Kovalyova I. Influence of statins doses to their efficacy in patients with acute coronary syndrome without segment ST elevation.

The thesis is dedicated to increasing the effectiveness of treatment of patients with acute coronary syndrome without ST segment elevation with statins by determining their impact on long-term consequences in the real clinical practice and optimal dosing regimen for antiischemic efficacy and nonlipid effects. In the course of 1119 patients were examined with this diagnosis, of which 1030 observed retrospectively, 89 - prospectively. In a retrospective analysis of disease histories of 1030 patients with ACS without ST segment elevation it was found that therapy in conventional doses of statins reduces total mortality of 71.0%, but does not affect the frequency of recurrent hospitalizations with ACS. Evidence of this effect was independent of the initial level of total cholesterol.As a result of prospective survey of 89 patients with ACS without ST segment elevation revealed that more aggressive therapy of simvastatin (60 mg daily) does more significant corrective influence on lipid metabolism, systemic inflammation and indicators of tolerance to physical load compared with less aggressive therapy (20 mg daily). The effect on improving endothelial function and heart rate variability was equally pronounced in both groups of patients and did not depend on dose of statins