[The characteristics of neuroendocrine regulatory disorders in acute myocardial infarct in relation to the severity of the course of the disease].

A total of 45 patients aged 35 to 73 years who had sustained acute myocardial infarction (MI) were studied in a special cardiological unit. On days 1, 5, 14, 28 of hospital stay, each patient underwent measurements of cortisol, insulin, T3 and T4 and calculations of the mathematical clinic severity index after G.I. Marchuk et al. In acute MI, there were elevated plasma levels of cortisol depending on the MI severity with a small repeated peak of its increase on day 14 and its subsequent decrease, except deaths. In severe acute MI there were impairments of reciprocal cortisol/insulin ratios. This was particularly pronounced in patients with lethal outcomes. By the end of hospital rehabilitation, patients with acute MI displayed lower levels of thyroidal hormones. The maximum decrease in T3 and T4 was found in patients with lethal outcomes. There was a direct correlation between the mathematical clinical severity index of the natural history of acute MI and the levels of cortisole triidothyronine at the hospital stage of observation. In the course of the study it was found that the Marchuk clinical severity index serves as an informative severity index of MI course whose determination in its acute period allows one to predict the course of acute MI and to choose a differential therapy of and to make a diagnosis of possible complications.