[Efficacy of multifactorial preventive interventions in achievement of target levels of low density lipoprotein cholesterol in survivors of myocardial infarction].

Aim: To assess Efficacy of multifactorial preventive Interventions in achievement of target levels of low density lipoprotein cholesterol in survivors of myocardial infarction.
Methods: Design of the study was open randomized comparative prospective. Two groups of patients with history of myocardial infarction were formed ("active intervention", n=88, "observation", n=48) and followed for 12 months. All interventions consisted in recommendatory and expository measures. Achievement of target low density lipoprotein cholesterol (LDLCH) levels, modifiable risk factors, blood lipids spectrum were assessed in 2-3, 5-6 and 12 months of observation.
Results: Overall effect of undertaken multifactorial intervention on modifiable risk factors was positive. By the end of the period of observation number of risk factors per patient decreased from 3.8+/-0.99 to 2.8+/-1.29 (p<0.05). However target levels parameters in many cases were not reached. About half of patients could not decrease consumption of saturated fats and cholesterol, nearly 25% continued to smoke. More than 55% maintained excessive weight and 64% had abdominal obesity. Among patients of "observation" group only 5 (4.2%) began to take lipid lowering drugs. In active intervention group average LDLCH lowering was 23%, 38% of patients received lipid lowering drugs and 44% (of those who completed the study) achieved target LDLCH levels.