The polymorbidity and the efficiency of stable CHD beta-blockers treatment in the post-infarction period

Author(s):  O.V. Zamakhina, Omsk State Medical University, Omsk , Russia, ozamakhina@yandex.ru

S.S. Bunova, Dr., Prof., Belgorod National Research University, Belgorod , Russia

N.A. Nikolayev, Dr., Prof., Omsk State Medical University, Omsk , Russia

E.V. Usacheva, candidate of Sciences, associate Professor, Omsk State Medical University, Omsk , Russia

A.V. Nelidova, candidate of Sciences, associate Professor, Omsk State Medical University, Omsk , Russia

L.A. Zhivilova, candidate of Sciences, associate Professor, Omsk State Medical University, Omsk , Russia

Issue:  Volume 42, № 2

Rubric:  Cardiology

Annotation:  The effect of co-and polymorbidity in increasing the heart rate (HR) pathology on achieving the target HR in the beta-adrenergic blockers (BAB) treatment of patients with stable coronary heart disease (CHD) after myo-cardial infarction (MI) is studied. As part of an open, one-center, comparative study, 320 patients who had had MI more than 6 months ago were examined. They were counted on an outpatient HR and selected the optimal maximum tolerated dose of BAB in achieving HR, then were divided into 2 groups: 1) with a resting HR ≤60 per min. and 2) with resting HR> 60 per min. Co-and polymorbidity in increasing the HR pathology and its severity in the studied groups were identified and compared. Results: co-and polymorbidity in the increasing the HR pathology was significantly more common in patients with heart rate> 60 per 1 min .: smoking (p = 0.002); latent alcohol abuse (p = 0.024); carbohydrate metabolism disorders (p = 0.01); congestive heart failure (p = 0.01) with a functional class of 3 or more (p = 0.02); anemia (p = 0.04) and latent iron deficiency (p = 0.02); respiratory failure of 2 or more degrees (p = 0.03); high situational (p = 0.01) and high personal anxiety (p = 0.007). The number of co-and polymorbidity in the increasing HR pathologies in the group with HR> 60 in 1 min. were more: more patients with three (p = 0.008), four or more (p <0.001) of such diseases and condi-tions at the same time. The Charlson comorbidity index was also higher in this group (p <0.05). Conclusion: in 55.9% of the studied patients it was not possible to reach the target HR, it was associated with an older age (p = 0.048) and the presence of co-and polymorbidity in the increasing HR pathology.

Keywords:  stable coronary heart disease, myocardial infarction, comorbid pathology, polymorbid pathology, target heart rate.

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