The impact of the early statin use of different generations on the functionality of the cardiovascular system in acute myocardial infarction

Abstract

Aim. Verification of hypothesis about the positive impact of early prescription of statin of II-III generations for men with primary Q-myocardial infarction (Q-MI) on the functionality of the cardiovascular system (CVS); comparison of the efficiency of statins depending on the nature and dosage of medicine.
Methods. In accordance with the inclusion-exclusion criteria 99 men aged 40–70 years with Q-IM without cardiac complications and clinically significant somatic diseases were selected. Randomization for statins intake was made, 4 groups were formed: atorvastatin 10mg/day (n=17), atorvastatin 20mg/day (n=16), fluvastatin 80mg/day (n=33) and a control group (n=33). Statins were prescribed staring with the first day of admission of patients without taking into account plasma lipids levels. Functional state of the CVS was evaluated twice: in 18-21 days and in 8 weeks after MI by means of the 6-minute walk away (TSMW) test and the method of veloergometry accompanied by the calculating of double product (DP) and chronotropic reserve (CHR) at the highest point of exercise stress and before discharge from the hospital. Differences in covered distances according to repeated TSMW were evaluated with the help of 3 endpoints, DP and CHR changes were evaluated with the help of 2 endpoints.
Results. Early atorvastatin prescription doses being 10mg and 20mg/day, fluvaststin dose being 80mg/day for patients in the acute period Q-MI for 8 weeks were marked with a reliable increase in CVS functionality and physical status of the patient. According to DP and CHR indicators early prescription of atorvastatin doses of 10, 20mg/day for patients with Q-IM has a more distinct positive effect on the functional abilities of the myocard compared with fluvastatin dose of 80mg/day.
Conclusions. Prescribing atorvastatin doses of 10 mg, 20mg/day, fluvastatin dose of 80mg/day for patients with Q-IM since the first days of the disease within 8 weeks showed no significant differences in the effects on the functional status of patients assessed by TSMW. The DP and CHR levels at the height of submaximal physical stress reflect the significant positive impact of statins on the functional ability of the heart muscle more rapidly.