THE PULMONARY CIRCULATION PECULIARITIES IN YOUNG AND MIDDLE-AGED MEN WITH MYOCARDIAL INFARCTION AND RECURRENT EPISODES OF ISCHEMIA

2021 ◽  
pp. 60-65
Author(s):  
Gordienko A.V. ◽  
Epifanov S.Yu. ◽  
Nosovich D.V.
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Circulation ◽  
Comparative Assessment ◽  
Study Group ◽  
Type I ◽  
Pulmonary Resistance ◽  
The Third ◽  
Group I ◽  
Circulation Parameters ◽  
Ischemic Events

Relevance. The pulmonary hypertension (PH) and heart failure (HF) development during myocardial infarction (MI) in men with recurrent ischemic events (RIE) has not been adequately studied. Aim. To evaluate changes in pulmonary circulation parameters (PCP) in men under 60 years old (y.o.) in acute and subacute MI periods with RIS to improve understanding of PH and HF developmental options and to search for possible ways to improve prevention. Material and methods. The study included men aged 19-60 years old with type I of MI. Patients are divided into two age-comparable groups: I - the study group, with RIS - 110 patients; II - control, without it - 555 patients. A comparative assessment of PCP in the first 48 hours and the end of the subacute period of MI in these groups was performed. Results. In the first hours of MI the higher values of total pulmonary resistance (TPR) and mean pulmonary artery pressure (MPAP) were noted in the study group. When considering their dynamics at the end of the third MI week the MPAP decreased in both groups (I: by 8.7%; p˂0.0001; II: by 15.0%; p˂0.0001). TPR decreased in both groups (I: by 30.6%; II: by 29.6%; p˂0.0001) too. The heart rate - I: by 6.2%; p=0.03; II: 8.4%; p˂0.0001). At the end of the third MI week, MPAP remained elevated in the study group (I: 30.6 ± 12.7; II: 27.2 ± 7.7; p = 0.03).

THE PULMONARY CIRCULATION IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY PULMONARY DISEASE

2021 ◽  
pp. 34-39
Author(s):  
Men’shikova A.N. ◽  
Gordienko A.V. ◽  
Nhan Trinh Van
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Circulation ◽  
Comparative Assessment ◽  
Pulmonary Diseases ◽  
Study Group ◽  
Type I ◽  
Pulmonary Resistance ◽  
The Third ◽  
Mean Pressure ◽  
The Mean

Relevance. Formation of pulmonary hypertension (PH) in myocardial infarction (MI) and chronic inflammatory pulmonary diseases (CIPD) remains poorly understood. Aim. To evaluate changes in pulmonary circulation indicators (PCI) in men under 60 years old (y.o) with CIPD that in acute and subacute MI periods to improve understanding of developmental options and prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CIPD - 142 patients; II - control, without it - 424 patients. A comparative assessment of PCI in the first 48 hours and the end of the subacute period of MI in these groups was performed. Results. In the first hours of MI, higher values of total pulmonary resistance (TPR) (I: 572.4 ± 276.0; II: 505.3 ± 286.6 (dyn×sec×cm-5)) were noted in the study group. When considering their dynamics at the end of the third week of MI, the mean pressure in the pulmonary artery decreased in both groups (I: 18.3%; p˂0.0001; II: 11.2%; p˂0.0001). TPR decreased in both groups (I: 36.1%; II: 24.4%) and heart rate also decreased (I: 11.0%; II: 5.3%; p˂0,0001 for all indicators). Conclusions. The study group is distinguished by more pronounced disorders of pulmonary circulation in the first hours of MI, which confirms the feasibility of their assessment and study of indicators of the severity of CIPD as additional markers of a negative prognosis of PH.

