Current Status of Dyslipidemia in Patients of Acute Myocardial Infarction And their Treatment Outcome in Bangladesh

Background: Dyslipidemia is one of the modifiable risk factorsof acute myocardial infarction which is caused by presence ofabnormal amount of lipid in blood.Objective: In this study our main goal is to evaluate the statusof dyslipidemia in patients of acute myocardial infarction andtheir treatment outcome in Bangladesh.Method: This cross-sectional prospective observational type ofstudy was conducted among 200 purposively selected patientsof acute myocardial infarction attended in CardiologyDepartment of NICVD, for treatment to see their pattern ofdyslipidemia and treatment outcome during January 2011 toDecember 2011. Study subjects were selected from admittedpatient at emergency department and at in-patient departmentof the Cardiology Department with acute coronary syndrome.Fasting lipid profile in next morning of admission was done andassessed. Dyslipidemia was considered according to ATP IIIguideline with Serum Total cholesterol > 200 mg/dl, TG>150mg/dl, LDL >100 mg/dl, HDL. Collected information waschecked repeatedly. Information was collected by theresearchers.Results: During the study, male patients were 58% higher thanfemale and most of them belongs to 51-60 years age group(40%).77% patients had dyslipidaemia and after treatment 57%patients got discharged.Conclusion: We can conclude that hypertriglyceridemia andhypercholesterolemia are the most prevalent dyslipidemia inpatients of acute myocardial infarction in Bangladesh. Furtherresearch, in particular longitudinal studies, is needed for betteroutcome.

The Association of Cardiac Troponin I Level on Admission with the Angiographic Severity of Coronary Artery Disease in Acute STEMI Patients

Objective: In this study our main goal is to find out theassociation of cardiac troponin I level on admission with theangiographic severity of coronary artery disease in acuteSTEMI patients.Method: This cross-sectional observational study was done inthe NICVD, Dhaka from October 2010 to September 2011. Atotal of 100 consecutive patients were included. Studypopulations were sub-divided into two groups on the basis ofcTn I level. In group I cTn I level ≥20ng/ml and in group II cTnI level <20ng/ml. 50 patients were included in group I and 50patients were included in group II.Results: Most of the patients presented with more than 4hours chest pain which was 68% vs. 60% patients in group Iand group II respectively. Where mean heart rate was higher ingroup I than group II (83.08.4 vs. 78.210.6). It wasstatistically significant (p=0.01) in student-test. Vessel score 2and 3 together formed the main bulk of the patients (68%) ingroup I, while vessel score 0 and 1 were frequently common ingroup II (80%). In group I there was no patient with vesselscore 0, in group II 12(24%) patients had vessel score 0 (5patients had normal coronaries and 7 patients had insignificantlesions, p-value from Chi square test).Conclusion: From our study we can say that, estimation ofserum cardiac troponin I might facilitate the triage of patientswith acute myocardial infarction by clinicians and moreaggressive approach to promote myocardial reperfusion mightbe warranted in the patients with high cardiac troponin I level.

Reduction of Peri - Procedural Myocardial injury by Loading dose of Atorvastatin during Elective Percutaneous Coronary Intervention.

Background: The purpose of the study was to find the effect of loading dose of atorvastatin on the reduction of myocardial injury resulting from percutaneous coronary intervention (PCI). Methods: A total 100 consecutive patients were included in this study of which 50 patients were in the group I who were treated with a loading dose of atorvastatin and the rest 50 patients were in the group II who were treated without the loading dose of atorvastatin.The occurrence of myocardial injury was measured by serum cTn-I level in patients undergoing PCI with or without loading dose of atorvastatin.