О нетипичных вариантах дислипидемий при инфаркте миокарда и нестабильной стенокардии

Aim. To analyse atypical variants of dyslipidemia (DLP) in coronary heart disease (CHD). Material and methods. The study included rehabilitation unit patients with myocardial infarction (MI). Over 5 years, 78 patients with severe hypertriglyceridemia (HTG) or selective decrease in anti-atherogenic lipoproteins were selected. The patients with the DLP phenotypes most typical for CHD (IIa, IIb) were not included in the study. Mean age of the participants was 46± 1 years. All participants were divided into three groups: with combined hyperlipidaemia (HLP) due to increased cholesterol (CH) and triglycerides (TG), but with prevalent HTG — Group I (n=24); with isolated HTG — Group II (n=23); with selective reduction in high- density lipoproteins (HDL) — Group III (n=31). Results. Group I was characterised by substantial increase in the levels of CH and TG (6,8±0,5 mmol/l); Group II — by isolated increase in TG level (4,1±0,4 mmol/l); and Group III — by selective reduction in HDL-CL concentration (0,82±0,02 mmol/l). Conclusion. Atherosclerosis and its complications might develop not only in HLP IIa and IIb, but also due to HTG or decreased anti-atherogenic lipoprotein levels. All primary DLP are hereditary, but typically they are linked to polygenic defects — i.e., are dependent on functionally important nucleotide polymorphisms in genes regulating lipid metabolism.