**7. Conclusion**

192 Lipoproteins – Role in Health and Diseases

study it is not only the problem for the eldery patients. The prevalence of the impaired low density lipoprotein cholesterol by the gender was similar both for men and women and it was high for the patients with established coronary artery disease, taking notice that elevated low density lipoprotein cholesterol can be managed and controlled successfully with lifestyle changes, medications or a combination both of them. We have found that decreased high density lipoprotein cholesterol level is a significant independent risk factor for cardiovascular one year mortality. Interestingly, in another similar studies reduced high density lipoprotein cholesterol more often were found in young men. In our study 90% of females with coronary artery disease had a decreased high density lipoprotein cholesterol level. Also, insufficient high density lipoprotein cholesterol level more often have been found in eldery people. Although high density lipoprotein cholesterol less than 1,3 mmol/l for women has been widely considered as a cardiovascular risk factor, in the present study we selected a cutoff point of less than 1,2 mmol/l as a lowest high density lipoprotein cholesterol value that allowed us to identify those females at risk of cardiovascular one year mortality. It have been evaluated that about 20% of participants of our study had reduced high density lipoprotein cholesterol with elevated low density lipoprotein cholesterol level together. So, it is let to suspect, that one year cardiovascular mortality risk for them have to be much higher. There are a lot of evidence, that decreased high density lipoprotein cholesterol significantly increases cardiovascular mortality risk in stable patients. Also, there are some studies, showed that reduced high density lipoprotein cholesterol is associated with a higher risk of adverse outcomes [40]. Some reports on lipoproteins did not evaluated cardiovascular mortality due to acute or chronic ischaemic syndrome. Comparing acute coronary syndrome and chronic coronary artery disease patients we have been evaluated the more important role of total cholesterol and low density lipoprotein cholesterol on cardiovascular one year mortality for acute patients, though not significant. In contrast, high density lipoprotein cholesterol was strong independent risk factor both for acute (not significant) and chronic patients. Suprisingly, total cholesterol more than 5,2 mmol/l and low density lipoprotein cholesterol more than 3,0 mmol/l reduced one year mortality risk both for acute and chronic patients significantly. Additionally, the previous studies showed the increased mortality rate due to elevated low density lipoprotein cholsterol, have not comprehensively evaluated the impact of different low density lipoprotein cholesterol and high density lipoprotein cholesterol lipoproteins levels on cardiovascular mortality. Lehto and al. evaluated, that among 35-64 years females with acute myocardial infarction total cholesterol more that 8 mmol/l significantly increases reccurence cardiovascular disease risk [42]. It was a reason to search an impact of different levels of low density lipoprotein cholesterol and total cholesterol on cardiovascular mortality risk for men and women. Our hypothesis was confirmed, as it became clear, that one year cardiovascular mortality risk sharply rises when signally increased total cholesterol more than 9 mmol/l and low density lipoprotein cholesterol more than 6 mmol/l, especially in women. The future major research need to evaluate a different lipoprotein and total cholesterol levels impact in cardiovascular mortality, not only in short term, but in long-term outcomes as well. It seems, the highest levels of lipids, that could be attributed to hereditary

Lipoproteins disorder is the main factor for development of the atherosclerosis and predicts cardiovascular mortality. The most important findings from our data concerns the inverse relationship between the high density lipoprotein cholesterol and cardiovascular mortality rates. This association is characterized by a high degree of generality and strength.
