INTRODUCTION: The most frequent cause of heart failure is ischemic heart disease (1). This paper was aimed at comparing the coronary score of patients with low ejection fraction whose ejection fraction was not significantly changed after sustained myocardial infarction. MATERIAL AND METHODS: The study involved patients after sustained myocardial infarction treated at the Institute of Cardiovascular Diseases in Sremska Kamenica. Total coronary score and score of each individual coronary artery were emphasized. RESULTS: The investigation study comprised 56 patients aged 33-83 years of various occupations. Patients were divided into two groups: the first--A group consisted of 28 (50%) patients with ejection fraction 35% or lower; the second--B group also consisted of 28 (50%) patients with ejection fraction higher that 35%. Table 1. shows the dominant coronary artery in investigated groups of patients. Table 2. shows values of total and scores of each coronary artery. The right coronary artery was dominant in 75% of patients from the A group and in 82.1% of patients from the B group. A significantly higher individual score of coronary arteries, as well as the total score, was established in the group of patients with low ejection fraction, and especially the score of the anterior descendent artery which is almost twice higher in regard to the second group of examined patients. Table 3. describes the analyzed score in male and female patients. DISCUSSION: Patients with low ejection fraction after sustained myocardial infarction have more changes of coronary arteries than patients with better ejection fraction. The total score, score of the right coronary artery (ACD), circumflex artery (RCX) and especially anterior descendent artery (LAD) are significantly higher in patients with ejection fraction lower than 35%. There are no differences in the dominant coronary artery in investigated patients. In both investigated groups women had a smaller score of ACD and RCX and a higher score of LAD, but the difference is not significant. In regard to total score there were no differences in men and women. Numerous investigations also point to the fact that patients with lower ejection fraction and ischemic heart disease have more changes on coronary artery than patients with better ejection fraction. CONCLUSION: 1. Patients with low ejection fraction after sustained myocardial infarction have a higher total score and scores of ACD. LAD and RCX. 2. There are no differences in coronary score of men and women within the same investigated groups. 3. There are no differences in dominant coronary artery in investigated groups of patients.

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[Hypertension as a risk factor in acute infarct in young people].

INTRODUCTION: Hypertension is one of the most frequent risk factors for acute myocardial infarction. The aim of this paper was to establish both the incidence of hypertension as a risk factor for myocardial infarction in young people and its characteristics. METHODS: The investigation involved patients younger than 40 years of age with acute myocardial infarction treated at the Institute of Cardiovascular Diseases in Sremska Kamenica from 1989 to 1994. RESULTS: The investigation involved 80 patients with acute myocardial infarction younger than 40 years--40 male and 40 female. Hypertension as a risk factor was found in 22 (55%) women and in 14 (35%) men and it was a moderate hypertension of systolic-diastolic type or unstable hypertension. In 10 (27.77%) investigated patients hypertension was detected during hospitalization (before that, it had not been controlled) while in 22 (61%) it was not seriously taken into account either by the patients, or their physicians and therefore it was not treated. As a single risk factor hypertension was found in 4 (10%) women, while it was not found in men. DISCUSSION: Hypertension is found in 10-15% of population, and in 10% young men and women. The existence of hypertension as the only risk factor for the occurrence of acute myocardial infarction was sufficient in these women, although it was considered that women in their generative period are protected from ishaemic heart diseases by their hormonal status. All that points to hypertension as a secret and mysterious killer. CONCLUSION: Hypertension as a risk factor was found in 22 (55%) women, and in 14 (35%) men. In 10% of women hypertension was the only risk factor, while it was not found as such in men. It was quite sufficient in these women for the occurrence of acute myocardial infarction, although it was considered that women in their generative period are protected from ishaemia in heart diseases by their hormonal status. Detection and adequate treatment of hypertension are of great importance as well as elimination of other risk factors.

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