MEDICAL AND SOCIAL ASPECTS OF REHABILITATIVE TREATMENT OF PATIENTS WITH MYOCARDIAL INFARCTION AND COMORBID DIABETES MELLITUS
DOI:
https://doi.org/10.11603/1681-2786.2018.4.10034Keywords:
myocardial infarction, diabetes mellitus, cardiac rehabilitation, Charlson Comorbidity IndexAbstract
Purpose: to establish criteria for readiness for rehabilitation of patients with myocardial infarction (MI), depending on the presence of comorbid diabetes mellitus, taking into account the peculiarities of the functional condition of the body.
Materials and Methods. 371 patients with acute myocardial infarction and comorbid pathology were examined. Diagnosis, treatment and rehabilitation of the patients were performed according to the current protocols.
Results. An in-depth statistical analysis proved the influence of comorbid diabetes mellitus on various functional systems of the acute MI patient and other marker parameters that could be used to control metabolic, hemodynamic and regulatory disorders in restoring health in patients with MI. In addition to glucose, as the traditional marker of comorbid diabetes, other parameters included a level of fibrinogen, INR, ECR, number of peripheral blood lymphocytes, duration of history of arterial hypertension, and Charlson Comorbidity Index. In case of MI complications, prevalent in patients with diabetes mellitus, left ventricular aneurysm and Dressler syndrome were more commonly diagnosed in these patients.
Conclusions. 1. The combination of myocardial infarction with comorbid diabetes mellitus is an independent predictor of the worst functional condition of the body, and such patients often suffer from MI complications and cardiac insufficiency, requiring more thorough monitoring of marker functional parameters, and an individual approach to rehabilitation measures.
2. An integral parameter for assessing the functional condition of a patient when planning rehabilitation measures may be the Charlson Comorbidity Index, which quantitatively reflects the degree of comorbidity in patients with diabetes mellitus.
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