Search

Aim: To examine antithrombogenic activity of the vascular wall, some hemostatic and rheological properties of blood in patients with unstable angina (UA) and various types of hyperlipoproteinemia (HLP)., Material and Methods: 102 UA patients were divided into groups by HLP types according to D. S. Frideriksen. Antithrombogenic properties of blood vessel wall were examined with the cuff test, blood rheology--with AKP-2 analyser, hemostasis and lipid metabolism--with standard test., Results: UA patients with HLP have low antithrombogenic activity of vascular wall. The most noticeable shifts to hypercoagulation were found in patients with HLP types 2a and 2b. Blood rheology was abnormal (high red cell aggregation in low deformability) in patients with HLP types 2a, 2b and 4., Conclusion: Patients with UA demonstrate relationships between antithrombogenic activity of vascular wall, intensity of lipid metabolism, hemostasis and blood rheology.

Aim: The study of the hypolipidemic efficiency, safety and tolerance of ciprofibrate (lipanor) in therapy of atherogenic hyperlipoproteinemia., Materials and Methods: The trial included 14 hypertensive postmenopausal females, 14 patients with diabetes mellitus type II, 14 males with coronary heart disease and primary hyperlipoproteinemia (total cholesterol > 6.5 mmol/l, triglycerides < 4.5 mmol/l under low-cholesterol diet). Lipanor was given for 12 weeks in a daily single dose 100 mg in the morning. Lipids and other biochemical indices were measured in a fasting state after 1 and 3 months of lipanor treatment., Results: After 1 month of lipanor treatment there was a 22-30%, 24-49% decrease in the level of low-density lipoprotein cholesterol, triglycerides, respectively. High-density lipoprotein cholesterol increased by 16%. The hypolipidemic effect of lipanor persisted for 3 months during which triglycerides continued to fall (up to 38.5%). Lipanor was well tolerated, only one patient with diabetes mellitus had hyperactivity of creatine phosphokinase manifesting with clinical symptoms (the drug was discontinued). 3 patients developed mild side effects. Alkaline phosphatase activity inhibited in all the groups by 25-41%., Conclusion: Lipanor is a highly effective, safe hypolipidemic drug with good tolerance. It can be recommended for correction of atherogenic hyperlipoproteinemia in patients at high risk of atherosclerosis progression.

Aim: Evaluation of effectiveness of hypolipidemic action of probucol in doses 500 and 1000 mg/day and comparison of probucol blood concentrations on the treatment month 3 and 6., Materials and Methods: Probucol (Akrikhin, Russia) was given to 41 patients with primary hypercholesterolemia in a dose 500 mg/day. 3 months later the patients were divided into two groups. Group 1 patients exhibited a > 10% decrease in cholesterol levels and continued to take probucol in the dose 500 mg/day. Group 2 patients were crossed over to higher cholesterol dose--up to 1000 mg/day. Lipids levels were measured by enzyme tests, apoproteins--by immunoturbidimetry and immunodiffusion, probucol concentrations--by high-performance liquid chromatography., Results: After 3 months of treatment, cholesterol lowered by 14.3 and 9.2% in groups 1 and 2, respectively. After 6 months, by 19.7 and 12.9%, respectively. Probucol concentrations in blood were higher after 6 months of treatment than after 3 months in both groups. No significant differences existed between the groups by probucol concentrations in 3 and 6 months., Conclusion: Hypolipidemic effect of probucol depended on the individual features of lipoproteins metabolic disorders rather than the drug blood concentration. Larger probucol doses fail to reduce cholesterol further.

Aim: To reveal the metabolic parameters of lipoproteins (L), which determine the benefits of hypolipidemic effects of simvastatin (S) and fluvastatin (F); to trace changes in the activity of lecithin-cholesterol acyltransferase (LCA) and cholesterol (C) ester transfer (CET) from high density lipoproteins to very low density lipoproteins (VLDL) and low density lipoproteins (LDL) and the levels of apoE in the blood and in some L classes during therapy with the above drugs., Materials and Methods: Thirty six patients took S, 10 mg/day, and 25 received F, 20 mg/day, for 3 months. The levels of lipids were measured by enzyme assays, apoprotein (apo) was determined by immunoturbidimetry and immunodiffusion., Results: The hypocholesterolemic and hypotriglyceridemic effect of S (19.6 and 25.5, respectively) and F (19.0 and 30.5%) were similar. With S, the reduction in the blood levels of C and LDL C positively correlated with the baseline apoE levels. With F, it did with C and LDL C before treatment. Lower blood apoE was found with S and F and lower HDL apoE/(VLDL + LDL) ratio was detected only with F. F treatment significantly lowered the activity of CET and LCA; before and after S treatment, they did not differ significantly., Conclusion: Analyzing the relationship between the benefits of the hypolipidemic effect and the baseline parameters of L metabolism indicates that the changes in serum C, LDL C and HDL C are due to the composition of HDL particles and the distribution of apoE among different L classes in the patient to a greater degree.