THE PULMONARY CIRCULATION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH PULMONARY HYPERTENSION, DEVELOPED DURING MYOCARDIAL INFARCTION

2020 ◽  
pp. 31-35
Author(s):  
Men’shikova A.N. ◽  
Goncharov S.A. ◽  
Gordienko A.V.
Keyword(s):  
Myocardial Infarction ◽  
Pulmonary Hypertension ◽  
Normal Level ◽  
Pulmonary Circulation ◽  
Comparative Assessment ◽  
Pulmonary Resistance ◽  
Group Iii ◽  
The Third ◽  
Group Ii ◽  
Observation Period

Relevance. Formation of pulmonary hypertension (PH) in myocardial infarction (MI) remains poorly understood. Aim. To evaluate changes in pulmonary circulation indicators (PCI) in men under 60 years old (y.o) with PH that is developing in subacute MI period to improve understanding of developmental options and prevention. Material and methods. The study included men aged 19-60 y.o. with MI and various dynamics of mean pulmonary ar-tery pressure (MPAP), determined by echocardiography (A. Kitabatake) in the first 48 hours (1) and completion of third week (2) of MI. Patients were divided into four groups: studied (I) included 84 patients (mean age 50.4±7.1 y.o) with PH (MPAP2 25 and more mm Hg) and normal level of MPAP1. Group II included patients with a normal level of MPAP in both phases of the study (88 men, 52.1±6.6 y.o); group III – with elevated levels of MPAP at both points of study (184 men, 51.2±5.5 y.o) and IV – with increased levels of MPAP1 and normal levels of MPAP2 (94 men, 50.5±6.8 y.o). A comparative assessment of PCI in selected groups was performed. Results. In first 48 hours of MI, the minimum values of MPAP (I: 21.9±3.3; II: 20.3±2.5; III: 39.0±11.2 (mm Hg)) and total pulmonary resistance (TPR) ) (I: 380.0±171.0; II: 306.8±136.3; III: 616.0±279.8 (dyn×sec×cm-5)) were noted in group II, and the maximum - in III (p˂0.0001). When considering their dynamics at the end of the third week of MI, MPAP increased in I (39.5%; p˂0.0001), decreased in III (16.0%; p˂0.0001) and IV groups (42.9%; p˂0.0001). TPR decreased in II (12.1%), III (28.6%) and IV (54.2%) groups (p ˂0.0001). Conclusions. The study group is distinguished by unfavorable changes in PCI during observation period, in contrast to other groups, which confirms expediency of assessing dynamics of these parameters as possible marker of negative prognosis for PH.

PULMONARY CIRCULATION IN YOUNG AND MIDDLE-AGED MEN WITH ACUTE KIDNEY INJURY DURING MYOCARDIAL INFARCTION

2021 ◽  
pp. 103-109
Author(s):  
Gordienko A.V. ◽  
Balabanov A.S. ◽  
Tassybayev B.B.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Kidney Injury ◽  
Chronic Heart Failure ◽  
Pulmonary Circulation ◽  
Kidney Injury ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Circulation Parameters

Relevance. Hemodynamics changes of the pulmonary circulation in myocardial infarction complicated by acute kidney injury are not well understood. Aim. To evaluate the characteristics of pulmonary circulation in men under 60 years old with acute kidney injury in myocardial infarction to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 486 patients. A comparative analysis of pulmonary circulation parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, analysis of the risks of developing acute kidney damage and chronic heart failure in the selected groups were performed. Results. The study group differed in a lower heart rate (HR1) (66.3±12.2 from the control group (75.8±18.8; p=0.003). It showed a tendency towards lower the mean pulmonary artery pressure (MPAP) and total pulmonary resistance (TPR) at both points of the study. In both groups, there was a similar dynamic of decrease in the MPAP and TPR levels, more pronounced in the control group (MPAPII: -14.3%; MPAPI: -6.1 %; TPRII: -29.9%; TPRI: -21.8%; p<0.0001) and multidirectional - for HR: in the study group, an increase in HR was noted by 0.9% (p<0.0001), and in the control - its decrease by 8.4% (p<0.0001). Risk markers of the acute kidney injury developing were MPAP1˂30.4 mm Hg, HR1˂67 per minute and TPR1˂622.8 dyne•s•cm-5, the presence of chronic heart failure and cardiac asthma among the disease complication. The predictors of chronic heart failure in the study group were MPAP1≥26.9 mm Hg and HR1≥62 min. Conclusions. In case of acute kidney injury, lower levels of pulmonary circulation indicators are noted, their lower dynamics during the observation period, and a greater frequency of observation of chronic heart failure in comparison with the control group. The above listed values of the pulmonary circulation parameters have been assessed as a risk marker of the acute kidney injury and chronic heart failure development.

