[National study of lipids in coronary patients]. / Estudio nacional de lípidos en coronarios.

Although coronary atherosclerosis is considered to have several etiologic factors there is little doubt that elevated plasmatic cholesterol level is the main one. The present study was carried out because of the lack of information concerning cholesterol, lipoproteins and triglycerides levels in the coronary population in Argentina. Patients were selected on the basis of a demonstrated coronary atherosclerosis, detected either by an abnormal coronary arteriogram or a documented myocardial infarction. Total seric cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were determined in a core laboratory. Blood samples were obtained after a 12 hour fasting period. LDL-C was also calculated by the Friedewald formula. Patients were stratified according to sex, age, having or not myocardial infarction, type (Q or non Q wave) and localization of myocardial infarction. A total of 653 patients were included. The mean values obtained were: TC 227 +/- 1.8 mg/dL; LDL-C 153 +/- 1.8 mg/dL; HDL-C 48 +/- 0.4 mg/dL and TG 180 +/- 3.6 mg/dL (expressed as mean +/- SE). Mean values in the male and female subsets are given in Table 1. In women, TC, LDL-C and HDL-C are significantly higher than in men. Cholesterol values according to age are displayed in Table 3. Young people have higher TC and LDL-C mean values than older ones. Different cholesterol levels were not observed when the coronary population in our study was stratified according to the presence or not of previous myocardial infarction (Table 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Estudio nacional de lipidos en coronarios / National study of lipids in coronary patients

El Estudio Nacional de Lípidos en Pacientes Coronarios (ES.NA.LI.CO) es un estudio multicéntrico realizado en 8 ciudades del país. Se analizaron los niveles de colesterol total, HDL, LDL y triglicéridos en 653 pacientes con enfermedad coronaria aterosclerótica confirmada por coronariografia y/o infarto de miocardio documentado. El colesterol LDL fue medido además de calculado por la fórmula de Friedewald. Los pacientes fueron estratificados por protocolo según sexo, edad, presencia o no de infarto de miocardio, tipo de enfarto (Q o no Q) y localización del mismo. Los valores medios para la población total fueron: colesterol total 227 mg/dL; HDL 46 mg/dL y LDL 153 mg/dL. El colesterol total y LDL fueron significativamente mayores en las mujeres, en los más jóvenes, en los pacientes con infarto de miocardio sin onda Q y en los infartos anteriores. No hubo diferencias significativas en los grupos con y sin infarto de miocardio. El colesterol LDL medido fue 7% mayor que el calculado. En conclusión, el nivel medio de colesterol total y LDL en los pacientes con enfermedad coronaria se encuentra dentro del rango considerado normal hasta hace poco tiempo. Las mujeres y los jóvenes con enfermedad coronaria tienen colesterol total y LDL mayores que el promedio. Los pacientes con infarto no Q tienen colesterol total y LDL más alto que los pacientes con infarto con Q. La fórmula de Friedewald debería ser modificada reemplazando 1/5 por 1/6 de los triglicéridos. Se debe recomendar a la población valores de lípidos más bajos que los hallados por nosotros en los enfermos cornonarios

Estudio nacional de lípidos en coronarios. / [National study of lipids in coronary patients]

Although coronary atherosclerosis is considered to have several etiologic factors there is little doubt that elevated plasmatic cholesterol level is the main one. The present study was carried out because of the lack of information concerning cholesterol, lipoproteins and triglycerides levels in the coronary population in Argentina. Patients were selected on the basis of a demonstrated coronary atherosclerosis, detected either by an abnormal coronary arteriogram or a documented myocardial infarction. Total seric cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were determined in a core laboratory. Blood samples were obtained after a 12 hour fasting period. LDL-C was also calculated by the Friedewald formula. Patients were stratified according to sex, age, having or not myocardial infarction, type (Q or non Q wave) and localization of myocardial infarction. A total of 653 patients were included. The mean values obtained were: TC 227 +/- 1.8 mg/dL; LDL-C 153 +/- 1.8 mg/dL; HDL-C 48 +/- 0.4 mg/dL and TG 180 +/- 3.6 mg/dL (expressed as mean +/- SE). Mean values in the male and female subsets are given in Table 1. In women, TC, LDL-C and HDL-C are significantly higher than in men. Cholesterol values according to age are displayed in Table 3. Young people have higher TC and LDL-C mean values than older ones. Different cholesterol levels were not observed when the coronary population in our study was stratified according to the presence or not of previous myocardial infarction (Table 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Estudio nacional de lipidos en coronarios / National study of lipids in coronary patients

