[Changes in the lipid pattern in acute myocardial infarction]. / Forandringer i lipidmønsteret ved akutt hjerteinfarkt.

This study comprised 20 patients who were hospitalized for acute myocardial infarction 0.5-12.5 hours after onset of chest pain. Lipid and lipoprotein values during the first seven days after the infarction were compared with the values three months later in order to assess whether lipid analysis in the acute phase provides sufficiently representative values to recommend dietary or medical intervention. Total cholesterol on admission was similar to the control value, but was significantly reduced during subsequent days. Triglyceride concentrations in the acute phase did not differ from the control value, but HDL- and LDL-cholesterol were significantly lower than in the control sample. The HDL-cholesterol/total cholesterol ratio on admission was similar to the control ratio, but was significantly reduced when analyzed later. Thus, total cholesterol and HDL-cholesterol/total cholesterol ratio on admission are representative, and are useful as a basis for intervention, provided that the delay from onset of infarction until hospitalization does not exceed 12.5 hours.

Diurnal and monthly intra-individual variability of the concentration of lipids, lipoproteins and apoproteins.

Diurnal and monthly variability of the serum concentration of lipids, lipoproteins and apoproteins were examined in 11 healthy subjects aged 32-63 (mean 46) years. For diurnal measurements, blood samples were drawn at 0800, 1200, 1500, 1800, and 2100 hours. The variability over 1 month was assessed from four analyses taken weekly at 0800 hours after at least 8 h fast. The analytical variability expressed as mean coefficient of variation (CV) ranged from 0.95% for cholesterol to 7.6% for apoprotein B. The mean CVs for diurnal biological variability were 2.4% for cholesterol, 3.5% for HDL-cholesterol, 5.1% for LDL-cholesterol, 29.5% for triglycerides, 6.5% for apoprotein A and 6.5% for apoprotein B. The respective biological CVs for monthly variability were 4.2%, 4.1%, 5.2%, 20.7%, 9.4% and 9.7%. A repeated-measures ANOVA revealed a significant increase of triglycerides (p less than 0.01) and decrease of LDL-cholesterol (p less than 0.01) during the day. Within 1 month, apoprotein A tended to rise (0.05 less than p less than 0.10). Although the best reproducibility was found for cholesterol, the results obtained indicate that six tests have to be taken before and after intervention by drug or diet to detect a reduction of 10% in an individual with a probability of 0.95.