Value and Limitations of Electrocardiogram in Diagnosis of Slight and Subacute Coronary Attacks

The electrocardiogram recorded at the initial consultation was compared with the final diagnosis in 211 consecutive suspected slight or sub-acute coronary attacks in 206 patients.In 77 (36%) of the 211 episodes, acute (or subacute) myocardial infarction was finally diagnosed. The initial E.C.G. showed a diagnostic pattern in only 19 (25%) of these 77 episodes; in 39 (50%) it was abnormal but not diagnostic of recent infarction; while in 19 (25%) the E.C.G. showed no abnormality classified under the Minnesota Code, though in 16 of these there were definite minor changes.In 61 (29%) of the 211 episodes acute myocardial infarction was excluded and an alternative diagnosis was made. The E.C.G. was strictly normal in only 23 (38%) of these 61 episodes; in 15 (25%) it showed minor abnormalities, and in 23 (38%) it was grossly abnormal.     

Ischaemic Heart Disease: A Secondary Prevention Trial Using Clofibrate

A trial is reported of the effects of giving clofibrate to prevent progression of pre-existing ischaemic heart disease. There were two groups randomly distributed between clofibrate (350 patients) and placebo (367 patients) regimens. The trial lasted about six years and was conducted in 19 hospitals in Scotland. The criteria of acceptance into the trial were precise and were monitored by one observer. The standards of diagnosis of events were defined and all protocols and electrocardiograms were read blind by one observer.Three categories of patients were admissible to the trial: (1) patients with one myocardial infarction (W.H.O. E.C.G. criteria) between 8 and 16 weeks before the start of the trial; (2) patients with angina of a duration of 3 to 24 months, provided their E.C.G. showed signs of myocardial ischaemia at rest or after exercise; and (3) patients with one recent myocardial infarction and pre-existing angina as defined above.There were fewer deaths in patients with angina (categories 2 and 3 above) treated with clofibrate than in those on placebo. The mortality in the former group was reduced by 62%, and this is a statistically significant difference. Clofibrate did not have any statistically significant effect in reducing the rate of non-fatal infarction in patients with angina or in those with myocardial infarction and pre-existing angina, though a beneficial trend was evident when both subgroups were combined (a 44% reduction compared with the placebo group). There was a significant reduction in all events (fatal and non-fatal) in patients with angina (“all anginas”) in the clofibrate-treated group; the rate was reduced by 53%.Clofibrate did not alter the overall mortality or morbidity rates in patients admitted to the trial with recent myocardial infarction without preceding angina of more than three months'' duration. In one subgroup there was a statistically significant adverse effect in the clofibrate-treated group. The lack of any overall effect in patients with myocardial infarction might be related to the unexpectedly low mortality rate (2·97%) in the placebo group; it is usually in the region of 4-9% per annum after first myocardial infarction.In patients categorized as “all anginas” there was significant reduction in events whether the initial serum cholesterol level was high (greater than 260 mg/100 ml) or normal. Clofibrate seemed to have a small but not significant beneficial effect in patients with myocardial infarction with initially high serum cholesterol levels, but was of no value in those with initially normal serum cholesterol levels. There was no significant relationship between the response or lack of response of serum cholesterol to clofibrate and the incidence of events either in patients with angina or in those with infarction.The main conclusion of this trial is that clofibrate had a beneficial effect in reducing mortality and, to a lesser extent, morbidity in patients who presented with angina (“all anginas”). This effect was independent of initial serum cholesterol levels or the extent to which serum cholesterol was lowered. The drug had no significant overall effect on prognosis in patients with myocardial infarction alone.     

Antioxidant vitamin levels do not exhibit negative correlation with the extent of acute myocardial infarction

Serum levels of vitamin E (VE), beta-carotene (BC) and vitamin C (VC) were determined in 50 patients with the first acute myocardial infarction (AMI) before starting thrombolytical treatment. VE and BC were determined by HPLC, VC spectrophotometrically. The reperfused patients were divided according to vitamin concentrations into four groups. The lowest quartile was compared with the rest of the studied population (VE: group with high (H)>15.6 microM>group with low (L), BC: H>0.07 microM>L, VC: H>25 microM>L) in the following parameters: extent of myocardial damage (area under the curves of troponin I, CK-MB during 48 h), arrhythmia and congestive heart failure occurrence, size of ejection fraction, positivity of ventricular late potentials. No significant differences between groups H and L for either VE, BC or VC were found (P 0.05). As no correlation between serum concentrations of vitamins E, C and beta-carotene and the extent and clinical course of AMI was found, the actual vitamin concentrations may be important for prevention of ischemic heart a disease, but they do not play a decisive role in the acute phase of myocardial infarction in humans.     

