The effectiveness of modern immunomodulatory and cardiometabolic therapy in correction the risk of hospital complications in patients with acute myocardial infarction with myocardial revascularization: the results of multifactorial analysis

Shumakov O.V.,Dovgan О.V.,Parkhomenko O.M.,Talaeva T.V.,Tretyak I.V.,Kushnir S.P.

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The effectiveness of modern immunomodulatory and cardiometabolic therapy in correction the risk of hospital complications in patients with acute myocardial infarction with myocardial revascularization: the results of multifactorial analysis

April 11, 2022

1028

Cardiology, Rheumatology

Therapy, General practice

Keywords :

acute myocardial infarction,

hospital complications,

leukocyte-platelet index,

quercetin,

trimetazidine

Specialities :

Cardiology, Rheumatology

Therapy, General practice

Resume

Objective: to study the set of factors that determine the severity of inpatient acute myocardial infarction (AMI), and to assess the possibility of correcting the risk of complications by prescribing therapy with immunomodulatory/anti-inflammatory and cardiometabolic properties.

Materials and methods. The study involved 98 patients with AMI with elevation of the ST segment on the electrocardiogram. The main group of patients was divided into two similar clinical and anamnestic characteristics subgroups (73 and 25 individuals) depending on whether they received in addition to basic therapy complex cardiometabolic treatment (intravenous quercetin and oral trimetazidine).

Results. One-factor analysis revealed a protective effect (p<0.05) of the studied treatment on the risk of >2 hospital complications, while the most important risk factor for complications was the patient’s age (p=0.02). The multifactor analysis revealed a link between the risk of numerous hospital complications with the patient’s age, smoking and the value of the leukocyte-platelet index (LPI, developed by us in previous works) ≥150 c.u. on the 1st day of the disease (odds ratio (OR)=3.28 (95% CI 1.21–8.89), p=0.02), while the appointment of the treatment (intravenous quercetin and oral trimetazidine) has a positive effect on the hospital course of AMI (OR=0.29 (95% CI 0.10–0.86), p=0.026).

Conclusion. Appointment of therapy with intravenous quercetin and oral trimetazidine in elderly patients, smokers and patients with LPI ≥150 c.u. can be used as a single diagnostic and treatment package of measures to reduce the number of hospital complications, improve quality of life and reduce additional costs for the treatment of complications in patients with AMI.

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