Relevance. Recurrent ischemic events (RIS) adversely affect the duration of treatment and the prognosis of myocardial infarction (MI).
Aim. To evaluate the coronary arteries condition in men under 60 years old (y.o.) with RIS and MI to improve understanding of the mechanisms of development and prevention.
Material and methods. The study included men 19-60 years old with type I of MI. Patients were divided into two age-comparable groups: I - study group, with RIS (early postinfarction angina pectoris and / or recurrent MI) - 26 patients; II - control, without them - 114 patients. A comparative assessment of angiographic data in the selected groups was performed.
Results. Patients in the study group had a greater (15.5%) than in the control (7.9%; p = 0.01) history of coronary artery bypass surgery, the degree of infarction-related artery stenosis (96.9 ± 7.7 and 92.3 ± 10.8%, respectively; p = 0.02). The magnitude of the narrowing of the coronary artery was associated with the coefficient of atherogenicity (r = 0.87; p <0.05), end-systolic (r = 0.53; p <0.05) and diastolic (r = 0.6; p <0, 05) left ventricle (LV) sizes, glomerular filtration rate (r = -0.5; p <0.05) in the first hours of MI, creatinine in the first hours (r = 0.47; p <0, 05) and at the end of the third MI week (r = 0.65; p <0.05).
Conclusions. In men under 60 y.о. with RIS during MI, the most pronounced association with a history of coronary artery bypass surgery and a greater lumen narrowing of the infarct-associated artery, which, in turn, increased with impaired renal function and lipid metabolism, and was also associated with LV dilatation.
Multivariate prediction of in-hospital mortality associated with coronary artery bypass graft surgery. Northern New England Cardiovascular Disease Study Group.