Metabolic studies in postmyocardial infarction patients.

One hundred and seven patients registered in the secondary preventive programme in Prague 4 were followed up for an average period of 3 years. The endpoints of the study were taken as criteria of the progression of clinical atherosclerosis (non-fatal myocardial infarction, cardiovascular death). The authors tried to detect the causes responsible for the high prevalence of impaired glucose tolerance, diabetes and hyperlipoproteinaemia. They analyzed the interrelationships of food intake, insulin secretion, serum fatty acids and lipoprotein phenotypes. There were 6% of non-fatal myocardial reinfarctions and 13% of cardiovascular death after 3 years. Multiple regression analysis identified the following 3 factors closely associated with cardiovascular death: 1) history of myocardial infarction 2) low proportion of linoleic acid in total lipids 3) hyperlipoproteinaemia. The authors show that analysis of the relationships of triglycerides, insulin and serum fatty acids could be of value for identifying the factors involved in a faster progression of atherosclerosis.