BUCHBESPRECHUNGEN

Book reviewed in this article:
reviews type of article–
M ason , J. L. (ed.): Evolution of domesticated animals . London, New York: Longman 1984.
G riffiths , G. C. D. (ed.): Flies of the Nearctic Region . Vol. VIII: Cyclorrhapha II (Schizophora: Calyptratae), Part 2 Anthomyiidae, Number 1 by G. C. D. G riffiths . Stuttgart: E. Schweitzerbart'sche Verlagsbuchhandlung 1982.
S impson , G. G.: Penguins . Past and Present, Here and There. New Haven and London: Yale University Press 1983.
G ans , E.; P ouch , F. H. (eds.): Biology of the Reptilia . Vol. 12. New York – London: Academic Press 1982. 564 S. DM 353,–. G ans , E. (ed.):
M atsuno , K.; D ose , K.; H arada , K.; R ohlfing , D. L. (eds.): Molecular Evolution and Protobiology . New York, London
F elsenstein , J. (ed.): Numerical Taxonomy . Nato AS1 Series. Series G Ecological Sciencesxs
S meets , W. J. A. J.; N ieuwenhuys , R.; R oberts , B. L.: The Central Nervous System of Cartilaginous Fishes . Structure and Functional Correlations. Berlin, Heidelberg, New York: Springer 1983
H echt , M. K.; W allace , B.; P range , G. T. (eds.): Evolutionary Biology . Vol. 18. New York and London     

纤维蛋白原与冠心病PCI介入治疗围术期心肌梗死的相关性

目的:探讨纤维蛋白原与冠心病介入治疗围术期心肌梗死的相关性。方法:2013年1月到2015年1月,选择在我院进行诊治的冠心病患者92例,都给予PCI介入手术治疗,在手术前后进行纤维蛋白原与心功能的测定,对围术期心肌梗死发生情况与临床资料进行调查与分析。结果:所有患者都介入手术治疗成功,术后LVESVI与LVEDVI值都明显低于术前(P0.05),而术后LVEF值明显高于术前(P0.05);术后患者的血浆纤维蛋白原值为3.66±0.42 g/L,明显低于术前的7.45±0.56 g/L(P0.05)。围手术期发生心肌梗死8例,发生率为8.7%。Spearman秩相关分析法结果显示心肌梗死发病与血浆纤维蛋白原、LVESVI、LVEDVI、LVEF值都存在明显相关性(P0.05),多元Logistic回归分析结果显示纤维蛋白原、LVESVI、LVEDVI、LVEF、年龄为导致冠心病围术期心肌梗死的主要危险因素(P0.05)。结论:介入手术治疗冠心病具有很好的效果,但是围术期心肌梗死的发生率比较高,纤维蛋白原能有效反应病变状况,在心肌梗死的发生发展中起着关键性作用。     

The complete amino acid sequence of the low molecular weight cytosolic acid phosphatase

This paper presents the complete amino acid sequence of the low molecular weight acid phosphatase from bovine liver. This isoenzyme of the acid phosphatase family is located in the cytosol, is not inhibited by L-(+)-tartrate and fluoride ions, but is inhibited by sulfhydryl reagents. The enzyme consists of 157 amino acid residues, has an acetylated NH2 terminus, and has arginine as the COOH-terminal residue. All 8 half-cystine residues are in the free thiol form. The molecular weight calculated from the sequence is 17,953. The sequence was determined by characterizing the peptides purified by reverse-phase high performance liquid chromatography from tryptic, thermolytic, peptic, Staphylococcus aureus protease, and chymotryptic digests of the carboxymethylated protein. No sequence homologies were found with the two known acylphosphatase isoenzymes or the metalloproteins porcine uteroferrin and purple acid phosphatase from bovine spleen (both of which have acid phosphatase activity). Two half-cystines at or near the active site were identified through the reaction of the enzyme with [14C] iodoacetate in the presence or in the absence of a competitive inhibitor (i.e. inorganic phosphate). Ac-A E Q V T K S V L F V C L G N I C R S P I A E A V F R K L V T D Q N I S D N W V I D S G A V S D W N V G R S P N P R A V S C L R N H G I N T A H K A R Q V T K E D F V T F D Y I L C M D E S N L R D L N R K S N Q V K N C R A K I E L L G S Y D P Q K Q L I I E D P Y Y G N D A D F E T V Y Q Q C V R C C R A F L E K V R-OH.     

