Введение и цель. Семейная гиперхолестеринемия (СГХС) распространенное наследственное заболевание, характеризующееся повышенным уровнем холестерина (ХС) липопротеидов низкой плотности (ЛНП) и преждевременным возникновением ишемической болезни сердца. Целью исследования была оценка частоты СГХС у пациентов с диагнозом острого коронарного синдрома (ОКС), поступивших в 2015 г. в клиники, участвующие в федеральном регистре ОКС. Материал и методы В анализ включены данные 924 лиц, из них 554 (60 ) мужчины, средний возраст 6512 лет, госпитализированных по поводу ОКС в 2015 г. При поступлении был выполнен сбор анамнеза для уточнения профиля риска и анализ крови с определением липидного профиля. Результаты Среди 924 пациентов, госпитализированных с диагнозом ОКС, частота возможной СГХС с уровнем общего ХС (ОХС) 7,5 ммоль/л и/или ХС ЛНП 5,0 ммоль/л составила 10 (n95), из них 35 (n33) лица моложе 60 лет артериальная гипертония диагностирована в 85 случаев, сахарный диабет 2-го типа у 15 участников, курение в настоящее время 20. Атеросклеротические сердечно-сосудистые заболевания (ССЗ) имели 65 (n62) человек, из них 24 (n23) лиц ранее перенесли инфаркт миокарда. Средний уровень ОХС составил 7,71,0 ммоль/л, ХС ЛНП 5,80,8 ммоль/л, триглицеридов 1,70,9 ммоль/л, ХС липопротеидов высокой плотности 1,10,2 ммоль/л. При поступлении только 4 (n4) принимали статины. При пересчете исходного уровня ХС ЛНП среди больных, получавших статины в общей группе, доля больных с потенциальной СГХС возросла до 15 (n140). Заключение. Частота возможной СГХС среди больных, госпитализированных по поводу ОКС в 2015 г. достигла 10, из них 2/3 уже имели атеросклеротические ССЗ. Таким образом, полученные результаты могут свидетельствовать о более высокой частоте СГХС среди пациентов, перенесших ОКС. Ключевые слова: регистр, острый коронарный синдром, гиперхолестеринемия, семейная гиперхолестеринемия , статины, холестерин липопротеидов низкой плотности.Aims. Familial Hypercholesterolemia (FH) is a hereditary common disorder that is characterized by elevated level of low-density lipoproteins cholesterol ((LDL-C) and premature coronary heart disease (CHD). The aim of the study was to estimate the frequency of FH among patients with acute coronary syndrome (ACS), admitted in 2015 to clinics participating in the federal ACS registry. Materials and methods: The database included 924 persons (554 (60) men, mean age 65 12 years), hospitalized with ACS in 2015. At the time of hospitalization for ACS were available medical history and lipid profile. Results: Among 924 patients hospitalized for ACS, the frequency of possible FH (total cholesterol level 7.5 mmol/l and/or LDL-C 5.0 mmol/l) was 10 (n95), of which 35 (n33) persons younger than 60 years hypertension is diagnosed in 85 of cases, diabetes mellitus in 15 of participants, smoking - 20. Atherosclerotic cardiovascular diseases (CVD) had 65 (n62) people, of whom 24 (n 23) had previously suffered myocardial infarction. The mean level of total cholesterol was 7.7 1.0 mmol/l, LDL-C was 5.8 0.8 mmol/l, triglycerides was 1.7 0.9 mmol/l, high-density lipoprotein cholesterol was 1,1 0.2 mmol/l. At the time of hospitalization only 4 (n4) used statins. When recalculating the baseline level of LDL cholesterol in patients who used statins in the general group, the part of patients with potential FH increased to 15 (n 140). Conclusion. The frequency of possible FH among patients hospitalized for ACS in 2015 reached 10, of which 2/3 already had atherosclerotic CVD. Therefore, the data may show a higher prevalence of FH in patients presenting with ACS.
Pulmonary arterial hypertension is a condition characterized by an increase in mean pressure in the pulmonary artery. This pathology is associated with high mortality, and specific therapy for pulmonary arterial hypertension does not affect the cause of the disease and is extremely expensive. In this regard, it is especially important to study the modifiable etiological factors of pulmonary arterial hypertension. One such factor is drugs. One of the leading groups of drugs-inductors is anorexigenic drugs. It was the representatives of this group, such as aminorex, who were the first inducers of pulmonary hypertension. Moreover, this adverse reaction was so significant that it led to the withdrawal of these drugs. Currently, the leading role in the context of drug-induced pulmonary hypertension is played by such drugs as anticancer, antiviral drugs, and interferons. These drugs lead to pulmonary hypertension through various pathophysiological mechanisms. The leading measures to prevent this pathology are to limit the use of culprit medications, reduce the spread of HIV infection, since several groups of drugs can be used to treat HIV-infected patients, leading to the development of pulmonary hypertension.
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