Pattern and Prevalence of Dyslipidemia among Patients with Acute Coronary Syndrome Admitted in a Tertiary Level Hospital

Abstract

Background: The leading cause of mortality in men and women worldwide is coronary artery disease (CAD). For hospitalization in our country, acute coronary syndrome (ACS) is a major reason. Dyslipidemia is found one of the most important modifiable risk factors for CAD.
 Aim: The aim of the study was to determine the pattern and prevalence of dyslipidemia among patients with ACS admitted in National Institute of Cardiovascular Diseases (NICVD), Dhaka.
 Subjects and methods: One thousand (1000) patients with ACS were included and classified according to clinical presentation, the findings on the admission electrocardiogram (ECG) and the results of serial cardiac troponin levels, into myocardial infarction(MI), either STelevation or non ST- elevation MI, and unstable angina(UA) subgroups. In the other group 500 healthy subjects were included as controls. All subjects were subjected determination lipid profile. ECG and Troponin- I were done for diagnosis and follow up of the patients.
 Results: In patients with ACS, high levels of TC (>200 mg/dl) were found in 60.67%,high levels of LDL (> 130 mg/dl) were found in 58%, high levels of TG (>150 mg/ dl) were found in 63.33%, however, low levels of HDL (< 40 mg/dl) were found in 66%. There was a statistically significant elevation in TC, LDL, TG serum levels in patients with ACS compared to control subjects (p<0.05) while the HDL was significantly low in ACS patient compared to control subjects (p <0.05). TC/HDL > 5 and TG/HDL> 4 were significantly higher in patients with ACS than controls. There was no significant difference between MI and UA patients regarding all lipid profile parameters. TC, LDL, TG were significantly higher in males than in females while HDL was significantly higher in females compared to males. Also TC/HDL and TG/HDL ratios were significantly higher in males compared to females. All lipid components were significantly more prevalent in males than in females except TG where there was no significant difference between males and females. Stepwise regression analysis of lipid parameters revealed that TC/HDL and TG/HDL ratios were independent risk factors for ACS.
 Conclusion: Dyslipidemia is one the major risk factors which is widely prevalent in patients with ACS and is more prevalent in males than in females. We recommend paying more attention to serum lipids and other modifiable risk factors for prevention of ACS and more studies about them as risk factors of atherosclerosis and its impact on other systems is advised.
 Bangladesh Heart Journal 2019; 34(1) : 31-36

Demographics and Characteristics of Patients Admitted With Acute Coronary Syndrome to the Coronary Care Unit at King Abdulaziz University

“…Males had significantly higher LDL-C, TC, and TG levels, whereas HDL-C values were higher in female patients. Our findings are consistent with those of prior studies [39][40][41]. In contrast, previous studies in a Polish population showed that high LDL-C levels were significantly higher in females compared to males (P = 0.033); additionally, other lipid profile components were found to be less controlled in females than in males [42].…”

“…Our research data show that the percentage of readmission among females was higher than that among males, a finding similar to that obtained in a study conducted in multiple centers worldwide that found a higher percentage of readmission in females than males [81]. A previous study showed that cardiovascular medications might have different effects on men and women because of variations in body composition, fluctuations in endogenous sex hormone levels (female monthly cycle and gestation), the pharmacokinetics/pharmacodynamics characteristics of some medicines, or the use of hormone replacement treatment or oral contraceptives [41,82].…”

Dyslipidemia and Conventional Risk Factors in Patients with Acute Coronary Syndrome Admitted in a CCU of a Tertiary Care Hospital of Bangladesh

“…The sample size of 96 was calculated based on the 63% prevalence of dyslipidemia in patients with ACS in the study conducted at another tertiary care hospital in Bangladesh with 15% permissible error. 8 Demographic features (age, gender) and cardiovascular risk factors [smoking: current or former, family history of CAD (first degree relatives such as siblings and parents usually aged <50 years {females} or <55 years {males}), hypertension: under medication, diabetes: random blood glucose ≥200mg/dl and/or under medication, reported dyslipidemia (under medication)] related data were recoded.…”

“…7 Dyslipidemia is an independent and modifiable risk factor that is common in our population. 8 It remains unrecognized until detected during the first presentation with ACS. So, this study aimed to find out the prevalence of dyslipidemia within 24 hours of admission with ACS and thereby help to the early classification of dyslipidemia and select the appropriate therapy.…”