Electroencephalographic and Plasma Electrolyte Changes After Cardiac Surgery in Children

Serial electroencephalographic studies were carried out during the first few days following open heart surgery in 53 children who had an uneventful surgical procedure and postoperative recovery. While the E.E.G. taken a few hours after the end of the operation was comparable to the preoperative one, an increase in slow activity subsequently occurred in all patients and reached its maximum on the first or second postoperative day. This increase in slow activity was not commonly associated with any obvious altered state of consciousness and the preoperative E.E.G. patterns reappeared within one week. A fall in plasma sodium level with a comparable fall in plasma chloride usually occurred around the second postoperative day, returning to the preoperative levels by the fourth postoperative day.It is suggested that both events are part of a normal reversible physiological response to the operative trauma. The presence of generalized slow activity in the E.E.G. in the first few days after heart surgery does not necessarily imply that there has been cerebral damage from anoxia.     

Lactic dehydrogenase isozyme patterns and alpha-hydroxybutyrate dehydrogenase activities in serum from newborns, patients with ovarian cancer or myocardial infarction

Lactic dehydrogenase (LDH) and alpha-hydroxybutyrate dehydrogenase (HBD) and LDH isozyme patterns were studied in serum from newborns and patients with ovarian cancer or myocardial infarction. LDH and HBD activities from newborns and patients with ovarian cancer or myocardial infarction were significantly increased, compared with those from patients with benign ovarian tumor. These increases were accompanied with a decrease of LDH-H and an increase of LDH-M in serum from newborns and patients with ovarian cancer, while an increase of LDH-H in serum from patients with myocardial infarction was dominant. However, the raised HBD activities in serum from patients with benign ovarian tumor did not affect the LDH isozyme patterns. From analysis of linear regression, a negative correlation between LDH-1 or -2 and HBD activity in serum from patients with ovarian cancer was observed while there was a positive correlation between LDH-4 and HBD activity. Similar patterns in serum from newborns were observed. On the other hand, a positive correlation between LDH-1 and HBD activity and a negative correlation between LDH-4 and HBD activity were found in serum from patients with myocardial infarction.     

The complete amino acid sequence of coagulogen isolated from Southeast Asian horseshoe crab, Carcinoscorpius rotundicauda

The complete amino acid sequence of coagulogen purified from the hemocytes of the horseshoe crab Carcinoscorpius rotundicauda was determined by characterization of the NH2-terminal sequence and the peptides generated after digestion of the protein with lysyl endopeptidase, Staphylococcal aureus protease V8 and trypsin. Upon sequencing the peptides by the automated Edman method, the following sequence was obtained: A D T N A P L C L C D E P G I L G R N Q L V T P E V K E K I E K A V E A V A E E S G V S G R G F S L F S H H P V F R E C G K Y E C R T V R P E H T R C Y N F P P F V H F T S E C P V S T R D C E P V F G Y T V A G E F R V I V Q A P R A G F R Q C V W Q H K C R Y G S N N C G F S G R C T Q Q R S V V R L V T Y N L E K D G F L C E S F R T C C G C P C R N Y Carcinoscorpius coagulogen consists of a single polypeptide chain with a total of 175 amino acid residues and a calculated molecular weight of 19,675. The secondary structure calculated by the method of Chou and Fasman reveals the presence of an alpha-helix region in the peptide C segment (residue Nos. 19 to 46), which is released during the proteolytic conversion of coagulogen to coagulin gel. The beta-sheet structure and the 16 half-cystines found in the molecule appear to yield a compact protein stable to acid and heat. The amino acid sequences of coagulogen of four species of limulus have been compared and the interspecies evolutionary differences are discussed.     

