scholarly journals Influence of Meldonium on Blood Lipid Spectrum and Echocardiography Parameters in Patients with Coronary Heart Disease and or Withoutconcomitant Arterial Hypertension

2021 ◽  
Vol 2-3 (35-36) ◽  
pp. 50-57
Author(s):  
D. Volynskyi ◽  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Arterial Hypertension ◽  
Total Cholesterol ◽  
Stable Angina ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Positive Effect ◽  
Lipid Spectrum ◽  
Concomitant Hypertension

Introduction. Coronary heart disease (CHD) is one of the main causes of high mortality, disability and reduced quality of life for patients in both Europe and Ukraine. Modern drug therapy of coronary heart disease in combination with arterial hypertension (AH) does not always achieve a satisfactory therapeutic effect. The use of meldonium, which has antioxidant properties, has a positive effect on NO release and has a lipid-lowering effect is promising for patients with AH. The aim of the study. To evaluate the influence of meldonium on lipid metabolism and echocardiography parameters in combination therapy in patients with CHD with stable angina and concomitant AH. Materials and methods. We examined 66 patients with CHD, stable angina pectoris II-III functional class, 40 of them with concomitant AH stage II-III. Patients were divided into 2 groups of 40 and 26 patients, respectively. The first group included patients with CHD and concomitant AH, the second - without pre-existing hypertension. Each of the groups was further divided into 2 subgroups: 1) Patients who were prescribed meldonium at a dose of 750.0 mg/d for 6 months in addition to the basic therapy of the underlying disease (n = 20 for CHD + AH and n = 14 for CHD without hypertension). 2) Patients who continued basic antianginal, disaggregating, hypolipidemic therapy (n = 20 for CHD + AH and n = 12 for CHD without hypertension). Serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol were assessed. Indicators of cardiac hemodynamics were determined by echocardiography with assessment of left ventricular end systolic and diastolic volumes and diameters (LVESV, LVEDV, LVESD, LVEDD respectively), the thickness of the interventricular septum and posterior wall of the left ventricle (IVST, LVPWT respectively), pulmonary artery pressure (PAP), LV myocardial mass (LVM) and LV myocardial mass index (LVMI). Results. The use of meldonium for 6 months in patients with CHD and concomitant AH led to a decrease in the concentration of total cholesterol from 5.07 to 4.34 mmol/l and LDL from 2.07 to 1.70 mmol/l. In the group of patients without concomitant hypertension there was a decrease in the concentration of total cholesterol from 4.80 to 3.93 mmol/l, LDL from 1.62 to 1.18 mmol/l and an increase in HDL from 1.18 to 1.37 mmol/l. At 6-month administration of meldonium as a part of combination therapy of patients with CHD with concomitant AH, there is a decrease in LVM from 216.90 g to 181.50 g and LVMI from 109.10 g/m2 up to 91.20 g/m2. In patients without concomitant hypertension, a decrease in LVM from 232,20 g to 183.90 g and LVMI from 121.50 g/m2 to 96.40 g/m2 was observed. Conclusions. Our study showed that meldonium has a positive effect on lipid metabolism and echocardiography. In the group of patients with coronary heart disease and concomitant hypertension on the background of additional use of meldonium for six months, we registered a decrease in TC, LDL and AI. LVPWT, PAP, LVM and LVMI also significantly decreased. In the group of patients with coronary heart disease without concomitant hypertension, we registered a decrease in TC, LDL, AI and an increase in HDL. LVM and LVMI also decreased significantly. Therefore, we consider it appropriate to use meldonium in the complex treatment of patients with coronary heart disease with stable angina and concomitant hypertension. Keywords: coronary heart disease, arterial hypertension, meldonium, echocardiography, blood lipid spectrum.

scholarly journals Chronic pancreatitis in patients with coronary heart disease: a lipid spectrum of blood, a possibility of correction

2018 ◽  
Vol 41 (3) ◽  
pp. 31-39
Author(s):  
T. M. Hristich ◽  
D. O. Gontsariuk
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Chronic Pancreatitis ◽  
Total Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Lipid Spectrum

