Resumo

SINIAWSKI, Daniel et al. Changes in the Lipid Profile of Patients with Acute Coronary Syndrome within the First Days of Hospitalization. Rev. argent. cardiol. [online]. 2010, vol.78, n.3, pp.238-244. ISSN 1850-3748.

Background Controversy exists regarding the temporal changes in lipid levels after an acute coronary syndrome (ACS). In our country, there is limited information about the basal characteristics of the lipid profile and the variability of its components after an ACS, and it does not include direct measuring of LDL-C or apolipoproteins. Objectives 1) To analyze the changes in lipoprotein and apolipoprotein levels in a group of patients hospitalized with ACS, and 2) to describe the basal lipid profile and compare it with that of a healthy population. Material and Methods Plasma levels of total cholesterol (TC), LDL-C, HDL-C, ApoB and ApoA were measured at admission, 18 hours and 42 hours in patients hospitalized with ACS. None of the participants were taking lipid-lowering drugs or received them within 48 hours after hospitalization. Results A total of 31 patients were included (mean age 61 years, 87% were men, 51% with Q-wave AMI, 19% with non Q- wave AMI and 30% with unstable angina). Plasma levels of TC, non HDL-C and LDL-C presented a significant reduction during hospitalization (mean ± standard deviation at admission, 18 hours and 42 hours, p value): TC (218±53, 206±40 and 194±41; p=0,005), non HDL-C (180±54, 169.8±40 and 157.6±39; p=0,01), LDL-C (136±30, 134±33 and 127±37; p=0.01). ApoB and HDL-C levels did not change in a significant fashion. Baseline  ApoA levels corresponded to the 5th percentile of a healthy population and there was an early and significant reduction during hospitalization (115±21, 108±18 and 106±3; p=0,01). Conclusions In patients with ACS basal lipid profile should be evaluated at the moment of hospitalization. ApoB levels remained stable and might be used to select the therapeutic strategy. Reverse cholesterol transport was affected in more than 50% of the population.

Palavras-chave : Apolipoproteins; Lipoproteins; Acute Coronary Syndrome.

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