El Estudio Nacional de Lípidos en Pacientes Coronarios (ES.NA.LI.CO) es un estudio multicéntrico realizado en 8 ciudades del país. Se analizaron los niveles de colesterol total, HDL, LDL y triglicéridos en 653 pacientes con enfermedad coronaria aterosclerótica confirmada por coronariografia y/o infarto de miocardio documentado. El colesterol LDL fue medido además de calculado por la fórmula de Friedewald. Los pacientes fueron estratificados por protocolo según sexo, edad, presencia o no de infarto de miocardio, tipo de enfarto (Q o no Q) y localización del mismo. Los valores medios para la población total fueron: colesterol total 227 mg/dL; HDL 46 mg/dL y LDL 153 mg/dL. El colesterol total y LDL fueron significativamente mayores en las mujeres, en los más jóvenes, en los pacientes con infarto de miocardio sin onda Q y en los infartos anteriores. No hubo diferencias significativas en los grupos con y sin infarto de miocardio. El colesterol LDL medido fue 7% mayor que el calculado. En conclusión, el nivel medio de colesterol total y LDL en los pacientes con enfermedad coronaria se encuentra dentro del rango considerado normal hasta hace poco tiempo. Las mujeres y los jóvenes con enfermedad coronaria tienen colesterol total y LDL mayores que el promedio. Los pacientes con infarto no Q tienen colesterol total y LDL más alto que los pacientes con infarto con Q. La fórmula de Friedewald debería ser modificada reemplazando 1/5 por 1/6 de los triglicéridos. Se debe recomendar a la población valores de lípidos más bajos que los hallados por nosotros en los enfermos cornonarios (AU)

Estudio nacional de lípidos en coronarios. / [National study of lipids in coronary patients]

Although coronary atherosclerosis is considered to have several etiologic factors there is little doubt that elevated plasmatic cholesterol level is the main one. The present study was carried out because of the lack of information concerning cholesterol, lipoproteins and triglycerides levels in the coronary population in Argentina. Patients were selected on the basis of a demonstrated coronary atherosclerosis, detected either by an abnormal coronary arteriogram or a documented myocardial infarction. Total seric cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were determined in a core laboratory. Blood samples were obtained after a 12 hour fasting period. LDL-C was also calculated by the Friedewald formula. Patients were stratified according to sex, age, having or not myocardial infarction, type (Q or non Q wave) and localization of myocardial infarction. A total of 653 patients were included. The mean values obtained were: TC 227 +/- 1.8 mg/dL; LDL-C 153 +/- 1.8 mg/dL; HDL-C 48 +/- 0.4 mg/dL and TG 180 +/- 3.6 mg/dL (expressed as mean +/- SE). Mean values in the male and female subsets are given in Table 1. In women, TC, LDL-C and HDL-C are significantly higher than in men. Cholesterol values according to age are displayed in Table 3. Young people have higher TC and LDL-C mean values than older ones. Different cholesterol levels were not observed when the coronary population in our study was stratified according to the presence or not of previous myocardial infarction (Table 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Beneficial effects of timolol on infarct size and late ventricular tachycardia in patients with acute myocardial infarction.

This investigation was undertaken to study the effects of beta-adrenergic blockade with timolol on infarct size and on the incidence of late ventricular tachycardia in patients with acute myocardial infarction of less than 6 hr of evolution. Patients were assigned randomly either to a placebo-treated group (98 patients) or to a timolol-treated group (102 patients). The patients were treated with 5.5 mg iv timolol (or matched placebo) as a bolus divided into four doses during the first 2 hr followed by 10 mg orally twice daily for 1 month. Cumulative total creatine kinase (CK) release, which reflects the amount of myocardial necrosis was 1677 +/- 132 IU/liter in the placebo group (n = 83) and 1274 +/- 73 IU/liter in the timolol group (n = 81, p less than .01), a 24% reduction. Cumulative release of CK-MB was 138 +/- 8 IU/liter in the placebo group and 106 +/- 8 IU/liter in the timolol group (p less than .01), a 23% reduction. Twenty-four hour Holter electrocardiograms were obtained on days 7, 14, 21, and 28 after the onset of the acute myocardial infarction in 80 patients in the placebo group and 82 patients in the timolol group. The incidence of ventricular tachycardia was lower in the timolol than in the placebo group (7 vs 16 patients, p = .05). We conclude that early administration of intravenous timolol followed by oral treatment in patients with acute myocardial infarction reduces infarct size as assessed by CK and CK-MB serum activity, and decreases the occurrence of late ventricular tachycardia.

Abnormal left ventricular diastolic function in chronic Chagas' disease: an echocardiographic study.

Simultaneous M-mode echocardiograms and phonocardiograms were recorded in 19 patients with chronic Chagas' disease, and were digitised and compared with normal in order to study systolic and diastolic left ventricular function. Five of the patients were in New York Heart Association class 1, 9 in class 2, and 5 in class 3. Left ventricular cavity dimensions were increased in 3 and shortening fraction reduced in 1. Peak velocity of circumferential fibre shortening was below the 95% confidence limit of normal in 9. In contrast to previous echocardiographic studies, diastolic abnormalities were common, with prolongation of isovolumic relaxation time in 9 patients and reduced rate of dimension increase in 11. However, in spite of regional disease, documented angiographically in 5 of 6 patients, there was no evidence of asynchronous wall motion during relaxation seen in patients with coronary artery disease and comparable segmental abnormalities of wall motion. The relative timing of aortic valve closure and minimum cavity dimension was normal in all but 3 patients, and a significant dimension change during isovolumic relaxation in only one. Thus diastolic disturbances are common at all stages of Chagas' disease, and may represent a fundamental aspect of the pathological process as it affects the left ventricle.