Рациональная фармакотерапия в кардиологии (Dec 2017)

SUBFRACTION DISTRIBUTION OF APO B-CONTAINING LIPOPROTEINS DEPENDING ON THE ACHIEVEMENT OF THE TARGET LEVEL OF LOW DENSITY LIPOPROTEINS UNDER STATINS THERAPY IN PATIENTS WITH CORONARY ATHEROSCLEROSIS

  • I. N. Ozerova,
  • V. A. Metelskaya,
  • N. E. Gavrilova

DOI
https://doi.org/10.20996/1819-6446-2017-13-6-794-799
Journal volume & issue
Vol. 13, no. 6
pp. 794 – 799

Abstract

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Aim. To reveal whether there are differences in subfractional distribution of apo B-containing lipoproteins in men and women with coronary atherosclerosis treated with statins depending on low density lipoprotein (LDL) cholesterol level.Material and methods. Patients aged 33-85 years with angiography documented coronary atherosclerosis were included into the study (n=133): 97 men (mean age 61±9.0 years) and 36 postmenopausal women (mean age 65±9.3 years). Patients were on statin therapy at least 6 months before admission: atorvastatin (10-40 mg/day), simvastatin (20-40 mg/day), rosuvastatin (10-40 mg/day) and pravastatin (20 mg/day). Subfractional apo B-containing lipoproteins distribution was analyzed by electrophoresis in a 3% polyacrylamide gel.Results. Men achieving target LDL cholesterol level (<2.5 mmol/l) as compared with those with higher LDL cholesterol level alongside with decreased proatherogenic lipids and apolipoproteins, had less atherogenic LDL subfractional profile: lower portion of LDL 2 (7.3±3.4 и 9.9±3.9%, p<0.01), small dense LDL 3 (1.3±1.2 и 2.2±2.2%, р<0.05), LDL 4 (0.2±0.2 и 0.3±0.5%, p<0.05), and concentration of cholesterol in this subfrtactions. These differences were associated with elevated mean size of LDL particles (270.8±3.0 vs 268.8±3.9 Å, p<0,01). On the other hand, women, despite achieving target LDL cholesterol level, had elevated apo B level and apo B/AI ratio without any differences in subfractional profile of low densities lipoproteins.Conclusion. In patients with coronary atherosclerosis treated with statins, antiatherogenic shifts in apo B-containing lipoproteins, decrease of cholesterol concentration subfractions coupled by elevation of mean LDL particle size were found only in men who reached target LDL cholesterol level.

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