Decrease of plasma triglycerides during the acute phase of unstable angina or non-ST elevation myocardial infarction is a marker of recurrent ischemia.
Both increase and decrease of plasma triglycerides during acute coronary syndromes (ACS) are reported, however, a clinical relevance for these distinct metabolic responses is unclear. To test the association between distinct responses of lipid metabolism and cardiovascular risk, 39 subjects admitted with non-ST elevation ACS within 48 h of presentation had plasma lipids measured on the first and sixth days of hospitalization, and continuous electrocardiogram was performed during the first 2 days to quantify recurrent ischemia and heart rate variability. No lipid-lowering therapy was offered to the patients. During the first 5 days, half of them experimented a decrease in triglycerides (n=19, median: -18 mg/dl) and the other half presented triglyceride increase (n=20, median: +44 mg/dl). A higher incidence of recurrent ischemia (35% versus 5%, P=0.02) and greater ischemic burden/patient (123 +/- 286 mm min versus 47 +/- 212 mm min, P=0.02) were observed in subjects with triglyceride reduction, when compared with those with triglyceride increase. Individuals with heart rate variability below the median presented a median decrease in triglycerides during the 5-day period, as opposed to the counterparts (P=0.05). In conclusion, triglyceride reduction during ACS is associated with a greater incidence of recurrent ischemia and may constitute a sign of higher sympathetic activity.
Ph.D. Program, School of Medicine, Federal University of Bahia, Salvador, Brazil.
Luis C L
LC
Correia
Luiz P
LP
Magalhães
Júlio C
JC
Braga
Mário S
MS
Rocha
José C
JC
Lima
Luiz C S
LC
Passos
Argemiro
A
D'Oliveira
J
J
Péricles Esteves
Andrei C
AC
Spósito
D000208:Acute Disease; D000368:Aged; D000789:Angina, Unstable / Q000097:blood*; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis*; D012008:Recurrence; D013577:Syndrome; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides