Context: Indians are prone as a community to coronary artery disease (CAD) at a much younger age. CAD is affecting Indians 5-10 years earlier than other communities. Lipoprotein (a) (Lp (a)) is now recognized as an independent risk factor for CAD. It is a genetic risk factor. Aim: We evaluate the Lp (a) in young patients with myocardial infarction (MI). Settings and design: Study population consisted of 50 patients having MI and 50 control groups. Subjects and Methods: Fasting samples were collected from patients and were analyzed for Lp (a), lipid profi le, and blood sugar on fully automated analyzer. Statistical analysis used: Statistical analysis is carried out by using Student's t-test. Results: The difference in total cholesterol (P = 0.8192), high density lipoprotein-cholesterol (HDL-C) (P = 0.11), low density lipoprotein-cholesterol (LDL-C) (P = 0.8143), triglyceride (P = 0.1177) levels, and total cholesterol/HDLcholesterol ratio (P = 0.2129) were observed between the case and control groups in this study was not statistically signifi cant. The difference in the Lp (a) levels between the case and control groups was highly signifi cant (P-value = 0.0001). Conclusions:This study demonstrated that in young patients with MI there was a male predominance. Lp (a) level is an important and independent risk factor for CAD. Serum Lp (a) level is not dependent on serum total cholesterol level.

Objectives: Chronic renal failure (CRF) is complicated by characteristic dyslipidemias. CRF patients on hemodialysis have abnormalities in lipid profile and have a high incidence of cardiovascular diseases. Lipoprotein(a) [Lp(a)] is now considered as a novel cardiovascular risk factor and its level is increased in CRF patients with and without hemodialysis. We sought to evaluate the pattern of lipid profile including Lp(a) level in CRF patients with and without hemodialysis. Methodology: Study were divided into 3 groups, Group-I: healthy controls (30), Group-II: CRF patients who never undergone hemodialysis (30) and Group-III: CRF patients on hemodialysis for more than 6 months (30). We obtained serum samples from patients in the morning after an overnight fast and were analysed for total cholesterol (TC), triglycerides (TGs), HDL, LDL, Lp(a) using standard colorimetric assays on fully automated analyzer. VLDL concentration was calculated using Friedewald's Formula. Results: Among the various parameters tested triglyceride and VLDL levels were significantly higher in group-II and III as compared to controls (p<0.01). HDL levels were significantly lower in group-II and III as compared to control (p<0.05). HDL level was found reduced in group-III as compared to Group-II (p<0.01). There was no significant change (p>0.05) observed in total cholesterol and LDL levels in between healthy controls and CRF patients with & without hemodialysis. Lp(a) levels were significantly higher in group-II and III as compared to controls (p<0.01) but the difference between Lp(a) levels in group-II and III was found insignificant (p>0.05). There was no significant difference (p>0.05) observed between Lp(a) levels and lipid profile in male and female patients in control group and in CRF patients with and without hemodialysis. Conclusions: This study demonstrated that CRF patients with and without hemodialysis are at greater risk of development of dyslipidemias, characterized by hypertriglyceridemia, elevated VLDL and Lp(a) levels and decreased HDL levels. Total cholesterol and LDL cholesterol levels remain normal or decreased in these patients. Both male and female patients of CRF with and without hemodialysis have dyslipidemias without any discrimination of sex and it is not attenuated by the hemodialysis process.

Utility of serum ischemia modified albumin in the early diagnosis of acute coronary syndromeContext: Coronary artery disease (CAD) is the leading cause of death. Early detection of myocardial ischemia can decrease morbidity and mortality due to CAD. Ischemia modified albumin (IMA) is a newer biomarker for early detection of myocardial ischemia in patients of acute coronary syndrome (ACS) as compared to cardiac troponin T (cTnT). Aims: The aim of this study was to test the utility of "IMA," a new biomarker of myocardial ischemia, in the early diagnosis of ACS. Settings and Design: The cross-sectional study group consisted of 101 patients between the age group of 27 and 85 years having ACS and 100 control from a healthy population. Materials and Methods: Blood was collected from all the enrolled patients immediately after admission, and samples were analyzed for cTnT on the fully automated analyzer and IMA on a spectrophotometer. Statistical Analysis Used: Statistical analysis was carried out by calculation of the area under a curve using receiver operating characteristics (ROC) curve analysis for the IMA test in the 101 patients included in the study population. Results: ROC curve area for IMA was 0.89 (95% confidence interval 0.81-0.94). At the cut-off 95 U/ml, sensitivity, and specificity were 85% and 82% and positive predictive value and negative predictive value (NPV) were 88% and 78%, respectively. Conclusions: IMA is a useful ischemic marker for diagnosis of myocardial ischemia due to high sensitivity, and it also facilitates to rule out myocardial ischemia due to high NPV. Key words: Cardiac troponin T, coronary artery disease, myocardial ischemiaOriginal Article INTRODUCTIONAcute coronary syndromes (ACSs) is a spectrum of disease including unstable angina, associated with reversible myocardial cell injury, Q-wave and non-Q-wave acute myocardial infarction (AMI), non-ST-segment elevation MI and ST-segment elevation MI with large areas of necrosis.[1] Myocardial ischemia occurs either due to a lack of blood flow resulting in a shortage of oxygen and accumulation of waste products in the ischemic tissue. This results in a number of biochemical changes in the cells and if continued, leads to irreversible damage and necrosis.[2] ACS is becoming more common in the developing world such that in India, cardiovascular disease is the leading cause of death in India. [3] Every patient with acute chest pain presenting to Emergency Department should be identified and confirmed for ACS for accurate medical management.[4] Electrocardiography (ECG), troponin and creatine kinase-MB are conventional markers for diagnosis of ACS. These blood markers are extremely sensitive and specific for the identification of patients with myocardial necrosis, but their ability to identify patients with myocardial ischemia remains limited. ECG is rarely abnormal following transient myocardial ischemia, and the ECG at presentation is normal in approximately half of the patients with ACSs.[5] These highly specific markers might give negativ...