ELECTROLYTIC EXCHANGE FEATURES DURING MYOCARDIAL INFARCTION WITH RECURRENT EPISODES OF ISCHEMIA IN MEN UNDER 60 YEARS OLD

2021 ◽  
pp. 120-126
Author(s):  
Golikov A.V. ◽  
Epifanov S.Yu. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Blood Serum ◽  
Absolute Risk ◽  
Risk Groups ◽  
Unfavorable Outcome ◽  
Study Group ◽  
Type I ◽  
Sodium Potassium ◽  
The Third ◽  
Recurrent Myocardial Infarction

Relevance. Recurrent myocardial infarction and early postinfarction angina negatively effects on the prognosis of myocardial infarction. Aim. To evaluate myocardial infarction sodium, potassium, chlorides, calcium metabolism, features in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 110 patients; II - control, without it - 555 patients. A comparative analysis of blood serum electrolyte levels, their dynamics from the first hours to the end of the third week of myocardial infarction in the selected groups were performed. Their impact on the risk of recurrent ischemia and unfavorable outcome was assessed. Results. In the study group, in the first hours of the disease, the levels of chloride were higher (103.7±5.5 and 101.7±4.7 (mmol/l); p=0.002), and total calcium at the end of the third week of myocardial infarction (2.3±0.2 mmol/l) - lower than in the control (2.46±0.16; p=0.001). With an unfavorable outcome in the study group, the sodium level was lower in the first hours of the disease (138.7±4.9 and 142.7±6.6 (mmol/l); p=0.049). Moreover, the risk of its development was associated with sodium levels ≥148.0 mmol/l (absolute risk: 100.0%; relative - 13.8; p<0.0001) and potassium levels ≥5.3 mmol/l (absolute: 71,4%; relative - 12.4; p<0.0001). The risk of developing recurrent episodes of ischemia in the examined increased at chloride levels ≥104.7 mmol/l (absolute: 28.4%; relative: 3.1; p=0.0001) and sodium ≥139.0 mmol/l (absolute: 19.5%; relative: 1.7; p=0.03) in the first hours of myocardial infarction and calcium (<2.4 mmol/l) at the end of the third week of the disease (absolute: 31.0%; relative: 4.9; p=0.003). Conclusions. The listed combinations of levels of basic electrolytes in blood serum are markers of recurrence of ischemia in myocardial infarction and poor outcome. They should be used to identify risk groups with the necessary preventive measures and for predictive modeling.

THE CLINICAL COURSE OF MYOCARDIAL INFARCTION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH RECURRENT EPISODES OF ISCHEMIA

2021 ◽  
pp. 136-143
Author(s):  
Gordienko A.V. ◽  
Epifanov S.Yu. ◽  
Sotnikov A.V.
Keyword(s):  
Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Clinical Features ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Conduction Disorders ◽  
Recurrent Myocardial Infarction ◽  
Group I ◽  
Mechanical Devices