血清CREG蛋白在急性心肌梗死早期的表达研究

目的：探讨血清中CREG蛋白在急性心肌梗死发作早期的表达情况,尝试为临床心肌缺血的极早期诊断提供一种新的血清标志分子。方法：在2010年6月至2010年11月期间,入选在沈阳军区总医院心内科住院治疗的急性ST段抬高型心肌梗死患者50例及非AMI对照50例,于AMI组胸痛发作后的不同时间点采血测定CK、CK—MB、LDH和cTnT,同时应用Westem blot技术测定血清中CREG蛋白的含量,并与对照组比较。结果：AMI组发病72小时内的血清中CREG蛋白表达均较对照组有不同程度的增高（P〈0．05）。胸痛开始2h内,AMI组血清中CREG的含量即明显增高,其在2h、4h及6h的含量显著高于对照组（P〈0．001）。在胸痛已经发作2小时内,两组间血清cTnT、CK、CK-MB及LDH水平比较无统计学意义（P〉0．05）。结论：CREG在AMI患者血清中的表达增高．其在血清中表达时间早于cTNT及CK-MB。     

Ischaemic Heart Disease in Young Women

The mortality rate from ischaemic heart disease (I.H.D.) has increased in young women by about 50% in 12 years, and it is now possible to report the findings in 150 women who developed symptoms and signs of I.H.D. under the age of 45. Data obtained from 145 of these women form the basis of this report: 81 presented with myocardial infarction and 64 with angina. In the remaining five there was a definite nonatherosclerotic cause for the premature onset of I.H.D.Hypercholesterolaemia, hypertension, or excessive cigarette smoking each occurred in a large minority, and more than one of these major risk factors was present in most patients. Hypercholesterolaemia was the commonest factor. In women in whom lipoprotein typing was undertaken the type II pattern was more frequent than type IV. The prevalence of hypercholesterolaemia and hypertension was the same in those with myocardial infarction and in those with angina.Excessive cigarette smoking was more common in women with myocardial infarction than in those with angina. The latter did not differ in their cigarette smoking habits from the normal population.A premature menopause had occurred in 20% of these women, but there was no relation between the early onset of I.H.D. with age at menarche, parity, or the incidence of abortion. Oral contraceptives did not increase the risk of myocardial infarction unless one of the major risk factors was also present.Altogether 75% of patients with angina or myocardial infarction survived 12 years. Coexisting hypertension worsened the prognosis. The prognosis after myocardial infarction was similar in these women to that previously described for men under the age of 40.     

Surgical treatment of impending myocardial infarction: Report of two cases

Two men, aged 29 and 44, presented with clinical and electrocardiographic evidence suggesting impending myocardial infarction. Selective coronary angiography revealed serious obstructive coronary atherosclerosis including gross stenosis of the main left coronary artery in both. Emergency surgical operations were performed, a double aorto-coronary venous bypass in one and a single venous bypass combined with a Vineberg operation in the other. Neither patient sustained myocardial infarction. Both patients are very well more than six months after operation. Clinical, electrocardiographic and angiographic evidence of the effectiveness of these operations is presented.     

Buchbesprechungen / Book Reviews

Book reviewed in this article:
Sachs, L. , Angewandte Statistik (Anwendung statistischer Methoden).
Progress in Botany (Fortschritt der Botanik). Morphology—Physiology—Genetics—Taxonomy—Geobotany. Herausgeber: K. E sser , K. K ubitzki , M. R unge , E. S chnepf , H. Z iegler .
Cummins, G. B., and Yasuyuki Hiratsuka , Illustrated Genera of Rust Fungi.
Pirson, A., and M. H. Zimmermann (Eds.) , Encyclopedia of Plant Physiology, New Series, Vol 12 D. O. L. L ange , P. S. N obel , C. B. O smond , H. Z ieg - ler (Eds.): Physiological Plant Ecology IV.
Mass, J. L. (ed) , Compendium of Strawberry Diseases.     

Serum apolipoprotein B level and other parameters of lipid metabolism in patients after myocardial infarction

Total cholesterol, triglycerides, cholesterol HDL, and apolipoproteins B were determined in 117 patients including 87 patients with recent myocardial infarction. Cholesterol LDL was calculated from Friedewald-Frederickson 's equation. Calculated mean values of the above parameters of lipid metabolism were within normal values. In the group of patients with recent myocardial infarction the following subgroups were distinguished: male patients who under went myocardial infarction under 40 years of life (subgroup A), male patients who underwent myocardial infarction at the age over 40 years (subgroup B), and female patients (subgroup C). No statistically significant differences between male and female patients were noted. A sole lipid index differentiating subgroups A and B was serum apolipoprotein B level (1.5 g/L in subgroup A, and 1.16 g/L in subgroup B). Discrimination analysis has shown also a higher value of this parameter in distinguishing the subjects who underwent myocardial infarction in the young age.     

