RESUMO
AIM: To identify factors affecting effective management of patients with myocardial infarction for preventing recurrent coronary events in the outpatient setting. MATERIALS AND METHODS: The study group consisted of patients (n=111) with recurrent myocardial infarction. The control group consisted of patients with primary myocardial infarction (n=89) after percutaneous coronary intervention. Social and demographic, clinical and behavioral factors (weight loss, smoking cessation, adherence to therapy, physical and psychological rehabilitation) were evaluated. RESULTS: Risk factors contributing to the development of repeated MI were as follows: patients' age, concomitant polyvascular and multivessel disease, arterial hypertension, hypercholesterolemia, excess weight and smoking, poor adherence to the recommendations of cardiologists and general physicians. CONCLUSION: The analysis of the effectiveness of the management of patients with myocardial infarction demonstrated the importance of the outpatient rehabilitation in preventing repeated acute coronary events.
Assuntos
Infarto do Miocárdio/prevenção & controle , Prevenção Secundária , Adulto , Idoso , Feminino , Humanos , Hipercolesterolemia/complicações , Hipertensão/complicações , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea , Fatores de Risco , Fumar , Abandono do Hábito de Fumar , Resultado do Tratamento , Adulto JovemRESUMO
AIM: of the study was to assess efficacy of the use of fixed combination of nebivolol and amlodipine in patients with moderate and high degree of arterial hypertension (AH). MATERIAL AND METHODS: Patients with diagnosis of primary AH (n=124) were divided into 2 groups by random sample method. Patients of group 1 (n=62) received of fixed combination of nebivolol and amlodipine, while those of group 2 (n=62) received free combination of nebivolol and amlodipine. Study drugs were administered both as initial therapy and replacement of preceding treatment. Duration of observation was 3 months with visits after first 2 weeks and in 1, 2, and 3 months after enrollment. RESULTS: Starting from 2nd week visit of fixed combination of nebivolol and amlodipine treated patients had significantly lower levels of systolic and diastolic AP. Already after 2 weeks of combined two-component therapy 60% of group 1 and 52% of group 2 patients achieved target AP. Target AP was achieved by the end of month 1 by 86 and 71%, of month 2 - by 93 and 78% of patients in groups 1 and 2, respectively. In 3 months almost all patients had target AP, but in 1.6% of group 1 and 2.3% of group 2 patients this level was achieved after addition of a thiazide diuretic. Patients receiving of fixed combination of nebivolol and amlodipine achieved noromosyslolia more quickly compared with patients who received free combination of nebivolol and amlodipine. CONCLUSION: Combined therapy with fixed combination of nebivolol and amlodipine appears to be one of effective approaches to treatment of patients with moderate and high degree AH.