THE CLINICAL COURSE FEATURES OF MYOCARDIAL INFARCTION, COMPLICATED CARDIOGENIC SHOCK, IN MALES UNDER 50 YEARS OLD

Abstract

Relevance. Cardiogenic shock remains the most common cause of death in myocardial infarction. Aim. To evaluate the myocardial infarction complicated by cardiogenic shock clinical course features in males under 50 years old (y.o.) to clarify their significance for the development of this complication to improve prevention and outcomes. Material and methods. The study included males aged 19-49 y.o. with type I myocardial infarction. The patients were divided into age-matched groups. The study group consisted of seven patients with cardiogenic shock, the control group - without cardiogenic shock - 223 patients. Comparative analysis of the clinical course variants, complications in selected groups was performed. The influence of the studied parameters on the probability of cardiogenic shock development in the examined patients was assessed by the method of risk analysis using the Pearson Chi-square test. Results. In the study group, there was a predominance of kidney dysfunction (100 in the study group and 10.3% in the control group; p=0.004), chronic heart failure in history less than one year old (50.0 and 15.3%, respectively; p=0, 04), non-anginal variants (abdominal (16.7 and 1.5%; p = 0.0497), arrhythmic (16.7 and 2.5% p = 0.0497) and according to the type of increase in heart failure (16.7 and 1.5%; p=0.0497)) of the clinical course of myocardial infarction, the presence of two or more complications (100 and 38.1%; p=0.005) and combinations of all groups of myocardial lesions (57.1 and 6.3% ; р˂0.0001). The risk of developing cardiogenic shock increased in addition to the above situations with diastolic blood pressure ˂70 mm Hg (Absolute risk: 18.8%; relative: 13.3; p˂0.0001), systolic˂110 mmHg (14.3%; 9.9, respectively; p=0.0004), total peripheral resistance (37.5%; 35.8; p˂0.0001). Conclusions. These factors should be used in the formation of high-risk groups for the cardiogenic shock in myocardial infarction development for monitoring and timely implementation of the necessary treatment. It is also expedient to take them into account in the prognostic modeling of this complication.