Relevance. Recurrent myocardial infarction and early postinfarction angina negatively affects on the prognosis of myocardial infarction. Aim. To evaluate myocardial infarction clinical features in men under 60 years old with recurrent myocardial infarction and early postinfarction angina to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 79 patients; II - control, without it - 432 patients. A comparative assessment of the myocardial infarction clinical features frequency in selected groups were performed. Results. The studied groups did not differ in the frequency of the main variants of the myocardial infarction course. In patients of the study group more often than in the control group, a complicated course of the disease was observed (88.2 and 50.2%, respectively; p < 0.0001), deaths (13.6 and 3.4%; p < 0.0001). Complications in the study group were dominated by arrhythmias (47.3 and 33.7%; p = 0.007), cardiogenic shock (13.6 and 6.1%; p = 0.006), myocardial ruptures (3.6 and 0.5% ; p = 0.004), thromboembolism (15.5 and 2.2%; p <0.0001), urinary dysfunction (7.3 and 2.5%; p = 0.01), Dressler's syndrome (4.5 and 1.1%; p = 0.009) and mental disorders (16.4 and 5.6%; p < 0.0001). Conclusions. Nonanginal forms of the disease in the study group were observed in 17% of cases. The complications of the disease for group I are characterized by cardiac arrhythmias and conduction disorders, thromboembolism, myocardial ruptures, cardiogenic shock, extracardiac complications of myocardial infarction. The study group has a worse prognosis, which requires early diagnosis, revascularization, the use of auxiliary mechanical devices, and careful implementation of standardized treatment algorithms.

HEART RATE AND CONDUCTIVITY DISORDERS FEATURES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND RECURRENT ISCHEMIA

2021 ◽  
pp. 58-65
Author(s):  
Balabanov A.S. ◽  
Epifanov S.Yu. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Ventricular Fibrillation ◽  
Heart Rhythm ◽  
Left Ventricular ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Study Group ◽  
Type I ◽  
Conduction Disturbances ◽  
Recurrent Myocardial Infarction ◽  
Group I

Relevance. Heart arrhythmia in early postinfarction angina and recurrent myocardial infarction is negatively affected the prognosis of the disease. Aim. To evaluate the peculiarities of heart rhythm and conduction disturbances and electrocardiographic (ECG) changes in men under 60 years old with early postinfarction angina and recurrent myocardial infarction for improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with myocardial infarction type I. Patients were divided into two age-comparable groups: I - study group with recurrent episodes of ischemia (early postinfarction angina pectoris and / or recurrent MI) - 110 patients; II - control, without them - 555 patients. A comparative assessment of heart arrhythmias and electrocardiographic changes observation frequency in the selected groups was performed. Results. In the patients of the study group more often than among all other patients, ventricular fibrillation was observed (8.5 and 3.9%, respectively; p = 0.04), paroxysmal supraventricular tachycardia (5.7 and 1.8%; p = 0.02) and electrocardiographic signs of the right atrium enlargement (9.4 and 1.6%; p ˂ 0.0001). In group I, among the deceased, electrocardiographic signs of left ventricular hypertrophy were more often detected (93.3 and 57.9%; p = 0.02). Arrhythmias that started in the subacute period of myocardial infarction were recorded with the same frequency in both groups of patients (1.4 and 1.6%; p = 0.9). Conclusions. Men under 60 years old with recurrent episodes of ischemia in myocardial infarction are characterized by potentially curable ventricular fibrillation and supraventricular tachycardias. Electrocardiographic signs of left ventricular enlargement were an additional marker of a poor prognosis for these patients. The frequency of occurrence of "late" arrhythmias in this pathology is 1.4%, and the methods of their possible correction require clarification depending on the mechanism of their development.

CARDIOVASCULAR RISK FACTORS PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION AND CHRONIC INFLAMMATORY LUNG DISEASES

2020 ◽  
pp. 21-25
Author(s):  
Tupitsyn V.V. ◽  
Bataev Kh.M. ◽  
Men’shikova A.N. ◽  
Godina Z.N.
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Digestive System ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Internal Organs ◽  
History Of

