Изменение липидограммы и системы гемостаза у пожилых пациентов с инфарктом миокарда, артериальной гипертензией в зависимости от выраженности синдрома старческой астении

Background. The development of myocardial infarction (MI) is associated with the lipid and hemostatic disorders, which are not fully investigated in patients with senile asthenia syndrome (SAS). Objective. To analyze changes in the lipidogram and hemostasis system in elderly patients with MI, hypertension (HTN), depending on the severity of SAS. Design and methods. Indicators of lipid metabolism and hemostasis system were studied in patients aged 60–74 years with MI, grade 1–2 HTN (n = 80); 60–74 years with MI, grade 1–2 HTN with senile preasthenia (SP); 60–74 years with MI, grade 1–2 HTN and SAS in the period from 2 to 4 days after MI onset. The diagnosis of MI without ST segment elevation was established based on the criteria of the European Society of Cardiology, HTN was diagnosed in accordance with the “National Recommendations of the All-Russian Scientific Society of Cardiology”, SAS — according to the criteria of L. P. Fried. The study of lipid metabolism indicators performed on the analyzer “KoneLab 300” and “PersonalLab”, hemostasis systems — with the use of reagents “Technology Standard”. Results. In elderly patients with MI, HTN and SP, the level of triglycerides is significantly higher compared to those without senile asthenia (1,8 ± 0,04 vs. 1,4 ± 0,03 mmol/l), low-density lipoproteins (4,2 ± 0,07 vs. 3,6 ± 0,05 mmol/l), antithrombin III activity (105,8 ± 2,2 vs. 97,4 ± 2,3 %), plasminogen activator inhibitor (291,5 ± 3,8 vs. 275,2 ± 3,6 ng/ml). With the progression of senile transformation into SAS, these changes in patients 60–74 years old with MI, HTN are aggravated, and especially changes in apoliprotein-A1, leptin, very low density lipoproteins, fibrinogen, plasminogen activator inhibitor, in globulin-dependent fibrinolysis, which indicates a negative effect of SAS on lipidogram and hemostasis indicators. Conclusions. The changes in lipidogram and hemostasis indicators should be taken into account in the management of elderly patients with MI, HTN and SAS symptoms, they should be also considered as predictors of the MI outcomes.