Aim of research is to evaluate significance of changes in the lipid spectrum of blood in patients with chronic pancreatitis with coronary heart disease in the pathogenesis of the comorbidity of these diseases and in the dynamics of treatment with polycosanol. Materials and methods. The study was conducted in 22 patients (10 patients with chronic pancreatitis and dyslipidemia, 12 patients with comorbidity of chronic pancreatitis and coronary heart disease in CHD II-II A-B syndrome of stage II-III functional class) and in 10 almost healthy individuals. There were 13 men, 9 women, 31–69 years old. Patients of two groups in addition to protocol treatment were prescribed polycosanol 10 mg 1 time in the evening during dinner, up to 3 months. To study the characteristics of the lipid spectrum of the blood, the level of total cholesterol, high-density lipoprotein cholesterol, triglycerols was determined (using the Zlatix-Zack-based Lachema reagents (Czech Republic)). The level of low-density lipoprotein cholesterol was determined using the Friedewald calculation method, taking into account that the triglycerol concentration did not exceed 4.5 mmol/l. In addition, very low density lipoprotein cholesterol and an atherogenicity index were determined using conventional calculation methods. Results. In patients with a combined course of chronic pancreatitis with coronary heart disease, in most cases there is a significant (p<0.05) increase in total cholesterol, low and very low-density lipoproteins and triglycerols. When analyzing the types of dyslipidemia, it was found that ІІа and ІІв types were more common (22 і 25%, respectively), but with comorbidity ІІ and ІV type of dyslipidemia was more often detected. In the dynamics of a three-month treatment with polycosanol in patients with chronic pancreatitis, the cholesterol levels of high-density lipoproteins increased significantly and the triglycerol values ​​significantly decreased, indicating a hypolipidemic effect of the drug and the possibility of using it in combination with statins in order to reduce the risk of cardiovascular events. Conclusion. The comorbidity of chronic pancreatitis with ischemic heart disease increases the risk of progression of dyslipidemia and atherosclerosis. This is confirmed by an increased atherogenic index in this group of patients, along with the severity of lipid spectrum disorders. The addition of polycosanol to patients with chronic pancreatitis and dyslipidemia, as well as in combination with coronary heart disease, contributes to the reduction and normalization of certain parameters of the lipid spectrum of the blood. This allows us to recommend a drug for long-term treatment of these groups of patients, including in combination with statin therapy.

scholarly journals Optimal cut-off points after a daily meal corresponding to fasting goal levels of LDL-C and non-HDL-C in Chinese patients with coronary heart disease

2020 ◽  
Author(s):  
Li-Ling Guo ◽  
Yan-qiao Chen ◽  
Qiu-zhen Lin ◽  
Feng Tian ◽  
Qun-Yan Xiang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Blood Lipids ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Lipoprotein Cholesterol ◽  
Chinese Patients ◽  
C Statistic ◽  
Blood Lipid Levels

Abstract Background: Although the detection of non-fasting blood lipids has been recommended in patients with coronary heart disease (CHD), the non-fasting cut-off points corresponding to the fasting goals of LDL-C < 1.8 mmol/Land non-HDL-C < 2.6 mmol/L, respectively, have not been explored. Methods: This study enrolled 397 inpatients with CHD. One hundred and ninety-seven patients took statins for < 1 month (m) or did not take any statin before admission (i.e. CHD1 group), while 204 patients took statins for ≥ 1 m before admission (i.e. CHD2 group). Blood lipid levels were measured at 0 h, 2 h, and 4 h after a daily breakfast. Results: Non-fasting low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels significantly decreased after a daily meal ( P < 0.05). Both fasting and non-fasting LDL-C or non-HDL-C levels were significantly lower in the CHD2 group. The percent attainment of LDL-C < 1.8 mmol/L at 2 h or 4 h after a daily breakfast was significantly higher than that of its fasting point ( P < 0.05), whereas that of non-HDL-C < 2.6 mmol/L was significantly higher only at 4 h ( P < 0.05). Analysis of c-statistic showed that non-fasting cut-off points for LDL-C and non-HDL-C were 1.5 mmol/L and 2.4 mmol/L, corresponding to their fasting goal levels of 1.8 mmol/L and 2.6 mmol/L, respectively. When postprandial LDL-C and non-HDL-C goal attainments were re-evaluated by non-fasting cut-off points, there were no significant differences in percent attainment between fasting and non-fasting states. Conclusions: Determination ofnon-fasting cut-off points is important to evaluate the efficacy of cholesterol-lowering therapy if blood lipids are detected after a daily meal.

scholarly journals The Role of Fasting LDL-C Levels in Their Non-fasting Reduction in Patients With Coronary Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiuzhen Lin ◽  
Yan Fu ◽  
XueYan Zang ◽  
Qiming Liu ◽  
Ling Liu
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Influencing Factor ◽  
Low Density Lipoprotein ◽  
Linear Regression Analysis ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Serum Levels ◽  
Multiple Linear Regression Analysis ◽  
Lipoprotein Cholesterol

