Abstract:Background: Pulmonary hypertension (PH) has been reported to be high among maintenance dialysis patients. There is a paucity of data on the incidence and prevalence of pulmonary hypertension in chronic kidney disease (CKD)

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The objective of the present study is to find out whether the increased serum homocysteine level is associated with the increased serum troponin I as a surrogate marker of extent of myocardial injury in acute myocardial infarction patients. Elevated homocysteine levels are associated with increased thrombosis. In patients presenting with Acute Coronary Syndrome (ACS), it is not known whether this association is reflected in the degree of myocardial injury. This was a cross sectional study conducted among the patients with acute myocardial infarction in the Department of Cardiology, Dhaka Medical College Hospital during the period of October 2009 to September 2010 and which included 194 consecutive patients with acute myocardial infarction. The mean (±SD) serum homocysteine level was 20.2±14.3 mol/L with range from 7.4 to 129.1 mol/L. Mean serum troponin-I level was classified according to normal (<15µmol/L) and high (≥15µmol/L) levels of serum homocysteine values. The mean serum troponin-I level was 8.98.6 ng/ml in the patients having normal serum homocysteine level and 18.46.5 ng/ml in the patients having high serum homocysteine level. A significant positive correlation (r=0.273; p<0.001) was found between serum troponin-I level with homocysteine level. Patients with moderate hyperhomocysteinemia (≥15 mol/L) was found to be 7.09 times more likely to have increased serum troponin-I (a surrogate marker of extent of myocardial injury). The main observation of the present study was that elevated serum homocysteine level has a positive correlation with serum cardiac troponin-I in patients with acute myocardial infarction. So serum homocysteine is associated with increased extent of myocardial injury as measured by serum cardiac troponin-I level, a surrogate marker in patients with acute myocardial infarction. IntroductionAcute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. Primary risk factors have been identified with the development of atherosclerotic coronary artery disease and MI. These are hyperlipidaemia, diabetes mellitus, hypertension, smoking, male gender and family history of premature coronary artery disease. Other than the primary risk factors hyperhomocysteinemia is on special focus now a days. The detrimental effect of severe hyperhomocysteinemia on the cardiovascular system was first described by Mc Cully 1 . Since then several studies have been conducted in the last four decades regarding the association of hyperhomocysteinemia and cardiovascular disease.

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125

Severity of CAD was assessed by vessel score, stenosis score and extent score.Result: Significant positive correlation (r=0.7409; p<0.001 r=0.6648; p<0.001 and r=0.6386; p<0.001) Less than 50% of the CAD can be ascribed to traditional risk factors and rests are unexplained. 7 CRP has emerged as the most exquisitely sensitive systemic marker of inflammation and a powerful predictive marker of future cardiovascular risk. Role for inflammation has become well established over the past decade or more in theories describing the atherosclerotic disease process. 8 A body of evidence now suggests that atherosclerosis represents a chronic inflammatory response to vascular injury caused by a variety of agents that activate or injure endothelium and promote lipoprotein infiltration, retention, and modification, combined with inflammatory cell entry, retention and activation. 9 So, from a pathological viewpoint, all stages, i.e., initiation, growth, and complication of the atherosclerotic plaque might be considered to be an inflammatory response to injury. 10,11 Creactive protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. 12 Several prospective studies recently showed that plasma high sensitive Creactive protein (hs-CRP) levels, a more sensitive CRP test, are a powerful predictor of future myocardial infarction and cardiac death among apparently healthy individuals. 13 However, the association between the plasma hs-CRP levels and the severity of coronary stenosis in subjects remains controversial. Some studies previously demonstrated such associations whereas other could not found it. 14,15 This study was performed to determine whether the concentrations of hs-CRP correlate with the coronary atherosclerotic disease assessed by coronary angiography. was found between hs-CRP and vessel score, stenosis score and hs-CRP and extent score suggesting increasing level of hs-CRP strongly suggestive of extensive coronary artery disease. Conclusion: High level of hs-CRP strongly suggestive of extensive coronary artery disease Objectives:General Objective: 1. To correlate the levels of hs-CRP with angiographic severity of coronary artery stenosis in patients with IHD admitted for CAG in DMCH. Correlation between hs CRP with vessel score (n=90).Hs CRP was expressed in mg/L and vessel score ranges from 0 to 3 depending on the number of vessel involve. Significant positive correlations were found between hs-CRP and vessel score.The values of Pearson's correlation coefficient was 0.7409 which is highly significant (p<0.001). Therefore, there was linear positive correlation between hs-CRP and vessel score (Fig. 1). The values of Pearson's correlation coefficient was 0.6648 which is highly significant (p<0.001). Therefore, there was linear positive correlation between hs-CRP and stenosis score (Fig. 2).(p<0.001). Therefore, there was linear positive correlation between hs-CRP and extent score (Fig.-3). DiscussionThis cross sectional study was carried out with an aim to correlate the...