Aim: To specify characteristics of lipoproteins (LPs) metabolism in patients with diverse forms of hereditary hyperlipoproteinemia (HLP) and determine biochemical tests for their differential diagnosis., Materials and Methods: According to the criteria of polygenic hypercholesterolemia (PHCE), family combined hyperlipidemia (FCHL), family hypertriglyceridemia (FHTG) and family hypercholesterolemia (FHCE), 157 patients were selected aged 7 to 70 years of 192 examinees (76 patients with primary HLP and 116 their close relatives). Lipids were measured by enzyme methods, apoproteins (apo)--by immunoturbidimetry and immune diffusion., Results: Compared to healthy subjects, PHCE patients were characterized by higher apoB level and proportion cholesterol (CS)/apoB in very low and low density lipoproteins (VLDL and LDL). In unchanged level of high density lipoprotein (HDL) CS and proportion HDLP CS/apoA1 there were reduced quantities of free HDLP CS, HDLP2 CS and apoA1. In FHCE and FCHL there were also low levels of HDL CS in elevated ones of apoE in (VLDL + LDL). However, in FCHL, contrary to FHCE, the proportion SC (VLDP + LDL)/apoB was as in control group. FHTG patients differed from healthy subjects by diminished HDL parameters: lower HDL CS due to free CS and its esters, apoA1 and proportion HDL Cs/apoA. There were no differences with controls by content of apoB and proportion CS (VLDL + LDL)/apoB, apoE levels in different class lipoproteins., Conclusion: Biochemical parameters are proposed which can differentiate various forms of hereditary hyperlipoproteinemia.

Total and lipid-bound sialic acids (TSA and LBSA) were measured in the blood of 219 patients with primary or secondary hyperlipoproteinemia (129 patients with ischemic heart disease and 66 patients with diabetes mellitus type II) versus 24 normolipidemic healthy subjects. TSA levels in IHD patients differed significantly from those in IHD-free and diabetic patients. LBSA quantities were the same in IHD and IHD-free patients, being significantly higher in diabetes mellitus than in IHD. These findings give no proves to diagnostic value of TSA and LBSA as markers of IHD and coronary atherosclerosis. TSA levels may be used in the test for disturbed lipoprotein metabolism.

As many as 196 persons were examined. Of these, 106 were with a normal sinus rhythm and 90 had sick-sinus syndrome (SSS). Measurements were made of the level of malonic dialdehyde and the total antioxidant blood activity, the lipoprotein spectrum. Electrophysiological studies of the heart, ECG monitoring and bicycle ergometry were carried out. Maximal impairment of lipid peroxidation (LP) in type IIA hyperlipoproteinemia (HLP) was identified according to Fredrickson both in patients with SSS and without it. In patients with SSS, the rise of the closeness of the relationship between LP and HLP was observed. In patients with CHD and (or) EH, LP was mostly disturbed in EH and in associated CHD and EH (both in patients with and without SSS). As compared with the respective control groups, SSS patients showed considerable disorders of LP. It is suggested that LP disorders related to HLP may play a role in the pathogenesis of SSS.

The authors review the results of the clinical use of lovastatin in 150 patients with associated coronary heart disease and coronary atherosclerosis (according to coronarography). All the patients suffered from primary non-familial hyperlipoproteinemia (of the IIa and IIb types) and were entered into the placebo-controlled studies of the effectiveness of lovastatin. After 3 months of the treatment there was a decrease in the levels of total cholesterol (by 36%) (p less than 0.001); the content of cholesterol LDLP dropped by 48% (p less than 0.001), and that of triglycerides by 19% (p less than 0.01), while the level of cholesterol HDLP rose. Side effects were recorded in an insignificant number of cases. Therefore, lovastatin is a highly effective and well tolerable drug for the treatment of patients with coronary heart disease and hyperlipoproteinemia.

Parameters of platelet aggregation under the influence of different ADP concentrations and vascular endothelial antiaggregation activity using a test of shoulder compression with a sphygmomanometer cuff were investigated in 46 persons aged up to 60 [14 examinees had type IIa hyperlipoproteinemia, (HLP), 10--type IIb, 10--type IV-V HLP, and 10 healthy donors]. CHD was diagnosed in 19 of 34 HLP patients. In 2 examinees CHD was unaccompanied by HLP. A raised amplitude of the aggregation of plates and a decrease in the threshold of their sensitivity to ADP were established in the persons with types IIa and IIb HLP and in CHD without HLP. In the examinees with type IV-V HLP the amplitude of platelet aggregation was lowered significantly, and the threshold of sensitivity to the inductor was raised. Endothelial antiaggregation activity in all types of HLP and in the persons with CHD without HLP was inhibited.

In current studies of dyslipoproteinemia (DLP) development great emphasis is laid on the type of nutrition, its quantitative and qualitative characteristics, harmful habits, their formation in childhood and an attempt to influence them. However the problem of the start of stable DLP development and the role of dietary habits is yet to be solved. A random subsample of 169 school children aged 13 to 16 in the Krasnopresnensky District of Moscow was examined, among them 73 boys and 96 girls. High values of mean alimentary cholesterol, total and saturated fats and low mean amounts of consumed polyunsaturated fats were revealed. It could be inferred that the examined population was characterized by a high risk of the formation of atherogenic DLP stability. An analysis of the findings showed a considerable increase in the consumption of total and saturated fats as well as food rich in cholesterol in the group of children with stable DLP forms confirming the effect of the environmental factors including the alimentary ones, on processes of DLP formation in childhood. Further investigation of DLP in children should be conducted in the form of prospective studies otherwise design of activities in early prevention of atherogenic DLP seems impossible.