The level of low-density lipoprotein cholesterol (LDL-C) decreases to a certain extent after daily meals; however, the influencing factor of this phenomenon has not been fully elucidated. This study included 447 patients with coronary heart disease (CHD). Serum levels of blood lipid parameters at 0, 2, and 4 hours (h) after a daily breakfast were monitored in all subjects. The levels of total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C) and non-HDL-C significantly decreased, while those of triglycerides (TG) and remnant cholesterol (RC) significantly increased from baseline to 4 h in both male and female patients (P &lt; 0.05). Multiple linear regression analysis showed that fasting LDL-C level, the non-fasting change in RC level at 4 h and fasting TG level were significant predictors of the non-fasting change in LDL-C level at 4 h in patients with CHD, and fasting LDL-C level was the most significantly associated with the non-fasting change in LDL-C level. Patients with lower levels of fasting LDL-C had smaller non-fasting changes in LDL-C levels. When the fasting LDL-C level was &lt;1.4 mmol/L, both absolute reduction and percent reduction in LDL-C level at 4 h were almost zero, which means that the non-fasting LDL-C level at 4 h was approximately equivalent to its fasting value (P &lt; 0.05). This result indicated that the non-fasting changes in LDL-C levels were influenced by fasting LDL-C levels in patients with CHD. When the fasting LDL-C level was &lt;1.4 mmol/L, the non-fasting LDL-C level could replace the fasting value to guide treatment.

scholarly journals CORONARY HEART DISEASE;

2014 ◽  
Vol 21 (06) ◽  
pp. 1171-1173
Author(s):  
Munir Ahmed
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Density Lipoprotein ◽  
Total Cholesterol ◽  
High Density Lipoprotein Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol

Objective: This study was done to find any correlation among total cholesterol, triglycerides, low density lipoprotein cholesterol and high density lipoprotein cholesterol estimated in serum of offsprings of coronary heart disease patients. Study Design: A cross sectional comparative study. Patients and Methods: Two hundred and fifty (250) subjects having parents with coronary heart disease were selected from Punjab Institute of Cardiology Lahore. The serum total cholesterol, triglycerides, low density lipoprotein cholesterol, and high density lipoprotein cholesterol were estimated. Coefficient of variation was calculated to find whether observations in one series vary correspondingly with observations in another series. Results: Highly significant positive correlation was found between total cholesterol and triglycerides, and, total cholesterol and low density lipoprotein cholesterol. Highly significant negative correlation was found between low density lipoprotein cholesterol and high density lipoprotein cholesterol. Correlation between TG and LDL-c was also significant. Conclusions: Serum total cholesterol, triglycerides, low density lipoprotein cholesterol and high density lipoprotein cholesterol have strong association with one and other. For prediction, prevention and management of coronary heart disease it is important to estimate and observe the correlation among these parameters.

scholarly journals Protective lipid-lowering genetic variants in healthy older individuals without coronary heart disease

2021 ◽  
Author(s):  
Paul Lacaze ◽  
Moeen Riaz ◽  
Robert Sebra ◽  
Amanda J Hooper ◽  
Jing Pang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Rare Variant ◽  
Genetic Variants ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Carrier Status ◽  
Older Individuals ◽  
Loss Of Function

ABSTRACTBackgroundDisruptive genetic variants in the PCSK9 and APOB genes result in lower serum low-density lipoprotein cholesterol (LDL-C) levels and confer protection against coronary heart disease (CHD). Few studies have measured the prevalence and selective advantage of such variants among healthy older individuals without prior CHD events.Methods and ResultsWe performed targeted sequencing of the PCSK9 and APOB genes in 13,131 healthy older individuals without CHD aged 70 years or older enrolled into the ASPirin in Reducing Events in the Elderly (ASPREE) trial. We detected predicted loss-of-function (pLoF) variants in the PCSK9 and APOB genes, and associated variant carrier status with blood lipid levels. We detected 22 different rare PCSK9/APOB candidate variants with lipid-lowering effect, carried by 104 participants (carrier rate 1 in 126). Rare variant carrier status was associated with 19.4 mg/dl (14.6%) lower LDL-C, compared with non-carriers (P=<0.001, adjusted for statin use). Statin prescriptions were less prevalent in rare variant carriers (16%) than non-carriers (35%). The PCSK9 R46L variant (rs11591147-T) was associated with 15.5mg/dl (11.8%) lower LDL-C in heterozygotes, and 25.2 mg/dl (19.2%) lower LDL-C in homozygotes, respectively (both P=<0.001).ConclusionsLipid-lowering genetic variants are carried by healthy older individuals and contribute to CHD-free survival.

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