PECULIARITIES OF CARDIOVASCULAR RISK FACTORS IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL IN- FARCTION AND RECIDIVATING ISCHEMIC EPISODES

Abstract

Recurrent ischemic events extremely negatively affects on the prognosis of myocardial infarction (MI). It has been shown that their frequency has recently increased against the background due to the increasing role of percutaneous coronary interventions. Moreover, information about the influence of risk factors of cardiovascular disease (CVD) on the development of recurrent episodes of ischemia (REI) is contradictory. The purpose of the study: a comparative assessment of the structure of CVD risk factors of men younger than 60 years old with recurrent episodes of ischemia (REI) in MI to improve prevention. It includes men from 18 to 60 years old with type I myocardial infarction with a glomerular filtration rate of 30 or more ml / min / 1.73 m2, who, in addition to the standard diagnostic algorithm, carried out a targeted search and analysis of the presence of basic and additional CVD risk factors. Patients were divided into two age-comparable groups: I - the study group, with REI (recurrent MI and / or early post-infarction angina pectoris) - 95 patients; II - without these complications - 471 people. Patients were examined and treated according to local standards at the time of hospitalization. Assessment of lipid metabolism included determination of concentrations of total cholesterol and its fractions, triglycerides, coefficient and atherogenicity indices. It is believed that the main cause of REI is the progression of coronary atherosclerosis. The main risk factors of REI include lipid metabolism disorders, physical inactivity, smoking, hypertension and obesity. Alcohol abuse, impaired renal function and diabetes mellitus have a lower frequency of observations. Recently, attention has been focused on an increase in the proportion of stent thromboses after percutaneous coronary intervention and distal embolism of the coronary arteries. Additional importance for the development of REI are physical inactivity, smoking, unstable angina, MI and history of bypass surgery, psychoemotional stress, as the cause of MI, winter and autumn periods of the year. The listed factors should be used when creating high-risk groups for the development of REI for monitoring and conducting preventive measures, as well as for prognostic modeling of REI.