WOMENS’ LONG-TERM SECONDARY PREVENTION ADHERENCE AFTER THE MIOCARDIAL INFARCTION

Abstract

The myocardial infarction (MI) is the reason of high mortality, disability and significant financial charges all over the world. Every year in Ukraine more than 50 thousand incidences of MI, and 50 % of these patients dye for next 5 years. Thus, the optimization of secondary prevention arrangements (such as life style modification, the following medicine therapy adherence) has the key meaning in these patients’ survival. Thought the compliance in any diseases can be reached only in 20–57 % of incidences, and the literature affirms the sex influence on its level.

The aim of the study – the multimentional evaluation of the women’s treatment adherence in post-infarction period.

Materials and Methods. 408 women with acute coronary syndrome of 46–94 years (average age (71.30 ± 0.44) years) were observed. The dynamic of the examined indexes after 6, 12, and 24 months could be followed in 52 patients. 2 groups were established accordingly to Morisky-Greens’ application (Morisky D.E.,Green L.W., 1986): I (first) – 27 persons were adhered, the average age (65.26±0.44) year and the second (II) – unadhered 25 persons, the average age (68.52±1.88) year. The analysis and the estimation of the clinical, laboratory and instrumental indexes were provided.

Results and Discussion. The comorbidity with arterial hypertension and diabetes mellitus type 2 and the overdue weight were detected in all observed women. Women from the group I were hospitalized earlier (within (15.37±4.9) hours) than in group II (in (6.45±18.9) hours) with bigger part of revascularization – 28.8% versus 5.7 % ; major myocardial necrosis mass; higher indexes of systolic and diastolic blood pressure (160±6.06) and (95.6±2.66) versus (153±6.11) and (89.4±2.37) mm Hg and lower cholesterol level – (5.59±2.99) versus (6.46±2.77) μmol/l. In dynamics the significant decreasing of the heart rate, systolic and diastolic blood pressure levels and the general cholesterol level were detected and the Echo-indexes approach to the proper normal myocardial geometry.

Conclusions. Women’s insufficient adherence level to the following secondary prevention in ambulatory treating stage was observed and mostly only the partly adherence is steel preserved, especially in a year after the MI. Very low adherence to the non-pharmacologic secondary prevention methods and correction risk factors and life style modification arrangements were established. Received results once more assure on necessity of the organization and prevention optimization arrangements on the ambulatory stage. Possibly the regression strategy in patients qualification from “compliance to concordance” allows to advance the secondary MI prevention.