods. The study included 116 men with coronary artery disease, who were divided into 2 groups according to their social status. Group I consisted of 60 patients from military population, while group II — 56 patients from general population. All patients were treated in the cardiovascular department of the Central Hospital of the Armed Forces (Baku, Azerbaijan). The age range was 3065 years (mean age, 55±3,6 years). The following risk factors for cardiovascular diseases (CVD) were studied: smoking, obesity, hypertension (HTN), hypercholesterolemia, stress and anxiety/depression.

Results. In the study group, the most common risk factor was hypercholesterolemia, which occurred in 80% of patients (46 and 47 patients among military and general population, respectively). HTN occurred in 78% and 68% of military and general population, respectively. Smoking was significantly more often detected among military personnel (68%) compared with the control group (50%). Abdominal obesity and diabetes were significantly more common among general population with CAD (57% and 36% vs 38% and 20%, respectively). Psychosomatic disorders (chronic stress, anxiety and depression) were >50% more often recorded among military personnel than general population.

Conclusion. In both groups of men with CAD, the most common risk factors are HTN and hypercholesterolemia. Smoking, chronic stress, anxiety/depression predominated among the military, while diabetes and abdominal obesity were more common among general population. The data obtained can be used to determine the strategy of treatment and secondary prevention of CVD among military population.

Aim. To compare the cardiovascular and psychological profile of young military population after coronavirus disease 2019 (COVID-19) with/without pneumonia.

Material and methods. We examined 26 military men under 30 years of age (22,3±3,7 years/21,0 [19,8; 24,3] years) with documented COVID 19 (3 months±2 weeks after two virus-negative polymerase chain reaction tests). The participants were divided into 2 groups: experimental group (n=16) — those with COVID-19 pneumonia; comparison group (n=10) — those without pneumonia. All subjects underwent a complex of clinical and diagnostic tests.

Results. Military men with COVID-19 pneumonia were significantly older (23,0 [20,5; 28,5] years vs 19,5 [19,0; 20,0] years, p=0,001). They had a prolonged PQ interval (154,5 [140,0; 163,5] ms vs 137,0 [134,0; 144,0] ms; p=0,014). According to echocardiography, the following parameters were significantly larger in experimental group: anteroposterior right ventricular dimension (26,0 [24,5; 27,5] mm vs 23,5 [22,0; 25,0] mm, p=0,012), right atrium length (48,0 [46,0; 51,5] mm and 45,5 [44,0; 47,0] mm, p=0,047), tricuspid regurgitation peak gradient (18,0 [15,5; 22,0] mm vs 14,0 [12,0; 20,0] mm, p=0,047), pulmonary artery systolic pressure (PASP) (30,3 [27,6; 34,0] mm Hg vs 23,0 [20,5; 30,5] mm Hg, p=0,038), mean pulmonary artery pressure (20,3 [18,9; 22,7] mm Hg vs 16,8 [14,5; 20,6] mm Hg, p=0,038). The estimated pulmonary vascular resistance was significantly higher in the study group (1,50 [1,2; 1,8] Wood units vs 1,17 [1,1; 1,2] Wood units, p<0,001). The groups did not differ significantly in terms of symptoms of stress (perceived stress scale score of 10) and anxiety and depression disorders (GAD7 and PHQ9 questionnaires), quality of life (SF-36 survey).

Conclusion. In young military personnel, COVID-19 pneumonia in the long term after the disease is associated with longer PQ interval, older age and larger right heart sizes on echocardiography, as well as with a higher tricuspid regurgitation peak gradient, PASP, mean pulmonary artery pressure, and pulmonary vascular resistance. In this category of population, no association was found between the severity of COVID-19 and psychological status parameters.

Aim. To study the association between morphological changes and comorbidities and atrial fibrillation (AF) catheter ablation efficacy, and to evaluate morphological predictors of AF recurrence in patients with durable pulmonary vein isolation (PVI) after catheter intervention.

Material and methods. Fifty-four patients with paroxysmal/persistent AF without severe structural heart disease were enrolled in this study who underwent primary pulmonary vein cryoballoon ablation (CBA) with simultaneous implantation of an electrocardiogram loop recorder (Medtronic Reveal XT) and interatrial/interventricular septum biopsy. The follow-up duration was 12 months with scheduled 3, 6 and 12 month visits. Patients with recurrent AF were referred for redo procedure, where the PVI durability was assessed. The follow-up duration after the second procedure was also 12 months. The patients were divided into two groups: patients without recurrent AF and patients with recurrent AF after two catheter interventions.

Results. In interventricular septum biopsy samples we found the morphological criteria of myocarditis in 70% of the patients (n=34). Individual morphological changes were detected in all patients. The most common types were cardiomyocyte hypertrophy — 98,1% (n= 52), overcrossing of cardiomyocytes — 77,4% (n=41) and lymphohistiocytic infiltration of the interstitium by more than 14 cells — 75,5% (n=40). Patients with persistent AF were significantly more likely to have endothelial cell swelling (55% vs 45%, p=0,022). Interstitial tissue edema was the only morphological parameter significantly associated with AF recurrence (p=0,03).

Conclusion. In patients with AF and no structural heart disease who underwent drug-resistant AF cryoballoon ablation, morphological changes in the myocardium of the atria and ventricles are detected in 100% of cases. The predominant biopsy diagnosis is myocarditis. Morphological signs of the inflammatory process activity, as interstitial tissue edema are associated with the high incidence of non-venous AF. Further preoperative evaluation is needed to identify patients with non-venous atrial fibrillation, which will increase the effectiveness of interventional approach.

