CORRECTION OF LIPID AND HEMOSTATIC DISORDERS IN PATIENTS AT HIGH RISK OF CARDIOVASCULAR DEATH

Aim - to study the peculiarities of lipid and coagulation abnormalities in high risk patients, and also the possibilities of their correction with statin therapy. Methods. 102 patients were studied, 1 group included patients with LDL 3.0-3.9 mmol/l (n=59), who received atorvastatin 40 mg daily with titration to 80 mg daily, 2 group - patients with LDL >4.0 mmol/l (n=48), who received rosuvastatin 10 mg daily with titration to 20 mg daily. Results. In the 1 group of patients, after 24 weeks mean LDL level decreased by 43.3% (p<0.001), 51 patients (94.4%) achieved target level of LDL. In the 2 group, mean LDL level decreased by 50.6% (p<0.001), 43 patients achieved target level of LDL. The mean level of Willebrand factor (vWf) (127.1+21.9% in the 1 group and 124 + 34.8% in the 2 group) and D-dimer (1.0+0.6 pg/ml in the 1 group and 0.9 + 0.5 pg/ml in the 2 group) was higher than before treatment. In the patients of the 1 group, after 24 weeks of treatment fibrinogen levels decreased by 19.1% (p<0,001), vWf-by 20.5% (p<0,001). D-dimer levels - by 12% (p=0,046). Fibrinogen levels in the patients of the 2 group decreased by 23.5% (p<0,001), vWf - by 31.6% (p<0,001), D-dimer -by 33.3% (p=0,01) and starting time of ADF induced platelet aggregation increased by 11.8% (p=0,008). Conclusions. Patients at high risk of cardiovascular death show the rise of vWf and D-dimer levels along with dyslipidemia. Statin treatment during 24 weeks leads to achievement of target levels of LDL, decreasing of endothelial dysfunction and also thrombogenic potential of the blood.

atherosclerosis, dyslipidemia, blood coagulation, statins