ИЗМЕНЕНИЯ ЛИПИДНОГО ОБМЕНА В НАЧАЛЬНЫЕ ПЕРИОДЫ ИНФАРКТА МИОКАРДА, ОСЛОЖНЕННОГО ОСТРЫМ ПОВРЕЖДЕНИЕМ ПОЧЕК, У МУЖЧИН МОЛОДОГО И СРЕДНЕГО ВОЗРАСТА

Abstract

Relevance. Changes in lipid metabolism during myocardial infarction (MI) complicated by acute kidney injury (AKI) are potentially important for evaluating the effects of therapy and expanding the possibilities of prevention. Aim. To evaluate the changes in lipid metabolism during acute and subacute MI periods and their role in the complication’s development in men under 60 years old (y.o.) with AKI to im-prove prevention and outcomes. Material and methods. The results of inpatient examination and treatment of men aged 20-60 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 parameters of lipid metabolism and their dynamics were compared in the first hours (1) and at the end of the third week of MI (2) in selected groups, their influence was assessed (risk analysis by Pearson's Chi-square test) on the risk of AKI development and complications MI in the study group. Results. In the study group, the following were observed: higher levels of low-density lipo-protein2 (LDL2) (5.53±2.50 mmol/l) compared to the control group (3.33±2.45 mmol/l; p=0.02); an increase in the levels of very low-density lipoproteins, a coefficient and an atherogenic index, a decrease in triglycerides (TG) at the end of the third week of the disease. The risk of AKI development was associated with the concentration of TG1≥1.88 mmol/l (p=0.007). Complicated course of MI in the study group is characterized by levels of LDL1≥4.0 (p=0.02), high-density lipoprotein1 (HDL1)˂1.1 (mmol/l; p=0.02), and their ratio (LDL1/HDL1) ≥4.5 (p =0.02). Conclusions. In AKI, persistent atherogenic changes in lipids are noted both in the acute and at the end of the subacute period of MI. The risk of developing AKI increases at levels of TG1≥1.88 mmol/l, and the complicated course of MI in the study group is associated with lev-els of LDL1≥4.0, HDL1˂1.1 (mmol/l) and LDL1/HDL1≥4.5. It is expedient to use them in predictive modeling.