Features of postinfarction remodeling in able-bodied patients

Objective. To evaluate postinfarction remodeling (PR) according to Q myocardial infarction (Q-MI) location within 1 year in able-bodied men during combination therapy including thrombolysis and maximum doses of statins. Subjects and methods. A follow-up was performed in 106 men under 60 years of age with primary Q-MI, who were randomized into 2 groups: 1) 55 patients who took rosuvastatin 40 mg/day as part of drug therapy; 2) 51 patients received atorvastatin 80 mg/day as part of drug therapy. According to age, the patients were divided into subgroups: A) 49 (46.23%) young patients aged 30–44 years; B) 57 (53.77%) patients aged 45 to 60 years. A control group consisted of 30 apparently healthy people without cardiovascular diseases. Results. The patients with Q-MI who took rosuvastatin for 1 year achieved more pronounced reductions in low-density lipoprotein (LDL) and C-reactive protein (CRP) levels compared to those who received atorvastatin. In the subgroup of young patients, the anterior location of MI prevailed in 79.6%; in the subgroup of patients aged 45–60 years, the lower location of MI was in 64.9%. In both subgroups, the patients with anterior Q-MI showed an increase in the left ventricle (LV) end-systolic diameter (ESD) during both early and late PR; in those with lower Q-MI, the increased LV ESD was observed in persons aged 30–44 years during late PR. Conclusion. It is preferable to prescribe rosuvastatin 40 mg/day as part of combination therapy for able-bodied patients with the anterior location of Q-MI, by taking into account the characteristics of PR, as it contributes to a faster achievement of the target level of both LDL and CRP, which is one of the criteria for predicting the severity of Q-MI. One-year administration of the maximum doses of statins has been shown to be safe.