Early and long-term prognosis in patients with acute coronary syndrome

Abstract

Basing on literature data, the effect of arterial hypertension on the course of myocardial infarction was analyzed in short- and long-term observation. Myocardial infarction without ST segment elevation and with changes in ST-T segments in lower number of leads on ECG is more frequent in hypertensive patients (HA) as compared to normotensive patients (NA), whereas the size of myocardial necrosis estimated by enzymatic activity does not demonstrate any significant difference. In the course of hospitalization, paroxysmal atrial fibrillation, recurrent angina pectoris and deterioration of renal function are more frequently observed in HA patients as compared to NA ones. However, hospitality in HA and NA patients is similar.
In long-term observation of HA patients as compared to NA patients, exacerbations of angina pectoris and repeated infarcts are more frequent particularly in patients with high systolic and low diastolic pressure or isolated arterial hypertension. Mortality in long-term observation is higher in HA patients than in NA patients. In HA patients, the severity of chronic hypertensive disease, the presence of other risk factors particularly such as diabetes and renal dysfunction have an unbeneficial effect on the course of myocardial infarction. In the group of elderly subjects, isolated systolic hypertension and high pulse pressure are the factors deteriorating the prognosis.