Changes in the lipid profile after acute myocardial infarction at the stage of outpatient follow-up
-
Published:2020-09-30
Issue:3
Volume:88
Page:27-37
-
ISSN:2414-4495
-
Container-title:Medicine Today and Tomorrow
-
language:uk
-
Short-container-title:MTT
Author:
Sid’ E.V.1ORCID, Kulbachuk O.S.1ORCID
Affiliation:
1. Zaporizhzhia Medical Academy of Post-Graduate Education, Ministry of Health of Ukraine, Zaporizhzhia, Ukraine
Abstract
The changes in the lipid profile after acute myocardial infarction at the stage of outpatient follow-up and the predictor significance of some immune-inflammatory markers in relation to the development of cardiovascular events were determined. The results of the study are based on data from a comprehensive examination of 186 patients with STEMI, who were admitted to the Regional Medical Center for Cardiovascular Diseases. The main condition for inclusion in the study was the presence of STEMI in the first 12 hours from the onset of the disease. Further observation was carried out on an outpatient basis for one year. Patients were divided into groups depending on the dose of statin they received against the background of standard treatment: in 131 patients, statin was used at a medium dose, in 55 at a high dose. At the screening, the level of CPK-MB, troponin I, high sensitive C-reactive protein, interleukin-6, and expanded lipid profile were examined. After 3 months and after 12 months, an expanded lipid profile was examined. The safety of treatment with statins was determined by the level of aspartate aminotransferase and alanine aminotransferase during screening and over time. During the entire observation period, new cases of cardiovascular events were monitored. The cardiovascular event included conditions requiring emergency medical care: recurrent myocardial infarction, ventricular tachycardia, angina attacks. It was found that a high dose of statins in patients after acute myocardial infarction showed a greater effect in reducing the level of total cholesterol and low-density lipoprotein cholesterol and made it possible to achieve their target levels in a significantly larger percentage of patients compared to treatment with medium doses. However, there was no significant difference in the safety profile of statins. It was found that the relative risk of a cardiovascular event increases 3.038 times among patients with acute myocardial infarction with an increase in the level of high sensitive C-reactive protein above 9.95 mg/1, and the use of high-dose statins in patients after AMI was associated with a decrease in the risk of events at 0.286.
Keywords: acute myocardial infarction, STEMI, cholesterol, low density lipoprotein, C-reactive protein, cardiovascular event, statins.
Publisher
Kharkiv National Medical University
Subject
General Earth and Planetary Sciences,General Environmental Science
Reference19 articles.
1. Reed, G.W., Rossi, J.E., & Cannon C.R (2017). Acute myocardial infarction. The Lancet, vol. 389, is. 10065, pp. 197–210. DOI: 10.1016/S0140-6736(16)30677-8. PMID: 27502078. 2. McNamara, R.L., Kennedy, K.F., Cohen, D.J., Diercks, D.B., Moscucci, M., Ramee S. et al. (2016). Predicting in-hospital mortality in patients with acute myocardial infarction. Journal of the American College of Cardiology, vol. 68, is. 6, pp. 626–635. DOI: 10.1016/j.jacc.2016.05.049. PMID: 27491907. 3. Arnett, D.K., Blumenthal, R.S., Albert, M.A., Buroker, A.B., Goldberger, Z.D., Hahn E.J., et al. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, vol. 140, is. 11, pp. e596–e646. DOI: 10.1161/CIR.0000000000000678. PMID: 30879355. 4. Alabas, O.A., Jemberg, T., Pujades-Rodriguez, M., Rutherford, M.J., West, R.M., Hall, M. et al. (2020). Statistics on mortality following acute myocardial infarction in 842,897 Europeans. Cardiovascular Research, vol. 116, is. 1, pp. 149–157. DOI: 10.1093/cvr/cvzl97. PMID: 31350550. 5. Milano, S.S., Moura Junior, O.V.D., Bordin, A.A., & Marques G.L. (2019). C-reactive protein is a predictor of mortality in ST-segment elevation acute myocardial infarction. International Journal of Cardiovascular Sciences, vol. 32, No.2, pp. 118–124. DOI: 10.5935/2359-4802.20180086.
|
|