LIPID METABOLISM IN MEN UNDER 60 YEARS OLD IN ACUTE AND SUBACCUTE PERIODS OF MYOCARDIAL INFARCTION COMPLICATED BY ACUTE KIDNEY INJURY

Abstract

Background. Lipid metabolism changes in myocardial infarction (MI) complicated by acute kidney injury (AKI) in men are important for evaluating the effects of therapy and expanding the possibilities of prevention. Purposes and tasks. To evaluate the lipid metabolism parameters in acute and subacute periods of MI complicated by AKI and their role in the complication development in men under than 60 years old (y.o.) to improve prevention and outcomes. Materials and methods. The results of in patient examination and treatment of men aged 32-60 y.o. with MI were studied. Patients were divided into two age comparable groups: the study group, with AKI - 22 patients and the control group, without it - 141 patients. The lipid metabolism parameters and their dynamics were compared in the first hours (I) and at the end of the third week of MI (II) in selected groups. Their influence was assessed (risk analysis by Pearson’s Chi square test) on the risk of AKI development and MI complications in the study group. The results. In the study group, higher levels of low density lipoprotein-2 (LDL2) (5.53 ± 2.50 mmol/l) were noted in comparison with the control group (3.33 ± 2.45 mmol/l; p = 0.02). In the study group, an increase in the levels of very low density lipoproteins, atherogenic coefficient and index, a decrease in triglycerides (TG) at the end of the third MI week were registered. The risk of AKI development was associated with the concentration of TH1 ≥ 1.88 mmol/l (p = 0.007). The complicated course of MI in the study group is characterized by levels of LDL1 ≥ 4.0 (p = 0.02), high1 (HDL1) ˂1.1 (mmol/l; p = 0.02), LDL1/HDL1 ≥ 4.5 (p = 0.02). Conclusions. In AKI, atherogenic changes in lipids are enhanced both in the acute and at the end of the subacute period of MI. The risk of AKI development increases with TG1 ≥ 1.88 mmol/l. The complicated course of MI in the study group is associated with LDL1 ≥ 4.0, HDL1˂1.1 (mmol/l) and LDL1/HDL1 ≥ 4.5 levels. It is expedient to use them in predictive modeling.