The analysis of renal dysfunction development risk factors in the initial periods of myocardial infarction in men under60 years old

Abstract

Background. Renal dysfunction (RD) in myocardial infarction (MI) significantly worsens the prognosis of the disease in men under 60 years old (y. o.). Purposes and tasks. To evaluate the significance of various factors for the development of DP at the end of the subacute period of MI in men under 60 y. o. Materials and methods. The study included men 19-60 y. o. with type I IM diagnosed and treated according to the standards at the time of hospitalization. DP was verified with a decrease in glomerular filtration rate of less than 60 ml/min/1.73 m2 at the end of the third week of MI at its normal values in the first 48 hours of MI. Patients were divided into two age comparable groups: I - the studied, with DP - 21 patients; II - without impaired renal function - 176 patients. Analysis of variance (ANOVA) was performed to study the effect of anamnestic, objective, clinical, instrumental and laboratory factors on the development of DP in the subacute period of myocardial infarction. The results. The index of the final systolic volume of the left ventricle (107.5 ml/m2 or more), the size of the left atrium (51 mm and more), tachycardia of more than 108 per minute and hypertriglyceridemia (6.7 mmol/l or more) in the first hours of MI in association with aneurysm of the left ventricle and its thrombosis, fibrillation and atrial flutter both before the development of MI and during the period of the disease. A combination of these factors with a medical history of unstable angina, prothrombin level (84% or more), GRACE value (134 points or more) and TIMI (8 points or more), dyslipidemia at the end of the subacute MI period indicate a high risk of developing DP in this period. Conclusions. These factors can be used to form a high risk group for the development of this condition for preventive measures.