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

Authors

DOI:

https://doi.org/10.11603/ijmmr.2413-6077.2022.1.12910

Keywords:

myocardial infarction, comorbid pathology, Charlson comorbidity index, 6-minute walk test, predictors of functional reserves

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.

Author Biographies

L. V. Levytska, I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE

Professor, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

V. V. Yurkiv, I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE

Professor, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

M. M. Korda, I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE

Professor, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

References

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Asso­ciation. Circulation. 2021 Feb 23;143(8):254-743. https://www.ahajournals.org/doi/10.1161/CIR. 0000000000000950

Moroz DM. [Problems of health and medical care and a model of improvement in modern con­ditions: a manual for cardiologists, rheumatologists, therapists, health organizers and general practi­tioners]. In: Kovalenko VM, Kornatsky VM., editors. Institute of Cardiology of M.D. Strazhesko of the AMS of Ukraine. Kyiv: Hordon Printing House; 2016 (in Ukrainian).

Caughey GE, ramsay EN, Vitry AI, Gilbert AL, Luszcz MA, Ryan P, et al. Comorbid chronic diseases, discordant impact on mortality in older people: a 14-year longitudinal population study. J. Epidemiol. Community Health. 2010; 64(12): 1036-1042.

https://doi.org/10.1136/jech.2009.088260

Simić-Panić D, Bošković K, Milićević M, Rabi Žikić T, Cvjetković Bošnjak M, Tomašević-Todorović S, et al. The impact of comorbidity on rehabilitation outcome after ischemic stroke. Acta Clin Croat. 2018; 57(1): 5–15.

https://doi.org/10.20471/acc.2018.57.01.01

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal Chronic Disease. 1987; 40(5): 373-383.

https://doi.org/10.1016/0021-9681(87)90171-8

Bellet RN, Francis Rl, Jacob JS, Healy KM, Bartlett HJ, Adams H, et al. repeated six-minute walk tests for outcome measurement and exercise pre­scription in outpatient cardiac rehabilitation: a longitudinal study. Arch Phys Med rehabil. 2011; 92(9):1388-1394.

https://doi.org/10.1016/j.apmr.2011.04.014

Shved MI, Levytska LV. [Modern strategies of treating patients with acute coronary syndrome]. Kyiv: Publishing House Medknyha; 2018. p. 176 (in Ukrainian).

Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45(6):613-619.

https://doi.org/10.1016/0895-4356(92)90133-8

listerman J, Bittner V, Sanderson B, Brown T. Cardiac rehabilitation outcomes: impact of comor­bidities and age. J Cardiopulm rehabil Prev. 2011; 31(6):342–348.

https://doi.org/10.1097/hcr.0b013e31822f189c

Rashid M, Kwok CS, Gale CP, Doherty P, Olier I, Sperrin M, et al. Impact of co-morbid burden on mortality in patients with coronary heart disease, heart failure and cerebrovascular accident: a sys­tematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2017;3(1):20–36.

https://doi.org/10.1093/ehjqcco/qcw025

Shved MI, Levytska LV. [Approaches to the assessment of risks and functional reserves of the cardiovascular system in patients with myocardial infarction with comorbid pathology, who are in the acute period of cardio-rehabilitation]. World of Medicine and Biology. 2018;4(66):124-130 (in Ukrainian).

https://doi.org/10.26724/2079-8334-2018-4-66-124-130

Levytska L, Shved M, Korda M. Estimation of functional reserves of the body and risk of car­dio­vascular events in patients with myocardial infarction with comorbid pathology undergoing rehabilitation Health Problems of Civilization 2019;13 (3):178-186.

https://doi.org/10.5114/hpc.2019.86209

Levytska LV. [Constellation of biochemical and physical markers of the functional state of the body in patients with myocardial infarction with of sistolic and diastological arterial pressure levels and the possibility of their using in the rehabilitation pro­cess]. MCCh. 2019;1:92-102 (in Ukrainian).

https://doi.org/10.11603/mcch.2410-681X.2019.v0.i1.10013

Grolla DL, Tob T, Bombardierc C, Wright JG. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005;58(6):595-602.

Bellet RN, Francis R, Jacob JS, Healy KM, Bartlett HJ, Adams L, et al. repeated six-minute walk tests for outcome measurement and exercise pre­scription in outpatient cardiac rehabilitation: a longitudinal study. Arch Phys Med rehabil. 2011; 92(9):1388–1394.

https://doi.org/10.1016/j.apmr.2011.04.014

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Published

2022-09-05

How to Cite

Levytska, L. V., Yurkiv, V. V., & Korda, M. M. (2022). PREDICTORS OF LOW FUNCTIONAL RESERVES IN REHABILITATION OF PATIENTS WITH MYOCARDIAL INFARCTION COMPLICATED BY COMORBID PATHOLOGY. International Journal of Medicine and Medical Research, 8(1), 5–10. https://doi.org/10.11603/ijmmr.2413-6077.2022.1.12910