MODERN PRINCIPLES OF CARDIO-REHABILITATION OF PATIENTS AFTER ACUTE CORONARY SYNDROME (REVIEW OF LITERATURE AND OWN DATA)

Abstract

Acute myocardial infarction is one of the main causes of mortality nowadays. The introduction of effective cardio-rehabilitation programs for patients with severe coronary heart disease is an important tool for improving the life quality and duration. In most of the recommendations, cardio-rehabilitation has Class I A level of evidence. The plan of rehabilitation should be individual and based on pre-made stratification of risk, determining the level of functional capacity and specific needs of the patient. Today, in addition to the traditional model of cardio-rehabilitation, which includes 4 stages, alternative models with the use of personalized telemedicine, focusing on an individual profile of risk factors, as well as community and home-based programs that take into account the possibility of choosing for patients according to their needs and benefits, are proposed.

The aim of the study – improvement the effectiveness of rehabilitation of patients with acute myocardial infarction, who underwent percutaneous balloon angioplasty and coronary artery stenting for acute coronary syndrome, by implementing an individualized adapted cardio-rehabilitation program at an early out-patient stage.

Materials and Methods. 92 patients with myocardial infarction were examined, 58 of which in the early post-infarction period the course of the original individualized adapted cardio-rehabilitation program was conducted for three months and 34 patients of the control group, comparable by age, sex and clinical manifestations of myocardial infarction, a standard rehab program was conducted. The evaluation of the effectiveness of both programs of cardio-rehabilitation was carried out by comparing the reduction of clinical manifestations of myocardial infarction, restoring the parameters of systole-diastolic function of the heart, the degree of tolerance to physical activity and assessing the quality of life of patients.

Results and Discussion. Using the individually adapted rehabilitation program in the post-infarction period in patients with ACS, whom were performed percutaneous balloon angioplastic and stenting of the coronary artery, promotes to faster and more efficient elimination of clinical manifestations of heart failure and violations of the systole-diastolic function of the left ventricle. At the same time, these patients were significantly increased with tolerance to physical activity, which was accompanied by improved self-esteem and compliance with medical recommendations and showed improved quality of life.

Conclusions. The use of the original individually adapted program of cardio-rehabilitation at the early outpatient stage can reduce the signs of systole-diastolic dysfunction of the heart and significantly increase the patient's tolerance to physical activity, which ultimately improves their quality of life.