D- 二聚体在急性心肌梗死诊断中的应用研究

目的:探讨D-二聚体在急性心肌梗死诊断中的应用价值,为提高急性心肌梗死的诊断准确性提供有益的参考.方法:以我院2010年1月至2011年1月收治的急性心肌梗死患者34例为实验组,以我院同期健康体检的34例为对照组,对两组的基础水平以及实验组溶栓治疗各时间点的D-二聚体水平进行检测分析.结果:在基础状态下实验组的D-二聚体为(1.59±0.31)mg/L,显著高于对照组(P＜0.05).实验组患者在溶栓治疗6h后的D-二聚体水平为(3.48± 1.40)mg/L,显著高于溶栓治疗前(P＜0.05).其余各时间点的测量值差异无统计学意义(P＞0.05).结论:D-二聚体检测有利于急性心肌梗死患者的诊断,对临床治疗和预后有较好的指导意义,是较好的心肌梗死诊断分子标志物.在发现D-二聚体水平异常时,应结合临床症状、心电图、胸部X光片的结果进行综合判断,确保诊断的可靠性.     

Functional studies of mutations in the human protoporphyrinogen oxidase gene in variegate porphyria.

The autosomal dominant disorder, variegate porphyria (VP), results from mutations in the protoporphyrinogen oxidase (PPOX) gene. We have investigated the effects of 22 disease-associated missense mutations in this gene on enzyme activity. Mutants were generated in the expression plasmid pHPPOX by site-directed mutagenesis. They were screened for PPOX activity by complementation of the Escherischia coli strain SAS38X which lacks PPOX activity. Ten mutants (G40E, L85P, G232R, de1281H, V282D, L295P, V335G, S350P, L444P, G453V) had no detectable PPOX activity. PPOX activity of the remaining 12 mutants (L15F, R38P, L73P, V84G, D143V, R152C, L154P, V158M, R168H, A172V, V290L, G453R) ranged from less than 1% to 9.2% of wild-type activity. Our findings show that all 22 mutations substantially impair or abolish PPOX activity in a prokaryotic expression system and add to the evidence that they cause VP.     

Monoclonal antibodies directed against gonococcal protein I vary in bactericidal activity

Monoclonal antibodies (Mab) with specificity for protein I (PI) from Neisseria gonorrhoeae (GC) were examined for bactericidal activity. Mab 4G5 (gamma 3), ID3 (gamma 2a), and 1G6 (gamma 2a) bound to surface-exposed epitopes on PI of GC strain R11 (IA serotype) as assessed by co-agglutination and 125I protein A uptake. Mab 2H1 (gamma 3) that were directed against IB serotype strains and Mab 2E9 (gamma 2a) were negative in co-agglutination and protein A uptake assays and served as controls for some experiments. Only 4G5 and 1D3 were bactericidal for R11 when presensitized organisms were incubated in 10% absorbed, pooled normal human serum (PNHS) or 10% hypogammaglobulinemic serum (H gamma S) despite binding of nearly equivalent numbers of 4G5, 1D3, and 1G6 to R11 during presensitization, as assessed by 125I-protein A uptake. These Mab activated complement to a similar extent on GC R11, leading to deposition of 56.4 X 10(3), 61.9 X 1093), and 47.1 X 10(3) molecules of C3/organism during incubation in 10% C8-deficient serum. Deposition occurred almost exclusively via the classical complement pathway. Measurement of complement component C9 binding to R11 during incubation in H gamma S showed 35,700 molecules of C9/organism with 4G5, 32,600 C9/organism with 1D3, and surprisingly, 29,600 C9/organism with 1G6. Eight thousand four hundred molecules of C9/organism bound to 2E9-coated organisms, 6000 C9/organism to 2H1-coated bacteria, and 3600 C9/organism to nonpresensitized organisms. The C5b-9 complex deposited by 4G5 had a different sedimentation profile by sucrose density gradient analysis from the C5b-9 complex deposited by 1G6, consistent with a different molecular configuration of the bound complex. Mab 1G6 and 1D3, but not 2E9 or 2H1, were able to compete with 125I-4G5 for binding to GC R11. A Mab (2E6) directed against protein III of GC competed weakly with 125I-4G5 for binding to GC R11. Mab 1G6, but not 1D3, blocked 4G5-dependent killing in a dose-related fashion. Both 4G5 and IG6 reacted weakly with native PI of GC R11 by immunoblotting, but neither Mab recognized the 34,800 m.w. fragment of PI generated by trypsin and chymotrypsin treatment of outer membranes. In contrast, 2E9 reacted strongly by immunoblot with both native and cleaved PI of GC R11, suggesting binding to buried determinants of PI. These experiments show that Mab directed against identical or closely associated, surface-exposed epitopes on gonococcal PI differ markedly in bactericidal activity, despite leading to deposition of nearly equivalent numbers of C3 and C9 molecules per organism.     

