Dubrovinska T. V.

COMPARATIVE ANALYSIS OF THE EFFECT OF HIGH-DOSE ATORVASTATIN ON BLOOD LIPID PROFILE AND HEPATIC CYTOLYSIS IN PATIENTS WITH MYOCARDIAL INFARCTION WITHOUT CONCOMITANT LIVER PATHOLOGY AND IN COMBINATION WITH METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS

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About the author:

Dubrovinska T. V.

Heading:

PHYSICAL THERAPY AND REHABILITATION

Type of article:

Scientific article

Annotation:

Myocardial infarction remains one of the leading causes of mortality worldwide, while atherogenic dyslipidemia plays a central role in its pathogenesis. Current clinical guidelines recommend high-dose statin therapy to achieve target low-density lipoprotein cholesterol levels. However, in patients with concomitant metabolic dysfunction-associated steatohepatitis, the use of high-dose statins may be accompanied by impaired liver function and an increased risk of hepatotoxicity. The aim of the study is to evaluate the efficacy and safety of high-dose atorvastatin therapy at 80 mg/day in patients with myocardial infarction combined with metabolic dysfunction-associated steatohepatitis by assessing lipid profile parameters and markers of hepatic cytolysis. The study included 45 patients with acute myocardial infarction hospitalized within 24–48 hours after symptom onset. The main group consisted of 22 patients with concomitant metabolic dysfunction-associated steatohepatitis, whereas the control group included 23 patients without liver pathology. All patients received standard therapy for myocardial infarction according to current clinical guidelines and atorvastatin at a dose of 80 mg/day. During the six-month follow-up period, total cholesterol, low-density lipoprotein cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were assessed. Patients with myocardial infarction combined with metabolic dysfunction-associated steatohepatitis demonstrated more pronounced lipid metabolism disturbances compared with patients without liver pathology. After one month of treatment, most patients in the control group achieved target low-density lipoprotein cholesterol levels with sustained positive dynamics throughout the observation period. In contrast, patients with metabolic dysfunction- associated steatohepatitis exhibited an unstable lipid-lowering response with gradual loss of treatment efficacy after six months of therapy. Evaluation of hepatic cytolysis markers revealed normalization of transaminase activity within three months in patients without concomitant liver disease. However, patients with metabolic dysfunction- associated steatohepatitis demonstrated a repeated increase in alanine aminotransferase and gamma-glutamyl transferase activity after one month of treatment, indicating persistent hepatic dysfunction. The combination of myocardial infarction and metabolic dysfunction-associated steatohepatitis is associated with lower efficacy of high-dose atorvastatin therapy and a higher incidence of hepatic cytolysis manifestations. This category of patients requires an individualized approach to statin therapy, careful laboratory monitoring of liver function, and assessment of the benefit-risk ratio during long-term administration of high-dose statins.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 2, 181, 300-304 pages, index UDC 616.127-005.8: 616.36-008.6:616-008

DOI:

10.29254/2077-4214-2026-2-181-300-304