STUDY OF THE INFLUENCE OF MODIFIABLE CARDIOVASCULAR RISK FACTORS ON THE EFFICACY OF DUAL ANTIPLATELET THERAPY IN PATIENTS AFTER MYOCARDIAL INFARCTION IN THE KALININGRAD REGION
Keywords:
dual antiplatelet therapy, myocardial infarction, obesity, diabetes mellitus, smokingAbstract
It is known that the main component of the prevention of cardiovascular events in patients after myocardial infarction is dual antiplatelet therapy (DAPT)
The aim of the research was to study the effect of obesity, smoking and hyperglycemia on the effectiveness of DAPT in patients after MI.
Materials and methods:The study included 156 patients after myocardial infarction receiving DAPT. Anthropometric data (BMI), anamnesis data, information on pharmacotherapy, development of complications and outcomes were obtained using the medical information system "BARS. Healthcare". The following indicators were used as endpoints: the incidence of cardiovascular death (CVD), ischemic stroke (IS), recurrent MI, as well as a combined endpoint (CEP) - the development of any of the events - recurrent MI or IS.
Results:Within 1 year, MI, CVD, IS, recurrent MI, CEP developed in 4 (16.7%), 3 (12.5%), 5 (20.8%), 8 (33.3%) patients with diabetes, compared with 2 (1.5%), with 1 (0.8%), 6 (4.5%), 7 (5.3%), in patients without diabetes. CVD, IS, recurrent MI, CEP developed in 3 (3%), 4 (4%), 10 (10%), 14 (14%) patients with a combination of risk factors, compared with 3 (5.4%), with 0 (0%), 1 (1.8%), 1 (1.8%), in patients without risk factors.
Conclusion:It was found that in patients after MI who received DAPT, the presence of diabetes was associated with a significant risk of developing ischemic stroke in 12.5% of patients, recurrent MI in 20.8% of patients, and CVD in 16.7% of patients, which may be due to the low efficiency of DAPT. The presence of any of the studied risk factors significantly increases the incidence of CEP and the incidence of MI compared to the group of patients without risk factors - 14% and 10%, versus 1.8% and 1.8%, respectively.
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