As part of the acute phase reaction, lipid metabolism is significantly altered in
patients with unstable coronary syndromes. The clinical relevance and the mechanisms
underlying this phenomenon are discussed in this article. Cholesterol reduction takes
place in the first hours of an acute coronary event; thus, plasma levels determined
at this point should be interpreted with caution. This reduction may be just a consequence
of the inflammatory response, or it may be also related to an increase in cellular
uptake of cholesterol for tissue repair and hormonal synthesis. A synergistic effect
between this predisposition to cholesterol reduction and statin therapy appears to
exist during acute coronary syndromes. Triglyceride changes are variable during acute
coronary syndromes, and recent data indicate that the pattern of triglyceride variation
is a potential risk marker in those patients, possibly because it reflects neurohumoral
changes related to the acute phase.
KEYWORDS
Acute coronary syndromes - lipoproteins - cholesterol - triglycerides
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Dr.
Andrei C SpósitoM.D. Ph.D.
Director, Department of Cardiology, Instituto do Coração (InCor-DF)-Fundação Zerbini
Estrada do Contorno do Bosque-Cruzeiro Novo, Brasília
DF, Brazil, 70685.700
