MEDICATION ADHERENCE AND ITS IMPACT ON THE AVERAGE LIFE EXPECTANCY AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: THE RESULTS OF THE UKRAINIAN STIMUL REGISTRY.

OBJECTIVE: The aim: The present study aimed to evaluate the adherence to medications prior and within a two-year period after ST-segment elevation myocardial infarction (STEMI) and to estimate its impact on the average lifespan of patients after STEMI. PATIENTS AND METHODS: Materials and methods: 1,103 patients with STEMI were enrolled in the prospective Ukrainian STIMUL registry with 24-month follow-up. The relationship between adherence to medical treatment and average lifespan was evaluated. RESULTS: Results: The majority of prior STEMI patients were characterized with high and very high cardiovascular risk. The rate of revascularization was 29.9% (21.5% pPCI, 8.4% fibrinolytic therapy). The main reason for the low level of pPCI was late hospitalization and the inaccessibility of pPCI. This contributed greatly to in-hospital mortality (11.3%). Adherence to all medications progressively decreased (p < 0.001) within 24 months after STEMI. Permanent use of acetylsalicylic acid (ASA) and statins during the two-year follow-up was associated with 7.0% of the mortalities, whereas non-adherence to medications was related to a 15% risk of death (OR 4.2; 95% CI 0.2-0.9; p < 0.05). The average life expectancy with regular use of ASA and statins within 24 months after STEMI was 62.3 ± 1.1 years (95% CI 60.1-64.4; p < 0.05) and 61.2 ± 0.9 years with non-regular use of ASA and statins (95% CI 59.4-62.9; p < 0.05). CONCLUSION: Conclusions: Adherence to evidence-based medicines was low in the STIMUL population both prior and after STEMI. This worsened cardiovascular prognosis and reduced average lifespan by one year within the following two years after STEMI.

Evaluation and Comparison of the STIMUL Extended and Simplified Risk Scores for Predicting Two-Year Death in Patients Following ST-Segment Elevation Myocardial Infarction.

Background and Objectives: The management of ST-segment elevation myocardial infarction (STEMI) requires a patient's long-term risk to be estimated. The objective of this study was to develop extended and simplified models of two-year death risk estimation following STEMI that include and exclude cardiac troponins as prognostic factors and to compare their performance with each other. Materials and Methods: Extended and simplified multivariable logistic regression models were elaborated using 1103 patients with STEMI enrolled and followed up in the STIMUL (ST-segment elevation Myocardial Infarctions in Ukraine and their Lethality) registry. Results: The extended STIMUL risk score includes seven independent risk factors: age; Killip class ≥ II at admission; resuscitated cardiac arrest; non-reperfused infarct-related artery; troponin I ≥ 150.0 ng/L; diabetes mellitus; and history of congestive heart failure. The exclusion of cardiac troponin in the simplified model did not influence the predictive value of each factor. Both models divide patients into low, moderate, and high risk groups with a C-statistic of 0.89 (95% CI 0.84-0.93; p < 0.001) for the extended STIMUL model and a C-statistic of 0.86 (95% CI 0.83-0.99; p < 0.001) for the simplified model. However, the addition of the level of troponin I to the model increased its prognostic value by 10.7%. Conclusions: The STIMUL extended and simplified risk estimation models perform well in the prediction of two-year death risk following STEMI. The simplified version may be useful when clinicians do not know the value of cardiac troponins among the population of STEMI patients.

ANALYSIS OF STUDENTS' SOMATIC HEALTH AND EMOTIONAL STATE DURING SPORTS GAMES CLASSES.

OBJECTIVE: The aim: Is to investigate the impact of sports games (football) on the level of somatic health and emotional state of students in the process of studying. PATIENTS AND METHODS: Materials and methods: The study was conducted at Kharkiv State Academy of Physical Culture and Sumy State University (Ukraine) in 2018-2019. The study involved 87 male students of the main department. Two groups were formed: an experimental group (EG, n=42), the students of which were engaged in a sports-oriented form of physical education (in the class of football), and a control group (CG, n=45), the students of which were training according to the traditional methods of organizing physical education classes at higher education institutions. The somatic health of students was assessed according to the method of H. L. Apanasenko, which provided for the determination of body mass, life, power, and Robinson indexes, heart rate recovery time after a standard exercise. The emotional state of students was determined by the WAM (Well-being, Activity, Mood) methodology. RESULTS: Results: At the end of the study, the EG students showed a significantly better level of somatic health than the CG students; the difference was significant and accounted for 3.18 points (p<0.001). At the same time, during the study, the EG students had a more pronounced significant increase in all studied health indicators (p<0.001). The best emotional state level of the students of both groups was recorded at the end of the study, but in the EG students it was significantly (p<0.05) better than in the CG students by 0.55-0.73 points. CONCLUSION: Conclusions: It was found that sports games classes, including football, had a positive effect on the level of somatic health and emotional state of students. Significant changes were observed in the performance of the respiratory and cardiovascular systems of students. The high level of somatic health and good emotional state of students will help to improve mastering academic disciplines at higher education institutions, provide preparation for active life and help to improve future professional activities.