Relevance. Information about the cardiovascular diseases risk factors (CVD RF) for in men with chronic lung inflam-matory pathology (CLID) is contradictory and requires clarification. Aim. To evaluate the peculiarities of CVD RF in men under 60 years of age with CLID in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with CLID - 142 patients; II - control, without it - 424 patients. A comparative analysis of the frequency of observation of the main and additional cardiovascular risk fac-tors in groups was performed. Results. In patients of the study group, more often than in the control group we observed: hereditary burden of is-chemic heart disease (40.8 and 31.6%, respectively; p = 0.0461) and arterial hypertension (54.2 and 44.6%; p = 0.0461), frequent colds (24.6 and 12.0%; p = 0.0003), a history of extrasystoles (19.7 and 12.7%; p = 0.04); chronic foci of infections of internal organs (75.4 and 29.5%; p˂0.0001), non-ulcer lesions of the digestive system (26.1 and 14.6%; p = 0.007), smoking (95.1 and 66.3%; p˂0.0001), MI in winter (40.8 and 25.9%; p = 0.006). Less commonly were observed: oral cavity infections (9.2 and 23.6%; p˂0.0001); hypodynamia (74.5 and 82.5%; p = 0.0358), over-weight (44.4 and 55.2%; p = 0.0136), a subjective relationship between the worsening of the course of coronary heart disease and the season of the year (43.7 and 55.2%; p = 0.0173) and MI - in the autumn (14.1 and 21.9%; p = 0.006) period. Conclusions. The structure of CVD RF in men under 60 years of age with CLID with MI is characterized by the pre-dominance of smoking, non-ulcer pathology of the digestive system, frequent pro-student diseases, meteorological dependence, a history of cardiac arrhythmias and foci of internal organ infections. It is advisable to use the listed factors when planning preventive measures in such patients.

THE CLINICAL COURSE OF MYOCARDIAL INFARCTION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH PULMONARY HYPERTENSION

2020 ◽  
pp. 64-68
Author(s):  
Gordienko A.V. ◽  
Men’shikova A.N. ◽  
Sotnikov A.V.
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Clinical Course ◽  
Comparative Assessment ◽  
Study Group ◽  
Routine Examination ◽  
Group Iii ◽  
Appropriate Treatment ◽  
Level Group

Relevance. Pulmonary hypertension (PH) negatively affects the prognosis of myocardial infarction (MI). Aim. To evaluate MI clinical features (CF) in men under 60 years old (y.o.) with PH, arising during MI to improve pre-vention and outcomes. Material and methods. The study included men 19-60 y.o. with MI and various dynamics of mean pulmonary artery pressure (MPAP), determined by echocardiography (A. Kitabatake) in first 48 hours (1) and completion of third week (2). Patients were divided into four groups: studied (I) included 67 patients (mean age 50.4±7.1 y.o) with PH (MPAP2 25 and more mm Hg) and normal of MPAP1 level. Group II included patients with a normal MPAP in both phases of study (70; 52.1±6.6 y.o); group III – with elevated MPAP at both study points (149; 51.2±5.5 y.o) and IV – with in-creased MPAP1 and normal MPAP2 (61, 50.5±6.8 y.o). A comparative assessment of the MI CF frequency in selected groups were performed. Results. The study group occupied intermediate place frequency in medical history presence: coronary heart disease (I: 59.5; II: 61.4; III: 63.6 and IV: 48.9%; p = 0.04), chronic heart failure (CHF) (35.7 ; 34.1; 51.1 and 24.5%, respec-tively; p=0.001), repeated (45.2; 42.0; 47.3 and 29.8%) and early recurrent (3.6; 3.4 ; 6.0 and 3.2%; pIII-IV=0.006) MI, Q-MI (44.0; 35.2; 58.7 and 56.4; p=0.001), anginal MI phenotype (75.0; 74.7; 54.3 and 77.7%; p˂0.0001) and acute HF (ACF) (45,2; 36,8; 50,5 и 48,9%; р=0,002). No pulmonary edema was detected in it (p˂0.0001). Conclusions. Men under 60 y.o. with PH resulting from MI occupy an intermediate place in frequency of complica-tions, ACF and CHF in first 56 days of MI during routine examination compared with other MPAP dynamics patients. This confirms the need for additional verification of PH genesis for the appropriate treatment.

