Possibilities of the Complicated Rupture Myocardial Infarction Development Prediction in Young and Middle-Aged Men

Abstract

Relevance. Myocardial ruptures during myocardial infarction remain one of its most dangerous complications. Aim. To evaluate the features of risk factors for the development of myocardial infarction complicated by rupture in young and middle-aged men for predictive modeling of this complication to improve its prevention. Material and methods. The results of examination and treatment of men aged 19-60 years with myocardial infarction were studied. Patients were divided into two age-comparable groups: I – study group, with myocardial rupture – seven patients; II - control, without it - 558 patients. A comparative analysis of clinical, instrumental and laboratory parameters was performed, as well as an analysis of their influence (Pearson's Chi-square) on the risk of myocardial ruptures. Using binary and stepwise logistic regression, a model for predicting the risk of myocardial rupture was created. Results. The study group differed from the control group in terms of a more severe condition of patients (recurrent extensive lesions with multiple complications), the most significant of which were: electrocardiographic signs of right ventricular enlargement (absolute risk: 21.4%; relative: 27.0; p˂0.0001), the presence of thromboembolism (17.9%; 17.5, respectively; p˂0.0001) and pulmonary edema (9.0%; 44.6; p˂0.0001) among the complications myocardial infarction, history of coronary artery bypass surgery (6.6%; 11.0; р˂0.0001), III and IV severity class of acute heart failure according to T. Killip (12.1%; 21.3; р˂ 0.0001), the presence of asystole (18.8%; 23.5; p˂0.0001) and complete atrioventricular block (15.8%; 19.7; p˂0.0001). Conclusions. These factors were used to build a model for predicting the risk of myocardial rupture with good predictive characteristics, suitable for practical use.