Background Coronary artery ectasia is a relatively common entity characterized by inappropriate dilatation of the coronary vasculature. In some cases of acute coronary syndrome without obstructive coronary lesions, coronary ectasia is the sole cause. The exact mechanism of its development is unknown but evidence suggests a combination of genetic predisposition, common risk factors for coronary artery disease, and abnormal vessel wall metabolism. As there are few data regarding the pattern of coronary risk factors in patients with coronary ectasia, the objective of the study was to determine the frequency and distribution of coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia. Methods The study included 155 patients over a period of 6 months, with coronary angiographic evidence of coronary ectasia as the sole cause of acute coronary syndrome. There were 79 (51%) men and 76 (49%) women with a mean age 51.92 ± 7.83 years; 73 (47.10%) were aged 20–50 years and 82 (52.90%) were 51–80 years of age. The frequencies of coronary risk factors were stratified according to sex and the two age groups. Results Seventy-one patients (45.80%) had diabetes mellitus, 83 (53.54%) had hypertension, 55 (35.48%) were smokers, 46 (29.68%) had dyslipidemia, and 47 (30.3%) were obese. Conclusion Hypertension is the leading coronary risk factors in patients with acute coronary syndrome solely due to coronary ectasia, followed by diabetes mellitus and smoking.

Lipid lowering strategy has been widely used in both the primary as well as the secondary prevention of atherosclerotic cardiovascular disease, particularly in managing patients who are either diagnosed with ischemic heart disease or stroke or face great susceptibility to developing these complications as a result of risk factors like diabetes, hypertension, sedentary lifestyle and so on [1,2]. The mechanism of action of Statins is by inhibition of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase which is the rate-limiting step in cholesterol synthesis [3]. Statins hence have a great impact on the lipid metabolism and play a vital role in prevention of atherosclerotic complications [4]. They reduce LDL-C, Total cholesterol, and Triglyceride levels; slightly increase HDL-C levels [5]; and are also thought to have anti-inflammatory and other plaque stabilization effects, referred to as their pleiotropic properties [6].

Objectives: To determine the prevalence, patterns and behavioural attributes of tobacco abuse in patients of acute coronary syndrome (ACS). Furthermore, to assess the interaction of tobacco abuse with other conventional risk factors of cardiovascular disease (CVD). Methodology: This observational study included 230 consecutive patients with ACS. Data was collected regarding total duration and extent of tobacco consumption, “tobacco addiction” and various behavioural patterns related to it. Risk factors profile was acquired for hypertension, diabetes, obesity, family history of premature CVD and dyslipidemia. Odds ratios (OR) with 95% confidence intervals (CI) for these risk factors were calculated for tobacco abusers compared to non-abusers. Results: Among the study population, 63(27.4%) were active tobacco users. Urban residents had lesser odds of being tobacco abusers compared to non-urban residents (0.49, [0.27 – 0.89]). Tobacco abusers had a lower prevalence of hypertension compared to non-abusers (0.44 [0.24 – 0.81]). A similar trend was observed for diabetes, obesity and dyslipidemia, however, the differences could not reach significance thresholds. Cigarette smoking was the commonest mode of tobacco consumption (90.5%). “Tobacco addiction” could be attributed to 84.1% of abusers. Most (82.5%) were willing to give up tobacco abuse and 63.3% had already made attempts at quitting. Conclusion: About one-third of ACS patients were tobacco abusers with the majority being tobacco addicts. Tobacco abuse was observed to be independently implicated as a risk factor in ACS patients. Furthermore, tobacco abuse was inversely related to hypertension translating into a sub-multiplicative / additive impact of hypertension as a risk factor.

Objectives: To assess the improvement in left ventricular ejection fraction (LVEF) after Coronary artery bypass grafting (CABG) among patients with severe LV dysfunction. Methodology: This Quasi experimental study was conducted at Punjab Institute of Cardiology from January to June 2021. One hundred and thirty four patients of severe LV dysfunction with coronary anatomy suitable for CABG were included in the study.  Assessment of LVEF was carried out with echocardiography at baseline. All patients underwent CABG under general anaesthesia and were followed-up on 15th day with repeat echocardiography. Pre-CABG and post-CABG EFs were compared and mean changes in EFs were checked for potential effect modifications with gender, diabetes, CAD duration, age and body weight. Results: The mean LVEFs before and after surgery were 23.63 ± 1.17% and 32.11 ± 1.98% respectively. Mean improvement in LVEF after CABG was 8.5 ± 2.7 % (p < 0.001, 95% CI for difference 8.0 – 8.9) and did not different significantly according to gender, diabetes, CAD duration, age and body weight (P = 0.592, 0.167, 0.506, 0.138 and 0.458 respectively). Conclusion: Patients of CAD who underwent CABG had improved post-operative LVEFs independent of evaluated potential effect modifiers.