Clinico-Pathogenetic Regularities of Evaluation of the Effectiveness of the Restorative Treatment in Patients After Acute Coronary Syndrome at the Stages of Rehabilitation

Abstract

The implementation and improvement of new treatment methods for patients with acute coronary syndrome poses new challenges in finding the newest methods of rehabilitation and restorative treatment. The effectiveness of such interventions depends on the integrated approach and patient’s involvement. Accepting the disease, the patient builds an idea about the disease and integrates the internal picture of the disease into a new internal picture of health. The ability to see illness only as part of health is a strategy of self-preservation and self-renewing behaviour.
 Objective of the study. To evaluate the clinical-pathogenetic regularities of the effectiveness of the restorative treatment in patients after acute coronary syndrome (ACS) at the stages of rehabilitation.
 Materials and methods. There were 135 patients with acute coronary syndrome without ST segment elevation were examined, who were divided into the groups depending on the used treatment tactics – conservative or invasive – PCI. Clinical-anamnestic indices, psychometric, subjective and objective data were analyzed. Along with the traditional treatment, there was used the rehabilitation of patients according to the author’s method, based on a multidisciplinary approach with optimization of the internal picture of health. The examinations were performed before the beginning of rehabilitation, after 1 week, 1 month and 6 months.
 Results. The use of the program, along with the traditional treatment of patients, helped to improve the effectiveness of treatment by normalization of the major objective indices, reduction of the anxiety levels, and improvement of life quality. More pronounced dynamics was noted in patients with acute coronary syndrome without ST segment elevation with invasive treatment tactics.
 Conclusions. Clinical-psychological rehabilitation of patients with acute coronary syndrome without ST-segment elevation can improve the effectiveness of rehabilitation and rehabilitation, regardless of treatment tactics, although the effect is somewhat higher in patients with invasive therapy tactics. This approach helps to improve the course of the disease. A multidisciplinary approach involving a cardiologist and a physical restorative and rehabilitation physician, a psychologist and a physiotherapist is important.