AbstractPatients who have survived myocardial infarction (MI), compared to the general population, have an increased risk of reinfarction, myocardial revascularization, and death. In this study we investigated the prognostic significance of the predictors of the risk for adverse coronary events in 118 patients, both male and female, with a confirmed diagnosis of MI in the last 3 years. The predictors of reinfarction, revascularization and death in patients who survived MI were: poor adherence to hypolipemics (hazard ratio [HR] 3.06, p=0.006), physical inactivity (HR 2.22, p=0.056), the number of variable risk factors (HR 1.29, p=0.025), and age (HR 1.06, p=0.007). After the inclusion of the invariable risk factors in the model of multivariant analysis, the following factors were singled out as significant predictors of the risk: gender (HR 3.86, p=0.0015), physical inactivity (HR 2.38, p=0.007), change in the level of triglycerides (HR 1.49, p=0.040), change in the number of variable risk factors (HR 1.41, p=0.0007), and age (HR 1.05, p=0.009). A 3-year follow-up of the patients who survived the first MI and who were enrolled in this study of secondary prevention demonstrated that physical inactivity, the number of variable risk factors and age significantly contributed to an increased risk of reinfarction, revascularization, and death.

Our study has shown high prevalence of increased plasma concentrations in the total, LDL-cholesterol and triglycerides and low plasma concentrations of HDL-cholesterol, as well as the insufficient use of lipid-lowering drugs in diabetic and non-diabetic patients with previous MI. Decreasing the total cholesterol and increasing the HDL-cholesterol are significant, decreasing of triglycerides and LDL-cholesterol does not suffice. Therefore, secondary prevention measures of cardiovascular events should be intensified, especially in patients with diabetes.