Aim. To study the psychological continuum of elderly hypertensive patients with metabolic syndrome (MS) receiving chronotherapy with a fixed-dose combination of amlodipine, lisinopril and rosuvastatin.

Material and  methods. In a  clinical setting, 63 hypertensive  patients with MS aged 60-74 years (experimental group) received chronotherapy with fixed-dose combination of amlodipine, lisinopril and rosuvastatin (Ekvamer®) at a dose of 5/10/10 mg in the evening (8 pm). The control group of hypertensive patients with MS aged 60-74 years old (n=58) received Ekvamer® in the morning (conventional therapy) at the same dosage.

Results. With fixed-dose combination of amlodipine, lisinopril and rosuvastatin, the severity of psychological continuum abnormalities significantly decreases after 1 year in the chronotherapy regimen (evening intake) than with morning intake with an equivalent dosage of 5/10/10 mg per day in both cases. The dynamics of cognitive impairments in hypertensive patients aged 60-74 years with MS using chronotherapy regimen is characterized by a significant increase  in  the  mean MMSE score from the initial 17,8±0,3 to 23,5±0,4 points (p±0,001) vs 16,9±0,3 to 20,4±0,4 points (p<0,001) when taking the drug in the morning. Situational anxiety decreased from 40,0±2,2 to 30,6±1,8 points (p<0,05) vs 40,8±2,5 to 33,5±1,9 points (p<0,05), personal anxiety from 48,8±2,0 to 26,4±1,9 (p<0,001) vs from 44,9±1,9 to 30,7±1,7 (p<0,01) points, respectively. Depressive disorders slightly decreased with chronotherapy (14,1%) vs 7,7% than with the conventional scheme, but despite this, they corresponded to depressive spectrum disorders in both groups.

Conclusion. The results obtained indicate a greater efficiency of chronotherapy than the conventional use of fixed-dose combination of amlodipine, lisinopril and rosuvastatin in hypertensive patients with MS.

Heart failure (HF) with preserved ejection fraction (HFpEF) is currently the most common type of this condition, especially among elderly patients. Despite the preserved left ventricular (LV) and a moderate increase in natriuretic peptide, patients  with HFpEF have the same out-of-hospital mortality as those with HF with reduced ejection fraction (HFrEF). Diagnosis of HFpEF is difficult due to nonspecific symptoms, expensive blood tests, and questionable rest echocardiographic data on diastolic function. In addition, the reason for poor diagnosis of HfpEF in clinical practice may be old age and comorbidities, which can also cause nonspecific symptoms of moderate chronic shortness of breath, weakness, and palpitations. The consequence is the detection of HFpEF only in every fourth patient with an acute or chronic heart failure. The use of simplified clinical diagnostic protocols along with a non-invasive ultrasound stress test can help overcome the existing problems in the diagnosis of HFpEF.

The issue of the optimal timing of coronary artery bypass grafting (CABG) in acute coronary syndrome (ACS) remains controversial. It is known that on the one hand there will be a delay in revascularization, leading to recurrent myocardial infarction with irreversible cardiac dysfunction. On the other hand, there is an increased incidence of perioperative complications associated with surgery.

This article provides a detailed analysis of the evidence base and current guidelines on the validity and timing of coronary artery bypass grafting in various types of ACS. The emphasis is made on the contradictions regarding the earlier implementation of the active strategy in non-ST segment elevation ACS. We describe problem of insufficient evidence base on optimal timing of CABG, comparison of outcomes of percutaneous coronary intervention (PCI) performed in the first 24 hours and open surgery for high-risk non-ST segment elevation ACS, as well as a number of organizational and clinical issues to ensure the surgery availability.

Current review article, based on foreign and Russian studies, guidelines of the European and North American cardiological and surgical communities, summarizes the expert positions on the place of multidisciplinary “Heart Team” approach in the selection of management strategy for patients with various types of coronary artery disease. The positions of modern clinical guidelines regarding percutaneous coronary intervention and coronary artery bypass grafting in acute coronary syndrome are given. Prospective positions for optimizing the decisionmaking process by a multidisciplinary team when considering difficult patients are presented.

The dominant paradigm in the diagnosis of patients with stable coronary artery disease was the identification of patients with obstructive lesions of the coronary arteries, and then - ensuring the possibility of myocardial revascularization. The diagnostic algorithms used until recently led to the fact that in invasive coronary angiography obstructive changes in the coronary arteries were detected in less than half of the cases. In the 2019 European Guidelines for the Diagnosis of Chronic Coronary Syndrome, this algorithm was significantly revised, but the results of its implementation have not yet been published. Currently, several pathophysiological variants of angina pectoris have been proposed, which can be identified by an interventional diagnostic procedure for invasive coronary angiography. Recent studies have shown that up to 90% of patients without obstructive lesions of the epicardial coronary arteries have microvascular or vasospastic angina. This review focuses on these topical aspects of the problem of intact coronary arteries.

Currently, there is no information in novel clinical guidelines on the importance of active detection of atrial fibrillation (AF) in myocardial infarction (MI), as well as on the management of such patients. The aim of this review was to present actual information about possible risk factors, features of pathogenesis, as well as the prognostic significance of AF in MI. Analysis of the literature has shown that many researchers divide AF into new-onset AF (developed after MI) and chronic AF (existing in history before MI). New-onset AF is common complication in MI according to different studies (from 3 to 28% among all patients with MI), which is associated with death and cardioembolic events. Moreover, in every third patient with MI, AF is asymptomatic, which makes it extremely urgent to develop special algorithms aimed at its active search.

Published on behalf of the European Society of Cardiology.