PREDICTORS OF LOW FUNCTIONAL RESERVES IN REHABILITATION OF PATIENTS WITH MYOCARDIAL INFARCTION COMPLICATED BY COMORBID PATHOLOGY

Abstract

Background. Myocardial infarction (MI) is one of the leading causes of death in working age population; the risk of cardiovascular complications for survivors of acute MI complicated by comorbid pathology (CP) is very high. Objective. The study is aimed to search for reliable prognostic markers for risk of reducing the functional reserves of the cardiovascular system in myocardial infarction with comorbid pathology. Methods. The prospective study involved 371 patients with MI, who received non-invasive therapy and were observed for a 90-day period after admission to the hospital. All patients were examined and treated according to current protocols. Results. It was found that 6-minute walk test (6MWT) is a specific and highly sensitive prognostic marker of functional reserves for patients with MI with CP (specificity – 100%, sensitivity – 63%, prognostic value of a positive result – 100%) with the Charlson comorbidity index (CCI) ≥2. The correlation of 6MWT performed on the 10th, 30th and 90th day of rehabilitation was revealed with the age of patients, SpO2, respiratory rate, systolic blood pressure, heart rate, left ventricular ejection fraction, levels of troponin T, creatinine, the number of lymphocytes in the peripheral blood, CCI (p<0.05). Conclusions. During the 90-day rehabilitation period of a patient with MI complicated by CP, the markers of reduced exercise tolerance to be monitored are: blood pressure levels, respiratory rate, troponin T, creatinine, cholesterol, low-density lipoprotein, SpO2, the number of lymphocytes in the peripheral blood. To improve control over the process of rehabilitation in patients with MI complicated by CP the 6MWT and CCI should be used.