The study included 131 patients (mean age 51.9±9.13 year) with Q-wave myocardial infarction (Q-MI). All patients underwent echocardiography and 24-hour ECG monitoring on the 10th through the 14th days of MI. Treatment included thrombolytic therapy, early administration of beta-blockers, antiplatelet agents, anticoagulants, statins, ACE inhibitors, if needed - antiarrhythmics and aldosterone antagonists. Follow-up was 24 months. During the observation period, of the 131 study patients 17(13.0%) died suddenly. Our study suggests that the high risk of SCD (in the first 2 years after MI) in patients with Q-MI is associated with anterior localization, early pathological LV remodeling, low myocardial contractility, and development of AHF high Killip classes in the early period of MI, as well as the identification of high heart rate at rest, frequent PVCs (mainly polymorphic), systolic dysfunction in the early stages of observation (on the 10th through the 14th days), and older age of patients.