[Personal experience with lovastatin, a HMG-CoA reductase inhibitor (Mevacor, MSD) in the treatment of hypercholesterolemia]. / Nase zkusenosti s inhibitorem HMG-CoA reduktázy lovastatinem (Mevacor, MSD) v lecbe hypercholesterolémie.

The authors administered lovastatin (Mevacor, MSD) to 18 patients with primary hyperlipoproteinaemia (familial and non-familial) with a lipoprotein pattern type IIa and IIb. During treatment a marked reduction of atherogenic indicators of the lipid metabolism occurred, i.e. a decline of total cholesterol (-28.6%), LDL-cholesterol -39%), apolipoprotein B (-18.6%), the index of total cholesterol/HDL-cholesterol (-44.6%) and the index LDL-cholesterol/HDL-cholesterol (-48.2%). At the same time a favourable effect on indicators of the lipid metabolism to which a protective action is ascribed was recorded: a rise of HDL-cholesterol (+13.6%) and apolipoprotein AI (+13%) and AII (+13%). An excellent effect was observed also in four heterozygotes with familial hypercholesterolaemia which is usually rather resistant to other types of hypolipidaemic treatment. The drug was very well tolerated and subjective side-effects of treatment were minimal. Despite the fact that a number of laboratory indicators was followed up, the authors did not observe any undesirable side-effects, only a transient and marginal rise of ALT in one patient. Lovastatin is, due to its potent hypolipidaemic effect, a new hope in the treatment of hypercholesterolaemia. Its usefulness in the prevention of ischaemic heart disease, as well as its safety during prolonged administration are tested at present in long-term investigations.

[Obliterative disease of the carotid and peripheral arteries in hyperlipoproteinemia]. / Obliterující nemoc karotických a koncetinových tepen u hyperlipoproteinémií.

The authors give an account of changes of the carotid and peripheral arteries detected by ultrasonic examination in a group of 133 patients with different forms of primary hyperlipoproteinaemias. Stenoses in the extracranial carotid circulation were found in 31% of the group, stenoses of the peripheral arteries in 37%; in 18% combined changes of the carotid and peripheral system were found. The authors proved a rising trend of the number of risk factors with the rising number of arterial stenoses. The most frequent risk factors were obesity and smoking. In the entire group changes of the peripheral arterial system were found in more than half the patients (in 53%); in clinically asymptomatic subjects they were proved in 39%. The authors emphasize the necessity to introduce ultrasonic screening of the arterial system in all patients with hyperlipoproteinaemia.