THE HEART DAMAGE AND ITS STRUCTURAL STATE FEATURES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY

2021 ◽  
pp. 36-44
Author(s):  
Gordienko A.V. ◽  
Golikov A.V. ◽  
Tassybayev B.B. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Tricuspid Regurgitation ◽  
Interventricular Septum ◽  
Kidney Injury ◽  
Risk Groups ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Acute Kidney Injury Development

Relevance. The role of hemodynamic changes in myocardial infarction complicated by acute kidney injury is interpreted in different ways. Aim. To evaluate the heart chambers and structures peculiarities in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 366 patients. A comparative assessment of the heart chambers and structures parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed. Results. The study group differed from the control group in smaller sizes of the left atrium2 (38.1±6.0 and 42.0±5.4 (mm), respectively; p=0.01), a higher frequency of the middle anterior (100 and 15.6%; p=0.02) and antero-septal (100 and 17.7; p=0.04) segments akinesia and the absence (0 and 81.5%; p=0.04) of tricuspid regurgitation. In the study group, there was a smaller increase in the ventricles size than in the control group (left: 0.6 and 1.7%, respectively; right: 15.3 and 33.6%) and a greater decrease in the atria size, compared in the control group (left: -1.8 and -25.3%; right: -25.3 and -0.1%) (p<0.0001). The risk markers of the acute kidney injury developing were the dimensions of the left atrium1˂34 mm, interventricular septum≥12.0 mm, end systolic1≥4.23 and diastolic1≥5.3 of the left ventricle, right ventricle1˂2.6; of the right atrium1≥4.7 (cm), the mass of the left ventricle1≥328.8 g. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by lesions of the middle anterior and antero-septal segments, the absence of tricuspid regurgitation, and a smaller left atrium in the subacute period of the disease. The above of the heart chambers dimensions values should be used in the high-risk groups for the acute kidney injury development formation, as well as for prognostic modeling.

THE LIPID METABOLISM IN YOUNG AND MEDIUM MEN AGE WITH MYOCARDIAL INFARCTION AND RECURRENT EPISODES OF ISCHEMIA

2021 ◽  
pp. 66-72
Author(s):  
Golikov A.V. ◽  
Epifanov S.Yu. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Lipid Metabolism ◽  
High Density Lipoproteins ◽  
Total Serum ◽  
Control Group ◽  
Total Serum Cholesterol ◽  
Study Group ◽  
Type I ◽  
Prevention Measures ◽  
Recurrent Myocardial Infarction

Relevance. Dyslipidemia is considered one of the main risk factors for the development of recurrent myocardial infarction and early postinfarction angina. Aim. To evaluate the features of lipid metabolism in acute and subacute myocardial infarction in men under 60 years old with recurrent episodes of ischemia (recurrent myocardial infarction and/or early postinfarction angina) to search for new approaches to improve prevention measures. Material and methods. The study included men aged 19-60 years old with type I myocardial infarction. Patients are divided into two age-comparable groups: I - the study group, with recurrent myocardial infarction - 68 patients; II - control, without it - 427 patients. A comparative assessment of lipid metabolism parameters and their dynamics in selected groups were performed. Results. The study group differed in higher levels of total serum cholesterol (6.17±1.78 mmol/l) from the control group (5.56±1.28 mmol/l; p=0.02) at the end of the third week of disease, its dynamics during the observation period (I: 9.1%; p<0.0001; II: -1.8%; p<0.0001) and the dynamics of the atherogenic coefficient (I: -4.7.1; p=0.02; II: 6.3%; p<0.0001). In both groups, the group showed an increase in lipoproteins of low (I: 33.1; p=0.02; II: 45.5%; p<0.0001) and very low density (I: 275.8; p=0,0004; II: 233.4%; p<0.0001), atherogenic indices, decrease: triglycerides (I: -31.8%; p=0.02; II: -1.7%; p<0.0001) and high-density lipoproteins (I: -0.6%; p=0.02; II: -6.1%; p<0.0001). Conclusions. The group with recurrent ischemia is characterized by more pronounced hypercholesterolemia at the end of the subacute period of myocardial infarction in comparison with the control group due to an increase in the concentrations of atherogenic lipid metabolism fractions. The dynamics of indices and the coefficient of atherogenicity during this period is multidirectional, which requires additional study.

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