Introduction:Metabolic syndrome (MS) is characterized by multiple risk factors, including abnormal fat distribution, dyslipidemia, hypertension and hyperglycemia in relation to insulin resistance and obesity and persons with MS are considered to have high risk of cardiovascular diseases (CVD) and diabetes mellitus (DM). 1,2 Diabetes and cardiovascular diseases often appear as the two sides of a coin: on one side diabetes mellitus has been rated as an equivalent of coronary heart disease and conversely many patients with established coronary heart disease suffer from diabetes or pre-states. 3

DOI: http://dx.doi.org/10.3329/cardio.v4i1.9394Cardiovasc. J. 2011; 4(1): 75-79

Back ground: Hypertension is one of the most important modifiable risk factors for cardiovascular disease (CVD) and stroke. Dyslipidemia is closely associated with hypertension. Dyslipidemia and hypertension are the commonest risk factors for CVD. The aim of the present study was to compare different lipid parameters among newly diagnosed hypertensive patients with normotensive subjects in Bangladesh and find out the relationship. Methods: This study was a cross sectional study in which 42 newly diagnosed hypertensive patients who were on no antihypertensive medication and 42 subjects with normal blood pressure (normotensive) were enrolled for compare. Lipid parameters total cholesterol (TC), triglyceride (TG), low density lipoprotein ( LDLc) and high density lipoprotein (HDLc) were estimated by Enzymatic colorimetric test. Results: The mean systolic blood pressure of hypertensive and normotensive were 154.6±22.5 vs111.50±3.42 mmof.Hg and mean diastolic blood pressure were 93.2±5.20 vs 71.44± 3.21mm of Hg. The mean of SBP and DBP of hypertensive patients was found to be higher than normotensive (p< 0.05). There was significant increase in different lipid levels namely TC 199.4±44.5 vs188.7±37.9 mg/dl, TG155.9±88.8 vs 121.9±73.2 mg/dl and LDLc 119.8±35.6 vs112.7±28.6 mg/dl in hypertensive patients as compared to normotensive (p<0.05). However there was no significant difference in HDLc level. BMI and waist circumference showed significant association in hypertensive patients (p<0.001). Conclusion: Analytical results of the study revealed that hypertensive patients have been found to have close association with dyslipidemia, BMI and waist circumference. Hypertension and dyslipidemia can be modified either by proper life style changes or medical management or by the combination of the both. This study suggests that hypertensive patients need measurement of blood pressure and lipid profile at regular interval to prevent heart diseases and stroke. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18350 Cardiovasc. j. 2014; 6(2): 112-115

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Introduction:Coronary artery aneurysms after coronary intervention are rare, the incidence of coronary artery aneurysms after DES implantation is low within the first 9 months, with a reported incidence of 0.2% to 2.3%, a rate similar to that reported after bare-metal stent (BMS) implantation (0.3% to 3.9%) in the DES versus BMS randomized trials. Most "aneurysms" are in fact pseudoaneurysms rather than true aneurysms [1][2][3][4] . Residual dissection and deep arterial wall injury (rupture or resection of the vessel media) caused by oversized balloons or stents, high pressure balloon inflations, atherectomy, and laser angioplasty have all been associated with coronary artery aneurysms after coronary intervention 1-3 . Drug-eluting stents (DES), which locally elute antiproliferative drugs, can dramatically inhibit neointimal growth, thereby suppressing restenosis 5,6 , but at the same time potentially causing coronary aneurysms due to other mechanisms, such as delayed reendothelialization, inflammatory changes of the medial wall, and hypersensitivity reactions [7][8][9][10] . These findings may be due to delayed healing secondary to the antiproliferative action of the eluted drug, cell necrosis and/or apoptosis from the antimetabolite effect of the drug, and hypersensitivity reactions to the drug/polymer mixture on the DES 7-9 . Systemic administration of antiinflammatory agents (glucocorticoids and colchicine) after stent implantation may be associated with a greater risk of aneurysm formation. 11 However, the true incidence, clinical course, and treatment of coronary artery aneurysms after DES implantation remain largely unknown.Case Report: Mr. X, 60 years old non smoker, non alcoholic, diabetic, hypertensive businessman got admitted in NICVD with complaint of ischaemic chest pain on minimal exertion for 3 months. ECG was within in normal limit, ETT was positive and Echocardiogram showed Anterior wall hypokinesia with EF-65%. CAG showed Significant long lesion in LAD. Direct stenting to LAD was done at the same setting with Promus Element ( 2.75×38mm, at 18 ATM).Whole procedure was uneventful and patient was discharged from hospital with double antiplatelet coverage. After 10 days of PCI patient got readmitted in hospital with complaints of chest discomfort with high grade fever for 2 days. ECG showed AMI ( Extensive Anterior) indicating involvement of LAD territory with strong suspicion of Sub Acute Stent Thrombosis (SAST). Streptokinase could not be given due to delayed arrival. Patient was treated conservatively with LMWH. Blood and urine culture was negative. Check CAG was done 7 days after readmission showing Patent stent in LAD with aneurysmal dilatation at the distal end of stent in LAD. Drug-Eluting Stent (DES) Induced Coronary