ABSTRACT
Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD) is increasing rapidly in our country. Although studies were conducted abroad regarding association of serum uric acid with in-hospital outcomes in patients with acute coronary syndrome (ACS), no data is yet available to show the association in our country. Objective: The objective of this study was to assess the association of serum uric acid level on admission with in-hospital outcomes of the patients with ACS. Materials and Methods: This cross sectional comparative study was done in the Department of Cardiology, Dhaka Medical College Hospital (DMCH) from January to December 2012. After proper ethical consideration total 93 ACS patients were enrolled in the study by nonrandom sampling. Serum uric acid of all subjects was measured within 24 hours of admission. Then in-hospital outcomes were observed in all subjects. Results: The frequency of hyperuricemia among ACS patients was 24.7% (22.54% in male and 31.82% in female). Hyperuricemic patients significantly developed heart failure (30.4% vs 11.4%, p=0.032) and conduction defect (13.0% vs 1.4%, p=0.017) than normouricemic subjects. The mean ejection fraction was significantly lower in hyperuricemic patients than patients with normal uric acid level (50.87 ± 10.27% vs 55.94 ± 6.66%). The mean ± SD duration of hospital stay of hyperuricemic group was significantly longer in patients with ACS (8.26 ± 1.18 vs 7.51±1.18 days, p=0.010). Conclusion: The measurement of serum uric acid level, an easily available and inexpensive biochemical tool, might turn out as a valuable risk marker for prediction of in-hospital outcomes in patients with ACS.
ABSTRACT
Background: In epidemiological studies and clinical trials renal function has been shown to be an independent predictor of coronary artery disease (CAD). We conducted this study to find out the association between creatinine clearance rate (CCr) and coronary angiographic severity in patients with (CAD). Method: It was a cross sectional study carried out in the department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011 to March, 2012. All the patients with Ischaemic heart disease (IHD) admitted in the department of Cardiology who fulfill the inclusion and exclusion criteria and underwent coronary angiogram were taken as sampling population. Sampling technique was purposive and sample size was 118. By Cockcroft-Gault formula, CCr was estimated from serum creatinine. Coronary angiographic severity of coronary artery disease was assessed by vessel score and stenosis score. Statistical analysis was carried out by descriptive statistics, correlation coefficient test and one way ANOVA test. Level of significance was set at 0.05. Results: Mean CCr among study subjects was 72.57 ± 17.78 ml/min. Vessel score showed 18.6% had normal coronaries, 37.3% single vessel disease, 31.4% double vessel disease and 12.7% triple vessel disease. There was significant positive relationship between serum creatinine and vessel score, and also negative relationship between CCr and vessel score. The study also showed significant negative correlation between CCr and stenosis score. Conclusion: Angiographic severity of coronary artery disease is associated with degree of renal dysfunction. Decreased creatinine clearance is associated with more extensive CAD.