OPTIMIZED UPSTREAM THERAPY FOR MANAGING PATIENTS WITH POSTINFARCTION CARDIOSCLEROSIS ASSOCIATED WITH HYPERURICEMIA

Background. The recent epidemiological studies have shown that serum uric acid (SUA) is

a risk factor for cardiovascular diseases and a negative prognostic marker for mortality in subjects

with pre-existing heart failure.


Material and methods. 147 patients, (59.2±0.8) years old, with postinfarction cardiosclerosis

were included in this study. An evaluation of cardiohemodynamics, heart rhythm disturbances,

lipid and purine metabolism’s violation and systemic inflammation was performed before treatment

and six months afterwards.


Results. An elevated SUA level was associated with the progression of postinfarction heart remodeling.

Heterogenity of ventricular repolarization, decrease of heart rate variability, as well

as high grade premature ventricular complexes were observed in these patients. Complex treatment

with eprosartan provided a significant regress of left ventricle hypertrophy, achievement

of target blood pressure levels, complete recovery from ventricular tachycardia, prevention of

new-onset of atrial fibrillation. The use of fenofibrate resulted in reducing of total cholesterol,

triglycerides, low density lipoproteins, SUA and main markers of systemic inflammation as well

as an increase high density lipoproteins.


Conclusions. The use of eprosartan and fenofibrate is an optimized upstream strategy for managing

patients with postinfarction cardiosclerosis associated with hyperuricemia