The influence of drug and mechanical reperfusion on ekoendotoxicosis, central hemodynamics, electrical instability of the myocardium and clinical course in acute coronary syndrome patients, working in environmentally stressed conditions
Studied clinical and hemodynamic efficacy of complex use of monopril (fosinopril), propranolol (obzidan) with heparin and PCI; PCI conducted separately on hemodynamics, cardiohemodynamics, ekoendotoksikoz (SMP) and the clinical course of patients working in environmentally stressful conditions in the acute phase and follow-up period after MI. we provided the comparison of complex drug therapy and mechanical revascularization with PCI conducted separately. Investigated 42 patients with ACS: MI of the anterior wall with Q-wave and ST-segment elevation in the age of 30 to 70 years (56.7±1.20 years). 21 patients of 42 were treated with monoprilom, propranolol with heparin and PCI (group 1); 21 patients were treated with PCI alone (group 2). In both groups, the degree of ekoendotoksikosis in blood was assessed by EchoCG and Doppler EchoCG studied ESV, EDV, EF, SI, CI, an index of local contractility abnormalities of left ventricle (IALC), restenosis with the help of coronary angiogram, ECG ST-segment elevation and repeated anginal pain. The dynamics of systolic and diastolic blood pressure, clinical features of myocardial infarction during follow-up are established. Patients had been treated with monoprilom, propranolol, heparin and PCI have shown a stable indecies of central hemodynamics. The reduced CSR BWW, IALS and decreased degree of ekoendotoksikosis (SMP), improves left ventricular systolic function, increases PV. However, in this group, one patient on the third day was recorded DOS and one recurrent MI. In the group with only PCI 2 patients had a relapse of MI, 4 - restenosis, 2 - AHF and 1 patient died. The results show that the combined application of drug therapy with PCI provides a positive result in comparison with separately conducted PCI in case of ACS MI.