Clinical cases of various types of myocardialinfarction from the position of choosing the optimalapproaches to secondary prevention

Authors: Pecherina Т.B.1 2, Kashtalap V.V.1 3

Company: 1Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
2Kemerovo Regional Clinical Cardiology Dispensary named after academician L.S. Barbarash, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation;
3Kemerovo State Medical University, ulitsa Voroshilova, 22a, Kemerovo, 650056, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2019-13-4-363-374

For citation: Pecherina Т.B., Kashtalap V.V. Clinical cases of various types of myocardial infarction from the position of choosing the optimal approaches to secondary prevention. Creative Cardiology. 2019; 13 (4): 363–74 (in Russ.). DOI: 10.24022/ 1997-3187-2019-13-4-363-374

Received / Accepted:  29.11.2019/16.12.2019

Keywords: myocardialinfarction types 1 and 2 atrial fibrillation secondary prevention

Full text:  

 

Abstract

The article presents clinical cases illustrating the importance of the division of patients depending on the type of myocardial infarction into the types 1 and 2 in accordance with the new 4th universal definition of myocardial infarction. Two examples illustrate the difficulties in choosing optimal therapy in patients with different types of myocardial infarction and co-morbidities, including atrial fibrillation. In the first case, the patient has a classic type 1 myocardial infarction, with the need for aggressive antithrombotic therapy for 12 months and long-term baseline drugs for coronary heart disease. The patient from the second clinical case has a type 2 myocardial infarction with the need only for monotherapy with oral anticoagulants to improve the prognosis. However, in clinical practice, it is extremely difficult to distinguish patients with different types of myocardial infarction, and therefore therapy in such patients is suboptimal. Based on the aforesaid, it is proposed to actively use in wide clinical practice the possibilities of a new international conciliation document “Fourth universal definition of myocardial infarction”.

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About Authors

  • Tamara B. Pecherina, Cand. Med. Sc., Senior Researcher, ORCID
  • Vasiliy V. Kashtalap, Dr. Med. Sc., Associate Professor, Head of Laboratory, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery