SERUM-LIPIDS 4 WEEKS AFTER ACUTE MYOCARDIAL-INFARCTION ARE A VALID BASIS FOR LIPID-LOWERING INTERVENTION IN PATIENTS RECEIVING THROMBOLYSIS

Objective-To compare serum concentrations of total cholesterol, low de nsity lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) ch olesterol, and triglycerides four weeks after acute myocardial infarct ion with baseline levels measured within 24 hours after onset of sympt oms. Design-A prospective study including 141 patients with acute myoc ardial infarction who were admitted to the coronary care unit at a gen eral hospital. Measurements-Fasting serum concentrations of total chol esterol, LDL cholesterol, HDL cholesterol, and triglycerides. Main res ults-In patients receiving thrombolytic therapy, no significant differ ences were found in serum lipids four weeks after admission compared t o values estimated within 24 hours from onset of symptoms. In patients not receiving thrombolytic therapy, total cholesterol and low density lipoprotein cholesterol showed a minor increase four weeks after admi ssion compared to values obtained within 24 hours after onset of sympt oms. High density lipoprotein cholesterol and triglycerides remained u nchanged. Conclusions-In patients with acute myocardial infarction rec eiving thrombolytic therapy, serum lipids measured four weeks after on set of infarction are reasonably valid estimates of baseline lipid lev els and may be used to decide about lipid lowering interventions. This information can be a basis for actions against hyperlipidaemia early after hospital discharge when the patient is highly motivated to chang e lifestyles and is still in close contact with a cardiologist or othe r physician.