Among patients with unstable angina or myocardial infarction without ST-segment elevation, prasugrel did not significantly reduce the frequency of the primary end point, as compared with clopidogrel, and similar risks of bleeding were observed. (Funded by Eli Lilly and Daiichi Sankyo; TRILOGY ACS ClinicalTrials.gov number, NCT00699998.).

Raktažodžiai: hiperglikemija, miokardo infarktas, gliukozės tolerancijos mėginys. Santrauka. Tyrimo tikslas. Nustatyti miokardo infarktu susirgusiems ligoniams, kuriems nebuvo diagnozuotas cukrinis diabetas, hiperglikemijos dažnį hospitalizavus ir išrašant iš stacionaro. Tyrimo medžiaga ir metodai. Tirtųjų kontingentą sudarė 1552 ligoniai, susirgę miokardo infarktu, be cukrinio diabeto anamnezėje. 197 ligoniams, kuriems hospitalizavus nustatyta hiperglikemija (³6,1 mmol/l), išrašant iš stacionaro buvo atliktas gliukozės tolerancijos mėginys. Rezultatai. Hospitalizavus hiperglikemija nustatyta daugiau kaip pusei (51,6 proc.) susirgusiųjų miokardo infarktu, penktadaliui ligonių gliukozės koncentracijos padidėjimas buvo 6,1-6,99 mmol/l, trečdaliui -³7,0 mmol/l, o mažiau kaip pusei -gliukozės koncentracija buvo normali. Ligoniams, kuriems rasta hiperglikemija hospitalizavus, atlikus gliukozės tolerancijos mėginį, trečdaliui tiriamųjų nustatytas gliukozės tolerancijos sutrikimas, dešimtadaliui -cukriniam diabetui būdingas gliukozės koncentracijos padidėjimas. Išvada. Daugiau kaip pusei ligonių neatpažintas gliukozės tolerancijos sutrikimas iki jiems susergant miokardo infarktu, rodo gliukozės koncentracijos ištyrimo svarbą sergantiesiems krūtinės angina arba turintiems išeminės širdies ligos riziką, kad būtų galima kuo anksčiau pradėti šio rizikos veiksnio modifikaciją. Adresas susirašinėti: I. Milvidaitė, KMU Kardiologijos institutas, Summary. The objective of this study was to determine frequency of admission hyperglycemia and abnormal Susirgusiųjų miokardo infarktu hiperglikemijos dažnis hospitalizavus ir išrašant iš stacionaro Susirgusiųjų miokardo infarktu hiperglikemijos dažnis hospitalizavus ir išrašant iš stacionaro Medicina (Kaunas) 2007; 43 (12)

Cardiovascular disease, including coronary heart disease (CHD), is the leading cause of death among elderly adults across many European countries. In 2005, the Clinic of Cardiology, Hospital of Lithuanian University of Health Sciences (former Kaunas University of Medicine), started to gather the clinical data of patients with acute and chronic coronary syndromes according to the standards set by the Cardiology Audit and Registration Data Standards Project. The aim of our study was to evaluate one-year mortality after inpatient treatment for acute and chronic coronary syndromes in different risk groups. Material and methods. A total of 3268 patients who were treated for coronary heart disease - acute myocardial infarction, unstable angina, stable angina – at the Clinic of Cardiology, Hospital of Lithuanian University of Health Sciences (former Kaunas University of Medicine) in 2005 were randomly selected. Clinical data of the patients were collected by means of a standardized questionnaire. After one year, 1908 patients were reexamined, and predominant symptoms, treatment during one-year period, outcomes were evaluated. Results. Multiple logistic regression analysis revealed that one-year mortality after acute coronary syndromes was most influenced by age of 70–80 years, history of stroke, Killip class III-IV, and reduced high-density lipoprotein cholesterol levels. For patients who were treated for chronic coronary syndromes, reduced EF (<40%) and increased heart rate (>70 beats per minute) were the strongest independent predictors of one-year mortality. Conclusion. A scoring system for the assessment of mortality risk within one year for patients with acute and chronic coronary syndromes was constructed, which could be useful for cardiologists as well as family physicians for risk evaluation in inpatient and outpatient settings.

The risk score derived from clinical variables of first acute coronary syndromes permits a reliable determination of risk for cardiovascular death as well as the prediction of long-term survival in different risk groups.

The aim of this work was to assess the quality of pharmacological treatment in patients within one year after acute myocardial infarction. Material and methods. We performed a prospective survey of 985 consecutive patients with acute myocardial infarction who were treated in the Clinic of Cardiology of Kaunas University of Medicine Hospital in 2004. About half of patients were hospitalized from different regions of Lithuania. According to the follow-up protocol, an information on 514 patients and their used treatment within 13.8±3.2 months after myocardial infarction were collected by letter with questionnaire. Results. Beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and antithrombotic drugs were the most drug used (76%, 74%, and 76%, respectively) in patients following myocardial infarction. Most of the patients used a three-drug combination (36.8%), more rarely – two-drug (24.1%) or four-drug complex (19.8%). One drug was used only in 12.1% of cases; 7.2% of patients did not use any cardiac drugs. Betaadrenoblocker with angiotensin-converting enzyme inhibitor was the most common (40.3%) used drug combination in patients on two drug complex. The combination of beta-adrenoblocker, angiotensin-converting enzyme inhibitor, and antithrombotics was more frequently used in patients on three drug complex. The combination of two or three cardiac drugs with statin was used in several cases (1.6–10.3%). Conclusions. These findings underscore that the use of beta-adrenoblockers, angiotensin-converting enzyme inhibitors, and antithrombotics was high (about 75%) in patients during the first year after myocardial infarction, and the combination of these three drugs was used more commonly. The discordance between existing guidelines for statin use after myocardial infarction and current practice was determined in patients following myocardial infarction.