A study on patients with coronary artery disease with special reference to bone mineral density

Background: Osteoporosis and Coronary artery disease are known to share common risk factors, like inflammation, but a direct relationship between the two has not been established. Some of the previous studies showed low BMD (osteoporosis and/orosteopenia) as an independent predictive factor for coronary artery disease in ambulatory patients. However, some reports have failed to demonstrate a direct relationship between low bone mineral density (BMD) and CAD or cardiovascular risk factors. This study was carried out to estimate bone mineral density (BMD) in patients with coronary artery disease (CAD) and also to evaluate the association between bone mineral density and coronary artery disease.Methods: Hospital based prospective observational study, involving 96 consecutive patients who were referred for coronary angiography for the evaluation of established or suspected CAD and also patients who had acute coronary syndrome (ACS) are enrolled in this study. BMD was determined for the lumbar spine (L2-L4) and femoral neck using DXA scan.Results: The total number of subjects was 96. Out of 96, 24 (25%) patients were females and remaining 72 (75%) were males. Coronary angiography was carried out in all patients. 42 patients from the total had coronary angiography proven single vessel disease (SVD), 33 patients had double vessel disease (DVD) and 21 patients had triple vessel disease (TVD). DXA scan was carried out in all patients. T- score of neck of femur region and lumbar spine was calculated. Neither the presence of significant coronary stenoses ≥50% in two or more coronary vessels nor the prevalence of severe coronary stenoses ≥70% differed significantly between patients with normal bone density, osteopenia, or osteoporosis (p<0.05, respectively).Conclusions: The result of this study suggests that in patients undergoing coronary angiography for the evaluation of CAD, the prevalence of low BMD is high; however, there is no statistically significant relationship between osteoporosis, osteopenia and coronary artery disease state.

Association between Clinical Malaria and Blood Lipids in North Eastern India.

Background: Changes in lipid profile are seen in many patients infected with malaria parasite. The malaria parasite causes hepatocellular damage and disturbs lipid handling by the liver. Inside hepatocytes and erythrocytes the parasite replicates rapidly scavenging cholesterol and lipids required for its growth and metabolism from the host. It also requires host lipids for detoxification of free heme to form the malarial pigment, haemozoin. The important question is whether these changes are characteristic for malaria infection or are they simply part of an acute phase reaction? This study analyzes the correlation between malaria infection and derangements in lipid profiles. Materials and Methods: This study comprised of 29 confirmed malaria cases, and 29 subjects in apparent good health, without the infection were included as control cases. Malaria cases were confirmed using rapid antibody-based diagnostic card tests that detect histidine-rich protein 2 (HRP2) or lactate dehydrogenase antigens in finger-prick blood samples followed by microscopic confirmation of malaria parasite. A 12 -hour fasting lipid profile was estimated by enzymatic method on day 2. Data obtained were statistically analyzed using Student’s t Test, assuming p<0.05 as significant. All issues related to ethics were taken care of during the whole course of study. Results: As compared with control subjects, patients with malaria showed low HDL (16.48±6.490 mg/dL versus 41.38±15.110 mg/dL), low LDL (70.45±22.720 mg/dL versus 104.46±27.353 mg/dL), low cholesterol (103.52±35.331 mg/dL versus 169.45±34.040 mg/dL) and elevated triglycerides (214.24±109.365 mg/dL versus 131.15±30.813 mg/dL). The observations show a statistically significant difference in HDL, LDL, cholesterol and triglycerides between malaria patients and control subjects (p<0.05). Conclusion: These results show a characteristic pattern of derangements of lipid profile in malaria. Further studies are required to understand the diagnostic, prognostic and therapeutic implications of these derangements.