Carcinoembryonic Antigen in Management of Colorectal Carcinoma

Carcinoembryonic antigen (C.E.A.) estimation has been used in the preoperative assessment of colorectal carcinoma patients and has been shown to give a useful guide to the presence of metastatic disease and ultimately to a poor prognosis if the serum concentration is 100 ng/ml or more. C.E.A. has been shown to be a more reliable index of tumour spread than either clinical examination or serum alkaline phosphatase estimation. Raised C.E.A. levels of less than 100 ng/ml do not, however, necessarily imply a poor prognosis. Routine C.E.A. estimation may have a valuable role in the assessment of the colorectal cancer patient by identifying those likely to benefit from postoperative chemotherapy.The test has also been assessed in a group of patients attending cancer follow-up clinics after radical resection of a colorectal tumour. Raised C.E.A. occurred in most of those developing recurrent disease, and in several patients a rising C.E.A. level preceded clinical or biochemical evidence of recurrence. C.E.A. estimation is a superior guide and of clinical importance when applied to the follow-up of the colorectal cancer patient.     

Haplotype analysis of the beta2 adrenergic receptor gene and risk of myocardial infarction in humans

Polymorphisms in the beta2 adrenergic receptor (ADRB2), in particular G16R, Q27E, and T164I, have been implicated in the pathogenesis of cardiovascular and metabolic phenotypes. However, no prospective, genetic-epidemiological data are available on the risk of cardiovascular disease associated with these variants. Using DNA samples collected at baseline in a prospective cohort of 14,916 initially healthy American men, we evaluated the G16R, Q27E, and T164I polymorphisms among 523 individuals who subsequently developed myocardial infarction and among 2092 individuals who remained free of reported cardiovascular events during follow-up. The haplotype frequency distribution was significantly different among cases and controls (chi(2)(7d.f.) = 20.92, P = 0.0039). Haplotype-based logistic regression, adjusting for age, smoking, and randomized treatment group, indicated that G16-Q27-I164 (odds ratio 0.178, 95% C.I. 0.043-0.737, P = 0.017) and (non-G16-Q27)-T164 (odds ratio 1.235, 95% C.I. 1.031-1.480, P = 0.022) haplotypes were significantly associated with altered risk of myocardial infarction. These findings remained after further adjustment for BMI, history of hypertension, and presence or absence of diabetes. In conclusion, variation in haplotype frequencies for the beta2 adrenergic receptor gene was found to be associated with risk of myocardial infarction.     

The spectrum of mutations in the low-density lipoprotein receptor gene in the Russian population

The spectrum of mutations in the low-density lipoprotein (LDL) receptor gene was studied in a sample of hypercholesterolemia patients of Caucasoid origin from the population of Russia. The examined patients were 45 to 49 years old and had the highest level of total serum cholesterol in this age group. Seven previously nondescribed mutations have been revealed in exon 9 (R410G; M412V) and in exon 12 (Y/Y576; N/N591; L605V; L605R; A612G). Twelve previously described mutations have been identified in exons 2 (C/C27), 5 (C261F; E240X), 6 (E288K), 8 (A391T), 9 (E418G; L432R; D433E), 11 (G/G549; E558K; L/L568), and 12 (G592E). Only one of these mutations was previously described in Russia in a clinical sample of patients with familial hypercholesterolemia. The spectrum of LDL receptor gene mutations in the population sample of patients with hypercholesterolemia significantly differs from the mutation spectrum in patients with familial hypercholesterolemia (clinical samples). Sequencing of the LDL receptor gene is a highly efficient method for identifying the markers of hypercholesterolemia predisposition in a population.